Of pain management

This type of pain management is used for postoperative pain, labor pain, and cancer pain. The most serious adverse reaction associated with the administration of narcotics by the epidural route is respiratory depression. The patient may also experience sedation, confusion, nausea, pruritus, or urinary retention. Fentanyl is increasingly used as an alternative to morphine sulfate because patients experience fewer adverse reactions. 

The expected outcomes for the patient may include relief of pain, management of common adverse drag reactions, absence of injury, and an understanding of and compliance with the prescribed therapeutic regimen. 

Treating adverse effects of opioids is part of pain management... 

Berde, C.B., Sethan, N., and Koka, B.V. (1993) Pediatric pain management. In Warfield, C.A., ed. Principles and Practice of Pain Management. New York McGraw-Hill, pp. 325-346. 

Portenoy and Payne (1997) observe that physical dependency as a result of prolonged use of opiates in programs of pain management does not reliably lead to addiction. "A reasonable hypothesis is that addiction results from the interaction between the reinforcing properties of opioid drugs and any number of characteristics... specific to the individual... such as the capacity for euphoria from an opioid and psychopathy" (582). 

Eschalier, A., Ardid, D., Dubray, C. Tricyclic and other antidepressants as analgesics. In Sawynok, J., Cowan, A. (eds.) Novel aspects of pain management opioids and beyond. New York, Wiley-Liss 1999, 303-319. 

Hunter, J.C. Voltage-gated ion channel modulators in Novel aspects of pain management. Opioids and beyond, edited by J. Sawynok and A. Cowan. Wiley-Liss. Inc., 1999, 321-344. 

Outlook - The Future of Pain Management U. Jahnel and C. Gillen 569... 

The prior art expressly teaches one of ordinary skill in the art to combine an opioid with an NSAID.123 Furthermore, based on the prior art, a person of ordinary skill in the art of pain management would have had a reasonable expectation of success in combining hydrocodone, a narcotic analgesic, with ibuprofen, an NSAID. 

Ballantyne, Jane, ed. The Massachusetts General Hospital Handbook of Pain Management, 2nd ed. Philadelphia Lippincott Williams Wilkins, 2002. 

The peripherally acting and centrally acting analgesics are the mainstay of pain management in outpatient practice. The most useful agents in each class are discussed in the following sections. 

The use of opioids in very young patients is increasing. In a review of pain management in children, various routes of administration of opioids and their associated adverse effects have been discussed (SEDA-17, 78). Attention has been drawn to the adverse effects of intravenous codeine in children and to the risk of convulsions with pethidine in neonates, because of accumulation of its metabolite norpethidine. The risk of respiratory depression with morphine was also highlighted, and morphine is recommended for use only in neonates who are being ventilated or intensively nursed. Routine use of pulse oximetry has been recommended in all children receiving opioids (SEDA-21, 86). 

Use Provides symptomatic relief of allergic symptoms sedative/ antiemetic in surgery/labor decreases postop nausea/ vomiting adjunct to analgesics in control of pain management of motion sickness. Half-life UK minutes IM 20 minutes Rectal 20 minutes IV 3-5 minutes Onset PO 20 Peaks Duration 1-4 hours PO/IM Rectal/TV 2-8 hours... 

A. Cowen in J. Sawynok and A. Cowen, Eds., Novel Aspects of Pain Management Opioids and Beyond, Wiley-Liss, New York, 1999, pp. 21-47. 

Pharmacists should be involved in all steps of pain management. This includes the initial development of pain management policies and procedures development of standardized pain assessment and documentation forms development of standardized treatment orders, including recommendations to manage adverse effects education of staff on the implementation of the new pain management standards and quality assurance efforts to evaluate the policies and procedures. 

Regardless of the practice setting, pharmacy opportunities exist in the area of pain management. In most of these settings, patients can be followed and managed over the telephone. Other important issues for pharmacists include the treatment of adverse effects of pain medications, especially constipation. 

There are numerous organizations devoted to pain management. The decision on which one to join will be affected by the area of pain management in which you are involved. The American College of Clinical Pharmacy (ACCP) and the American Society of Health-System... 

In addition to pharmacy organizations for pain management, there are several national societies devoted to this cause. These organizations are multidisciplinary and provide an excellent resource for pharmacists who want to specialize in pain management. The area of pain management in which you want to specialize will once again affect the organization you choose to join ... 

American Academy of Pain Management http // www.aapainmanage.org/ (accessed October 2001). 

Pain management is a significant expectation of the JCAHO in their year 2000 surveys. Expectations not only include established treatment pathways, but also documentation of outcomes and patient satisfaction. Pharmacists, whether in acute or home health care, community, or ambulatory settings should strive to become leaders in the area of pain management. 

Lin, C.-C. Applying the American Pain Society s QA standards to evaluate the quality of pain management among surgical, oncology, and hospice inpatients in Taiwan. Pain 2000, 87, 43-49. 

Varrassi G, Marinageli F, Donatelli F, Beltrutti D. Pharmacoeconomics of pain management. Curr Pain Headache Rep 1998 2 151-156. 

In a web-based national survey of pain management in children, serious adverse events were associated with intravenous patient-controlled analgesia, with a response rate of 41% (294 of 724 practitioners) [59. Patient deaths and administration of naloxone to counteract cardiopulmonary adverse reactions were reported by 42 respondents. 

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