1. pharmacotherapy: opioids, nsaids, adjuvants, and analgesic e
TRANSCRIPT
1. Pharmacotherapy: opioids, NSAIDs, adjuvants, and analgesic e...
2. Pharmacotherapy of Pain
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 1
3. Mechanisms of Pain and Medication Activity Sites
4. Classes of analgesics
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 2
5. Severity: WHO analgesic ladder
6. Pain Source
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 3
7. Acute vs. chronic therapy
8. Acute vs. chronic therapy
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 4
9. Elderly Patients
10. Opioids
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 5
11. Positioning Opioid Therapy
12. Opioids: Mode of action
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 6
13. Guidelines for Management of Opioid Therapy
14. Opioid Agents
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 7
15. Morphine
16. When to consider alternatives to morphine?
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 8
17. When to consider alternatives to morphine?
18. When to consider alternatives to morphine?
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 9
19. When to consider alternatives to morphine?
20. When to consider alternatives to morphine?
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 10
21. When to consider alternatives to morphine?
22. Transdermal Fentanyl
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 11
23. Mixed Agonist-Antagonists/Partial agonists
24. Antagonists
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 12
25. Naloxone
26. Medication Schedules
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 13
27. Opioid Selection: Poor Choices for Chronic Pain
28. Opioid-drug interactions
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 14
29. Routes of Administration
30. Opioid Therapy: Dosing Guidelines
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 15
31. Opioid Therapy: Dosing Guidelines
32. Poor Opioid Responsiveness
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 16
33. Opioid Rotation
34. How does this look?
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 17
35. Equianalgesic Conversion
36. Tolerance
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 18
37. Incomplete cross-tolerance
38. Equianalgesic conversion
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 19
39. Conversion Table
40. Simple example
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 20
41. Simple example cont.
42. Equianalgesic conversion example
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 21
43. Equianalgesic conversion example
44. Equianalgesic conversion example
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 22
45. Equianalgesic conversion example
46. Equianalgesic conversion example
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 23
47. Equianalgesic conversion example
48. Equianalgesic conversion example
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 24
49. Nonopioid Analgesics
50. NSAIDs: Properties
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 25
51. Non-opioid analgesics
52. Non-opioid analgesics: WHO ladder
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 26
53. Positioning NSAID Therapy
54. Guidelines for Management of NSAID Therapy
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 27
55. NSAID with or without opioid?
56. NSAID with or without opioid?
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 28
57. NSAIDs - Adverse effects
58. NSAIDs: drug interactions
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 29
59. Which NSAID to choose?
60. Which NSAID not to choose?
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 30
61. NSAIDs: available agents
62. NSAID Recommendations
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 31
63. Coxibs - place in therapy
64. Adjuvant Analgesics
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 32
65. Adjuvant Analgesics
66. Adjuvant Analgesics - place in therapy
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 33
67. Adjuvant Analgesics
68. Risk factors for herpes zoster
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 34
69. Pharmacotherapy: Slide 69
70. Anticonvulsants
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 35
71. Gabapentin/Pregabalin
72. Gabapentin
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 36
73. Pregabalin
74. Pregabalin
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 37
75. Pregabalin in neuropathic pain
76. Antidepressants
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 38
77. Antidepressants
78. Local anesthetics and oral analogues
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 39
79. Steroids
80. Alpha-2 adrenergic agonists
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 40
81. NMDA-receptor antagonists
82. Topical Analgesics/Anesthetics
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 41
83. “Muscle relaxants”
84. Miscellaneous drugs
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 42
85. Adjuvant Analgesics for Cancer Pain
86. First-line medications for neuropathic pain
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 43
87. Add the following?
88. Treatment Options
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 44
89. Summary
90. Summary
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 45
91. NSAIDs: Summary
92. Summary
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 46
93. Pharmacotherapy: Slide 93
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Pharmacotherapy
OCW: Introduction to Clinical Pain Problems (E. McNicol) Page - 47