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30 Cards in this Set
- Front
- Back
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review: types of pain |
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causes of cancer pain in advanced cancer |
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Pain that isn't constant: 3 types |
1. intermittent pain: comes and goes, always same location and type of pain, may be managed with prn analgesia 2. breakthrough: episodes of pain superimposed on baseline pain may occur spontaneously or following some activity 3. incident pain: subtype of breakthrough pain that occurs during activity and ceases with rest |
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Edmonton Classification System For Cancer Pain (PANIC mnemonic) |
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it can take time to optimize pain control in cancer... |
d |
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WHO analgesia ladder for cancer pain |
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acetaminophen dosing 1. short term use, healthy p. 2. chronic use, healthy p 3. chronic use, unhealthy/at risk p. risk factors for hepatotox 5 |
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risks of NSAIDS? (>2 mo use) |
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opioid myths... |
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considerations in opioid prescribing |
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List 1 weak opiod 5 strong opioids |
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which drug SHOULD NOT BE PRESCRIBED for cancer pain |
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should know these... 6 early adverse effects of opioids |
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7 late adverse effects of opioids |
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Opioid induced neurotoxicity? 5 considering this has "Exam question" written below.. |
consider DDx.. infection, titration too rapid, dehydration |
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EXAM: how to pick up and treat opioid toxicity (4 tx points) |
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types of opioids available, short acting (6) and long-acting (5) formulations |
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suggested starting doses for Morphine NB: EXAM QUESTION: STARTING DOSE MORPHINE |
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special considerations for... opioid naive patient |
no codeine |
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special considerations for... renal failure/impairment |
often change to less frequent dosing, down to even qd |
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special considerations for... liver failure/impairmemnt |
Glucuronidation is generally more resistant toproblems in liver impairment (morphine and hydromorphone clearance is dependent on glucuronidation) Opioids not generally contraindicated in mild to moderate liver failure drop the dose and/or increase interval by 1.5-2 times |
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NB: How to write orders for opioid 5 aspects to hit |
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how to adjust opioids with interventional pain treatment |
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important: opioid risk tool for assessing risk of abuse |
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a few different things to consider: physical dependence, addiction vs. pseudo-addiction, tolerance |
d |
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pitfalls in cancer pain.. |
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example of non-pharmacologic adjuvants 7 |
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pharmacologic adjuvants for bone pain (2) neuropathic pain (4) other |
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pharmacological management of non-cancer neuropathic pain? |
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other important considerations for prescribing opioids.. 4 |
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