LEARNING OBJECTIVES:

 

  1. Define “pain” as per the International Association for the Study of Pain (IASP).
  2. List commonly used analgesic drug classes and individual drugs; describe their mechanism of action and identify common and major side effects.
  3. Recognize the indications for usage of patient-controlled analgesia (PCA) and define the necessary components.
  4. Define tolerance, dependence, addiction and pseudo-addiction.
  5. Demonstrate ability to calculate equal-analgesic doses of common opioids using an equianalgesic table.
  6. Demonstrate ability to convert from one opioid formulation (parenteral, oral, transdermal) to another.
  7. Manage acute pain using patient-controlled analgesia (PCA) for both opioid-nairve patients and patients already on chronic maintenance opioid therapy, and manage transition back to an oral pain regimen.
  8. Differentiate pain assessment techniques in pediatric, adult and geriatric patients.
  9. Identify preventative and therapeutic measures for opioid-associated side effects.
  10. Describe the multimodal approach to pain management, including non-pharmacologic measures.
  11. Select the best medication formulation based on patient dosing needs.
  12. Summarize the rationale for the following recommendations from the 2016 Center for Disease Control Guidelines for the Management of Chronic Pain:
    1. Consider opioid therapy only if expected benefits for pain and function outweigh risks
    2. Before starting opioid therapy for chronic pain, establish realistic treatment goals for pain and function with the patient.
    3. When opioids are used for acute pain prescribe the lowest effective dose; immediate release formulations; and quantity no greater than the expected duration of pain severe enough to require opiates.

 REFERENCES:

CDC Guidelines for Prescribing Opiates for Pain Control

Opioid Metabolism

What is the best method of treating acutely worsened chronic pain?

Patient Controlled Analgesia

Chronic Pain Management

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