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13 Cards in this Set
- Front
- Back
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breakthrough dosing of a long-acting regimen
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10% of the total daily dose q1h prn
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breakthrough dosing of a short-acting regimen
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50% of the intermittent dose q1h prn
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what is initial tx for an opioid naive patient with a score of 1-3 (mild)
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consider NSAIDs or APAP
co-analgesics PRN bowel regimen |
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what is initial tx for an opioid naive patient with a score of 4-6 (moderate)
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titrate SA opioid
co-analgesics prn bowel regimen |
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what is initial tx for an opioid naive patient with a score of 7-10 (severe)
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rapid titration of SA opioids
co-analgesics prn bowel regimen |
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in an opioid tolerant patient with a pain score of 1-3, an appropriate step is to
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convert from IR to ER formulation and adjust the BT dosing
opioid rotation if intolerable side effects |
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cancer pain syndrome: inflammation
high risk patients include monitor: |
inflammation
- tumor/mets location - pleural/peritoneal mets high risk: renal complications of NSAIDs, age > 60, dehydrated, interstitial nephritis, papillary necrosis; nephrotoxic drugs (Cyclosporin, cisplatin, any renally excreted chemo) monitor BP, renal function, fecal occult |
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cancer pain syndrome: inflammation
treatment? |
trial of NSAIDs/glucocorticoid
ibuprofen, ketorolac use medications that don't inhibit platelet aggregation - choline + mag salicylate - cox 2 inhibitor |
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cancer pain syndrome: nerve compression
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bone mets in spinal cord, tumor invasion, treatment-induced osteoporosis
treatment: dexamethasone, either burst or maintenance therapy |
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cancer pain syndrome: bone pain
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primrary tumor or mets sprad
local bone pain: - palliative radiation - nerve block Diffuse bone pain - bisphosphonate trial steroids (dexamethasone) nsaid/cox-2/apap |
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in the treatment of cancer pain syndrome: bone pain, what is the difference between dexamethasone and prednisone
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dex causes better bone penetration, less fluid retention
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if using zoledronic acid (Zometa) as a treatment for bone pain, what should be done
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give apap or benadryl to prevent infusion reaction
adjust the dose renally |
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what is Metastron (strontinum)
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systemic radionuclide therapy for bone pain
and IV infusion that provides pain relief for 3-6 months, although it does cause an initial increase in pain for 2-3 days considered when the person has multiple remote bone lseions and a life expectancy of <6 months and unable to tolerate systemic pharmacotherapy or it is refractory |
