ALS PCS: Analgesia Medical Directive Flashcards
INDICATIONS
PAIN
CONDITIONS (ACETAMINOPHEN)
Age ≥ 12 years
LOA: UNALTERED
CONDITIONS (IBUPROFEN)
Age ≥12 years
LOA: UNALTERED
CONDITIONS (KETOROLAC)
Age ≥12 years
LOA: UNALTERED.
SBP: NORMOTENSION (≥100 mmHg)
USE IS RESTRICTED TO THOSE WHO ARE UNABLE TO TOLERATE ORAL MEDICATIONS
CONTRAINDICATION (ACETAMINOPHEN) - 6
ACETAMINOPHEN USE WITHIN PAST 4 HOURS
ALLERGY OR SENSITIVITY TO ACETAMINOPHEN
HISTORY OF LIVER DISEASE
ACTIVE VOMITING
INABILITY TO TOLERATE ORAL MEDICATION
SUSPECTED ISCHEMIC CHEST PAIN
CONTRAINDICATION (IBUPROFEN) - 12
NSAID OR IBUPROFEN USE WITHIN PAST 6 HOURS
ALLERGY OR SENSITIVITY TO ASA OR NSAIDs
PATIENT ON ANTICOAGULATION THERAPY
CURRENT ACTIVE BLEEDING
HISTORY OF PEPTIC ULCER DISEASE OR GI BLEED
PREGNANCY
IF ASTHMATIC → NO PRIOR USE OF ASA OR OTHER NSAIDs
CVA OR TBI WITHIN PAST 24 HOURS
KNOWN RENAL IMPAIRMENT
ACTIVE VOMITING
INABILITY TO TOLERATE ORAL MEDICATION
SUSPECTED ISCHEMIC CHEST PAIN
CONTRAINDICATION (KETOROLAC) - 10
NSAID OR IBUPROFEN USE WITHIN PAST 6 HOURS
ALLERGY OR SENSITIVITY TO ASA OR NSAIDs
PATIENT ON ANTICOAGULATION THERAPY
CURRENT ACTIVE BLEEDING
HISTORY OF PEPTIC ULCERS OR GI BLEED
PREGNANCY
IF ASTHMATIC → NO PRIOR USE OF ASA OR OTHER NSAIDs
CVA OR TBI WITHIN PAST 24 HOURS
KNOWN RENAL IMPAIRMENT
SUSPECTED ISCHEMIC CHEST PAIN
TREATMENT (ACETAMINOPHEN)
12 ≤ age < 18
ROUTE: PO
DOSE: 500-650 mg
MAX SINGLE DOSE: 650 mg
DOSING INTERVAL: N/A
MAX # OF DOSES: 1
TREATMENT (ACETAMINOPHEN)
AGE ≥ 18
ROUTE: PO
DOSE: 960-1000mg
MAX SINGLE DOSE: 1000mg
DOSING INTERVAL: N/A
MAX # OF DOSES: 1
TREATMENT (KETOROLAC)
≥12 years
ROUTE: IM / IV
DOSE: 10-15mg
MAX SINGLE DOSE: 15mg
DOSING INTERVAL: N/A
MAX # OF DOSES: 1
CLINICAL CONSIDERATIONS
WHENEVER POSSIBLE, CO-ADMINISTER ACETAMINOPHEN AND IBUPROFEN
SUSPECTED RENAL COLIC PATIENTS SHOULD ROUTINELY BE CONSIDERED FOR KETOROLAC
IV ADMINISTRATION OF KETOROLAC APPLIES ONLY TO PCPs AUTHORIZED FOR PCP AUTONOMOUS IV
