pain management modalities Flashcards
examples of simple analgesics
paracetamol
NSAIDs
weak opioids - codeine, dihydrocodeine and tramadol
topical treatment examples ?
capsaicin cream
lidocaine patches
NSAID gels
membrane stabilizing drugs ?
anticonvulsants carbamazepine , gabapentin and pregabalin
tricyclin antidepressants for pain
amitriptyline and nortriptyline
what is the mechanism of action of ketamine ?
NMDA receptor antagonist
ketamine infusion can only be given in a hospital setting
however effect is short lived and the treatment needds to be repeatedd
what does the WHO analgesic ladder explain ?
step 1 - mild pain
step 2 - moderate pain
step 3 - severe pain
what is the management in step 1 of WHO analgesic ladder
patient identifies with mild pain , score 1-3
no medication
regular acetaminophen - 1g every 6 hours
Additional PRN drugs as needed:
NSAIDs
COX-2 inhibitors
what is thee management in moderate pain step 2 analgesic ladder
pain level is 4-6
regular weak opioids - like codeine
with or without acetaminophen
with or without NSAIDS and CoX2 inhibitors
Additional PRN of weak opioids
what is thee management in step 3 on the WHO analgesic ladder ?
regular higher doses of weak opioids
parenteral doses of morphine
Additional SC doses of morphine
what is the pain manageement modality for radicular leg pain ?
lumbar epidural
or caudal epidural
with steroids and local anesthetics
which ganglion is associated with sympathetic block ?
stellate ganglion
pain management modality in order to moderate pain in the face and upper limb ?
sympathetic block by targeting thee stellate ganglion
what is used for ischemic leg pain / rest pain ?
lumbar sympathetic block
what is used for visceral tumors such as pancreatic tumors
celiac plexus block
what theory does TENS use for pain modulation ?
gate theory of paiin
