Pain Slides Cont’d
Pain can be treated through:
Non-pharmacological therapies: Somatic (can range from heat/cold-simple,
to acupuncture/ultrasound-minimally invasive, to surgery/radiation-
invasive) or Psychological (psychotherapy through counseling/support and
self help groups, meditation, hypnosis, and patient education)
Pharmacological therapies: Primary analgesics (simple analgesics or
opids/narcotics), Adjuvant medications, and Neuropathic pain treatment
Mainstay class of analgesics, Effective for moderate to
severe pain (easily titrated with NO ceiling effect), Mechanism of action: Binds to
opiate receptors in the CNS altering the perception and response to pain,
*for moderate to severe pain, the more dosage the more CNS depression it will
cause. There is no cox1 and involved. You are not decreasing the cause of the
pain, but your perception of the pain.
Full Agonist: Sits on a receptor and elicits a response.
Morphine, Meperidine, Methadone, Fentanyl, Oxycodone, Codeine,
Usually associated with opiods?
Morphine like agonists: Morphine, Hydromorphone, Oxycodone,
Codeine, and Hydrocodone. Morphine is the standard that we
compare everything else to. All have the same potential of causing
the same level of analgesics, or pain relief.
is a prototype
opiod analgesic. The natural substance is isolated from the opium
plant. It is the first line agent to treat moderate to severe pain. It can
be given PO, IV, IM, SubQ, PR (per rectal), IT (intrathecal) or
Immediate and sustained release formulations. Morphine, however,
wears off pretty quickly.
is involved in the
management of moderate to severe pain. It is more potent than
morphine. It can be administered IV, Im, SubQ, PO (better oral
absorption that morphine). You can give smaller dosages to reach
the same level of a morphine. Oral absorption is more complete and
Used to treat moderate to severe pain.
Immediate and sustained release products. Only available PO.
Similar potency to morphine. It is available as combination products
with ASA, APAP, and Ibuprofen. Given ONLY orally. It is often used