Pain Control Flashcards
Types of pain
Acute Chronic Nociceptive Neuropathic Visceral Somatic
What is pain
Sensation caused by actual or potential nerve damage
Is pain static
No breakthrough pain
Pain can be experienced differently at different times
So PRN medication is important
What is the Total pain model concept
Incorporates physical attributes of pain but also the
Social
Psychological
Spiritual
Needs of the patient and their impact on the sensation of pain
Pain in cancer
Can be the tumour
Mets
Local effects of the tumour invasion compression
Indirect effects of the tumour
Assessment of pain
SOCRATES Assess PRN How long does it take to work Did it work How long did it work for How many PRN is needed
Prescribing opioids
Initiation As required 2.5-5mg immediate release morphine PRN 4 hourly 2x daily regime Start 10-15mg morphine BD Prescribe PRN dose and titrations accordingly Always prescribe a laxative Consider prescribing an antiemetic
What does the break through dose be
1/6th if the total daily morphine dose
Types of morphine
Short acting/ immediate release
Onset 20-30 mins lasts 4 hours
Long acting /modified release
Lasts 12hoirs
What is the max dose of morphine
No max dose
It is the good standard of treatment
What pain can patches be used for
Stable pain
Signs of opiate toxicity
RR <8
SAts <88
Not rousable
Cyanosis
Treatment of opiate toxicity
Naloxone
When is naloxone CI
If the patient is dying
Non opioid induced
Opioid induced drowsiness or delirium that is none life threatening
What can naloxone cause in those on long term regular opioids
Withdrawal
