Chronic conditions and pain Flashcards
What social conditions should you always look for in developmental disability
Communication issues
Neglect
Abuse
What underdiagnosed medical conditons should you think about in developmental disabilities
Vision
Hearing
Dental
List three things to think of when someone has a worsening of their chronic condition
Medication side effect
Disease getting worse
Exacerbation of disease
New condition
Ask biopsychosocial and function
What dose of ibuprofen
200-400 mg
What is the max of a new start for opioids
50 mg morpheine equivalents daily
Max dose of opioids you should try to taper down to
90 morphine equivalents daily
List five medications you should try before opioids
NSAIDS TCAs Nabilone Acetaminophen Pregabalin
List four non medications you should try before opioids
CBT
Exercise
Physio
RICE
How long should you give an opioid prescription for
3 days
Not more than 7
HOw to taper opioids
5% drop every 2-8 weeks
When can we use cannabis (other than for fun)
Neuropatinc pain
Palliative pain
Spasticity
Cheo induced Nausea and vomiting
When can you smoke and drive
6 hours after inhalation and 8 hours after oral ingestion
List Seven concerns specific for the elderly
Incontinence Memory disturbance Anorexia Sarcopenia Frailty Depression Falls Delirium Immobility
List the RISKS for being elderly
Roaming Intermittent danger (falls and fire) Self neglect Kinship (and abuse) Safe driving and substance abuse
List the activities of daily living
Dressing Eating Ambulating Toileting Hygiene
List the IADLs
Shopping Housework Accounting Food and meds Telephone and transport
List 5 non prescription ways you can change an olds life
Hearing aids Dnetures Glasses Walker Refer to occupational therapy or physio
What two screening tools can we use to deprescribe in the elderly
BEERS
STOPP
What medications should we try to deprescribe and why
- Benzos-Increased falls, confusion and all cause mortality
- Antipsychotics if on for over 3 months or if ineffective
How much should an old be allowed to drink
Women: 1 per day no more than 5 per week
Men 1-2 per day no more and 7 per week
Start on THiamine 50 mg daily if they are heavy drinkers
Consider pre op taper
Name five ways we can help with elder abuse
Optimize home care Identify alternate caregivers Assess mental health Address care giver burn out Assist in care planning (financial) Evaluate, treat and document physical abuse Refer to police Consider safety plan
