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CONTINUING PROFESSIONAL DEVELOPMENT
COUNSELLING IN PRACTICE
1. Select the MOST appropriate
treatment dosing option for teething
pain in a child.
a) Paracetamol 15 mg/kg four times a day.
b) Ibuprofen 30 mg/kg four times a day.
c) Topical lignocaine-based gel applied to
d) Topical choline salicylate-based gel
applied to the gums.
2. Which of the following options
regarding pain assessment scales in
children is CORRECT?
a) The Face, Lower back, Arms, Cry,
Consolability scale is the most common
observational scale in infants and
b) Pain assessment in children is simple as
they are able to adequately verbalise the
type, location and severity of their pain
c) The Verbal Numerical Scale is
appropriate in children older than eight
years due to the higher reliability in
self-reporting in this age group.
d) The Face, Legs, Arms, Cry, Consolability
scale is the most appropriate
observational scale for children aged
four to 12 years.
3. Which of the following is NOT a
precaution or contraindication for
use of ibuprofen in a child?
b) Four months of age.
c) Previous hypersensitivity.
d) Two months of age.
4. Which of the following non-
pharmacological options are suitable
to help alleviate teething pain?
a) A wet washcloth or teething ring to bite.
b) Applying strong pressure to the babies
gum with a clean finger.
c) Breastfeeding, a warm bath and music.
d) All of the above.
5. What should a pharmacist do to
reduce the likelihood of dosing
a) If the child is obese, use their body
mass index to determine the most
b) Always base the dose on a child’s age
rather than weight.
c) Avoid using more than one product
d) If a child is underweight, use the
average weight-for-age dose
recommended from the product label.
TAKE HOME MESSAGE
As pain is a common reason to seek
medical care for a child, pharmacists
are well placed to help with pain
assessment and recommend treatment.
There are many non-pharmacological
suggestions a pharmacist can make
to help a parent or guardian to
assist with pain relief in children.
If non-pharmacological methods
do not provide adequate pain relief,
over-the-counter medicines such as
paracetamol or ibuprofen can be used.
1. Brown JC, Klein EJ, Lewis CW et al. Emergency
department analgesia for fracture pain. Ann Emerg Med
2. Drendel AL Kelly BT, Ali S. Pain assessment for children:
overcoming challenges and optimising care. Paediatr
Emerg Care 2011;27(8):773–81.
3. Babl FE, Crellin D, Cheng J et al.The use of the faces, legs,
activity, cry and consolability scale to assess procedural
pain and distress in young children. Pediatric Emerg Care
4. Hicks CL, Von Bayer CL, Spafford PA et al. The faces pain
scale - revised: toward a common metric in paediatric pain
measurement. Pain 2001;93(2):173–83 .
5. Connelly M. The verbal numeric rating scale in the
pediatric emergency department: what do the numbers
really mean? Pain 2010;149(2):167–8 .
6. Analgesic Expert Group. Therapeutic Guidelines:
analgesics. Melbourne: Therapeutic Guidelines, 2012.
7. Australian Dental Association. Fact Card: Tooth
development in babies and toddlers 2014. At: www.awch.
8. Chin M, ed. AMH children’s dosing companion. Adelaide:
Australian Medicines Handbook, 2013.
9. The American Academy of Pediatrics. Health Alert: Baby
teething gels not recommended. At: http://aapnews.
10. Williams GD, Kirk EP, Wilson CJ, et al. Salicylate intoxication
from teething gel in infancy. The Medical Journal of
Australia 2011;194(3):146–8 .
11. Rossi S, ed. Australian medicines handbook. Adelaide:
Australian Medicines Handbook, 2014.
12. Rheumatology Expert Group. Therapeutic Guidelines:
rheumatology. Melbourne: Therapeutic Guidelines, 2010.
13. Sood M, Sood S. Problems with teething in children.
Pediatric Oncall Journal. At: http://pediatriconcall.com/
Parents and carers should be reminded
to store all medicines out of reach and
sight of children at all times to avoid an
Resolving Blake’s teething
Leigh thanks you for your time and
advice and buys a bottle of paracetamol
suspension for Blake, which she is keen
to try straight away. She is also very
eager to try the non-pharmacological
methods for pain relief that were
discussed and plans to use some
of the strategies you mentioned to
distract Blake from the pain. Leigh
was interested to hear of the different
pain scales and feels she will now
have a greater understanding of her
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