pain ladder Flashcards
what was the WHO analgesic ladder first made for
cancer patients
the WHO analgesic ladder has now been modified for
acute and chronic non-cancer patients
why do we need a pain ladder
- to assess degree in a patient through proper evaluation
- prescribe appropriate medications
- to include opioid rotation
- to balance the optimum dosage with the side effects of the drug
what was the original pain ladder
- mild pain
- mild to moderate pain
- moderate to severe pain
these increase in pain intensity
what therapy would you give to mild pain
NSAIDs
what therpay would you give to mild/moderate
weak opioid and nonopioid
what therapy would you give for moderate/severe
strong opioid and nonopioid
what are the limitations of the original pain ladder
unidrectional, only for cancer pain, second level of weak opioids seemed non-beneficial, did not include non pharmacological treatments
what are examples of non pharmacological treatments
hydrotherapy, psychotherapy, acupuncture
what are the steps of the new analgesic ladder
- nonopioid analgesics NSAIDs
- weak opioids
- strong opioids
- nerve block epidurals
what is the difference between the orignal and new ladder
it is interchangable and if the patient experiences side effects the patient decerases goes down the steps
what are the advantages of the analgesic ladder
focused on the quality of life
bidirectional approach
for acute pain the strongest analgesic is given first and then decreased
what are the limitations of analgesic ladders
- lack of proper knowledge on drugs
- fear of addiction
- lack of public awareness
what is the multimodal trolley approach
. It will be responsibility of clinician to draw on one or more drawers, and to choose in the drawers the most appropriate therapeutic modality,modify the choices on the basis of therapeutic needs at the time of presentation.
