Prescribing Safety Assessment (PSA) Practice Exam

Which medication is appropriate for severe non-neuropathic pain?

1. Paracetamol 1g PO QDS

2. Co-Codamol 30/500 2 tablets QDS

3. Naproxen 500mg BD

4. Tramadol 50mg

The correct answer is: Co-Codamol 30/500 2 tablets QDS

The appropriate choice for severe non-neuropathic pain is Co-Codamol 30/500 2 tablets QDS. This formulation combines two effective analgesics: codeine, an opioid pain reliever, and paracetamol (acetaminophen), which helps enhance pain relief. In cases of severe pain, the efficacy of an opioid component, such as codeine, is particularly crucial, as it can provide a more substantial analgesic effect than non-opioid medications alone. Codeine works by binding to opioid receptors in the brain, which can help to decrease the perception of pain. While paracetamol on its own is effective for mild to moderate pain, it may not sufficiently manage severe pain, especially in cases where the pain is significant. The combination of these two agents in Co-Codamol allows for better control over substantial pain levels and improves overall patient comfort. Other options, such as paraacetamol, naproxen, and tramadol, either do not provide a strong enough analgesic effect for severe pain or lack the synergistic benefit seen with the opioid and non-opioid combination found in Co-Codamol.