Lauer- Pain Management at the End of Life Flashcards
What acronym can be used to evaluate pain?
L-location O-other associated sxs C- character of the pain A- aggravating/alleviating factors T- timing, duration, pattern E- environment where pain occurs S- severity of pain
What acronym is used for an extended pain evaluation?
P-past hx w/ pain meds
A- allergies to meds
P- preconceived notions
A- anticipated course
What is post prandial pain?
pain that occurs with eating
Pain is often relate to what other two things?
Activity
Circadian rhythms
What are the 3 types of duration of pain?
Constant
breakthrough
incident
How do we dose breakthrough pain/ post-prandial pain (pain that lasts hours and peaks 3 x day)?
Treat pain 2 times a day when pain is occurring
How do you treat continuous pain?
Use constant level of medication all the time
(long acting med like oxycodone or phentonyl)
Get pt more comfortable over a long period of time
How do you treat continuous pain with increased spikes from certain activities?
Long acting with additional med as needed
What are the steps in the WHO pain tx ladder?
- non opioid + adjuvant
persisting or increasing pain - opioid for mild to moderate pain + non opioid + adjunct
persiting pain - opioid for mod to severe pain + non opioid + adjunct
Is there a maximum dose for opioids?
No, but you should know sxs of a max dose
What should you use for administration of opioids?
if the GUT works USE it
everything is equal though
Why should you avoid combination drugs?
Opiate and acetaminophen have different half lives so you can leave a pt not covered by a drug, and you’ll reach the maximum dose quickly. Better to have them swallow two pills.
What is the pain code?
Get them comfortable as fast and safely as possible
don’t walk away from a pt until they’re comfortable
How do you dose enteral opiates?
doing is based on half life
When is it safe to redose enteral opiates?
maximum blood conc peaks after an hour so it’s usually safe to redose then
