WOMEN’S INTERAGENCY HIV STUDY (WIHS)
SPANISH VERSION PAIN STUDY
RESPONSE CARDS
RESPONSE CARD BPI1
Form BPI: Brief Pain Inventory, Question B2 10/01/12
RESPONSE CARD BPI2
0 1 2 3 4 5 6 7 8 9 10
Sin dolor Dolor tan intenso
como se puede imaginar
Form BPI: Brief Pain Inventory, Questions B3 – B6 10/01/12
RESPONSE CARD BPI3
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Ningún Alivio
alivio total
Form BPI: Brief Pain Inventory, Question B8 10/01/12
RESPONSE CARD BPI4
0 1 2 3 4 5 6 7 8 9 10
No Interfiere
interfiere completamente
Form BPI: Brief Pain Inventory, Questions B9a – B9g 10/01/12
RESPONSE CARD PMU1
Antiinflamatorios no esteroideos (AINE):
Aspirina Tylenol Motrin Aleve Celebrex
Form PMU: Pain Medication Use Questionnaire, Question B1 10/01/12
RESPONSE CARD PMU2
Antiinflamatorios esteroideos:
Prednisone Prednisolone Albuterol
Form PMU: Pain Medication Use Questionnaire, Question B2 10/01/12
RESPONSE CARD PMU3
Fármacos antidepresivos:
Elavil (amitriptyline) Pamelor (nortriptyline) Norpramin (desipramine)
Form PMU: Pain Medication Use Questionnaire, Question B3 10/01/12
RESPONSE CARD PMU4
Fármacos anticonvulsivos/antiepilépticos:
Neurontin (gabapentin) Lyrica (pregabalin)
Tegretol (carbamazepine)
Form PMU: Pain Medication Use Questionnaire, Question B4 10/01/12
RESPONSE CARD PMU5
Anestésicos tópicos:
5% Lidocaine patch Capsaicin
Cortizone Ben-gay
Aspercreme Icy Hot
Orajel
Form PMU: Pain Medication Use Questionnaire, Question B5 10/01/12
RESPONSE CARD PMU6
Fármacos opioides leves:
Butalbital Codeine Combunox Darvocet Darvon E-Lor Endocet Endodan Fioricet Fiorinal Hydrocet
Hydrocodone Hydrogesic Lorcet
Lortab Norco
Oxycodone OxyContin Oxydose OxyIR Percocet
Percodan Propocet
Propoxyphene Roxicet
Roxicodone Roxiprin Tramadol Tylox
Ultracet Ultram Vicodin
Vicoprophen Wygesic
Zydone
Tylenol with Codeine (e.g., Tylenol #3)
Form PMU: Pain Medication Use Questionnaire, Question B6 10/01/12
RESPONSE CARD PMU7
Fármacos opioides fuertes:
Actiq Avinza
Butorphanol
Deordorized Tincture of Opium (DTO)
Demerol
Demerol Hydrochloride Dilaudid
Dolophine Duragesic Fentanyl Fentora
Hydromorphone Isonipecaine
Kadian
Levorphanol Meperidine
Levo-Dromoran Methadone
Methdose Morphine MSContin
Oramorph SR Paregoric
Pethidine Roxanol Roxanol-T Stadol
Form PMU: Pain Medication Use Questionnaire, Question B7 10/01/12
RESPONSE CARD PMU8
Marihuana:
Marihuana Hachís
Marinol (dronabinal)
Form PMU: Pain Medication Use Questionnaire, Question B8 10/01/12
RESPONSE CARD PMU9
Medicamentos para dormir:
Ambien (zolpidem) Halcion (triasolam) Restoril (temazepam)
Form PMU: Pain Medication Use Questionnaire, Question B9 10/01/12
RESPONSE CARD PMU10
Medicamentos sedantes o ansiolíticos:
Ativan (lorazepam) Xanax (alprazolam) Valium (diazepam)
Klonopin (clonazepam)
Form PMU: Pain Medication Use Questionnaire, Question B10 10/01/12
RESPONSE CARD PMU11
Relajantes musculares:
Flexeril (cyclobenzaprine) Skelaxin (metaxalone)
Baclofen
Form PMU: Pain Medication Use Questionnaire, Question B11 11/30/12
RESPONSE CARD PMU12
Medicamentos para las migrañas:
Imitrex (sumatriptan) Maxalt (rizatriptan)
Form PMU: Pain Medication Use Questionnaire, Question B12 11/30/12
RESPONSE CARD PMU13
Medicamentos estimulantes:
Ritalin (methylphenidate)
Dexedrine (dextroamphetamine)
Adderall (dextroamphetamine and amphetamine) Concerta (methylphenidate)
Form PMU: Pain Medication Use Questionnaire, Question B13 10/01/12
