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  • "-.DTSCT ............... : Critical Care Pain

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    Stephany L Jonathan
    25 views7 pages
    This document discusses various approaches for treating pain, including: 1) Non-pharmacologic approaches like self-regulation techniques, anxiety reduction, education, and spinal cord stimulation. 2) Pharmacologic approaches including NSAIDs, opioids, corticosteroids, antidepressants, anticonvulsants, local anesthetics, and neuromodulators. 3) A stepped approach is outlined starting with nonopioids and progressing through increasing levels of opioids to achieve adequate pain relief while minimizing side effects.

    Original Description:

    Cancer pain who

    Original Title

    Scan Sep 2, 2019

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    This document discusses various approaches for treating pain, including: 1) Non-pharmacologic approaches like self-regulation techniques, anxiety reduction, education, and spinal cord stimulation. 2) Pharmacologic approaches including NSAIDs, opioids, corticosteroids, antidepressants, anticonvulsants, local anesthetics, and neuromodulators. 3) A stepped approach is outlined starting with nonopioids and progressing through increasing levels of opioids to achieve adequate pain relief while minimizing side effects.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    25 views7 pages

    "-.DTSCT ............... : Critical Care Pain

    Uploaded by

    Stephany L Jonathan
    This document discusses various approaches for treating pain, including: 1) Non-pharmacologic approaches like self-regulation techniques, anxiety reduction, education, and spinal cord stimulation. 2) Pharmacologic approaches including NSAIDs, opioids, corticosteroids, antidepressants, anticonvulsants, local anesthetics, and neuromodulators. 3) A stepped approach is outlined starting with nonopioids and progressing through increasing levels of opioids to achieve adequate pain relief while minimizing side effects.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 7

    Treatment of Pain Sclf rcgulatlon IC'Cbn!

    qUN
    3.11Xlol)1ica
    nntldcprca~nQ
    corta cduc~tion,l"Xplanationrc-p:iin

    "-.Dtsct................
    Serotonin(TCA'1)
    norq,lnq,brinc Peridur.11 opfatc1
    cnkcph:illa1 TESS

    ' NSAID \
    spin~ cord 1timul:ition
    ~- SPmtagoni1t1
    GABA
    Clonldine
    b)-polulul■I - - - - lllllalllD
    Systenuc opi:itcs _ . - Pcridur.11 loc3l mn1hctk1
    NSAIDs
    I .-- Peripheral ilCl'\'C block
    ilL___ Painful
    ~I! ·· Jtlmulus

    Antibi111mine1
    slucoconicold1
    Sympathetic sanslfon NSA1D1
    btocbde - loc:il ancathctfc infihtatfon
    muscle iela.unil
    SP antagoni1i•
    Vi1cer:1 -.. .- V11odilaton serotonin antagonisll
    blood vcs1cl1 rmal-do1e dop.unine

    Handbook ofcritical-care pain 111ii1icigen1e;11,,i994


    OLadder
    om From Cancer Pain
    Step 3: Opioid for Moderate to Severe Pain
    :tNonopiaid
    Pain i,en;mns ~Juv.1n1
    ori Ing
    Step 2: Opioid for Mild to MGldetrate •
    + "oid
    Pain ·st1ng · ~Juwnt
    ori~ming
    Step 1: Nanap· .
    ~luvanl

    Pain , 1990. Used with aermis.sion.


    Cell 1\lembrane
    Phospbolipids Cyotkincs
    Growth Factors
    Endotoxin
    Angiotcnsin II reactive 02 molecules
    Steroids
    Bradykinin
    l\1E Phospholipase A 2 glucoconicoids ·1(
    Vasopressin
    COX-2 Cyclooxygenasc 2
    Arachidonic Acid Cyclooxygenase I

    Lipooxygenase xygenase

    5-Iiydroperoxyeicosatetraenoic Acid
    Cyclic Endoperoxides
    5-HPETE

    r
    5-H ydroeicosatetraenoic
    Acid
    Leukotrienes

    (5-HETE)

    Eicosanoid Prostanoid
    Pathway Pathway
    Titrate Opioids to Effects

    Dose
    of Pain free, trust the patient
    Opioid

    Time

    AlcQuay H a11d 1.\t/00,-e A, An e11ide11ce-based ,-esourceJo,-pain ,-e/ief, 1998


    Unconsciousness
    Apnea
    Respiratory depression
    Increased.sedation
    Increased nausea, vomiting

    Base-line '""'"'lo&S-wsia

    Incnasing~opioidtdose
    Pain Cycle With P Medications
    Patient PAIN
    \rariables
    a
    Sedation a
    Call for Nurse
    ••
    Relief
    (Analgesia) ♦a 13 13 13 ■■ 19 19
    •
    PCA
    Nurse Responds

    Body
    .~bsorbs
    U ptake/ The Drug

    ~
    Distibution
    Va.-iables
    · · ter
    Medications -
    Sim Out Medications

    ~ Nursing Vaiiablcs
    Prepare Medications
    Gra,·es et al,Am1 Int i\Jed,19S3
    P1·ofile of Plasma Drug Levels
    During PCA Therapy
    Rl;!spiratory d~pr~ssion
    C

    ·--0c:-: St!clation
    --
    ~

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