simple pain guide

[Sanchik]

I'm looking for a pocket guide that would give me doses/side effects of the common nsaids, adjuncts, opioids as i start my new job. Anyone know of such book?

 

[Gauss]

epocrates

 

[Sanchik]

Thanx Gauss,
I use epocrotes for looking up meds i know, but i am sure there are nsaids/adjuncts that i haven't tried yet.
In my outpatient time during resdency, my attendings didn't do med management (don't ask!) so i feel a little behind in that area

 

[Sanchik]

I guess I probably need two types of books- 1 to learn more comprehensively and one short "pocket guide" for daily use

 

[specepic]

I guess I probably need two types of books- 1 to learn more comprehensively and one short "pocket guide" for daily use

Something like the MGH Pain Handbook might be useful. You raise a great question: how do I learn what I need to know about a drug I have not used clinically before?

my 0.02:

package insert (doesn't take you long to read and will give the low down on side effects, interactions)

pain review course/conference- always lectures on nsaids, adjunctive meds, opioids, etc.

not sure what kind of gig you have but beware that PMR is a popular dumping ground and if you are a 'green horn" you may be targeted by collegues as an opioid dumping ground and by pts looking for a soft target.

opioids: in brief, think long and hard before Rx'ing for the long term in the setting of non-cancer pain and if you are non-confident with this class you are better of being too strict than too loose. Use a collegue who is pain trained for curbsides and consults when in doubt.

 

[Sanchik]

THanks for your reply. I'm going to get the handbook and try to get over my fear of prescribing things I have not before.
I don't plan on being a dumping ground- will be at an academic place where there are plenty of pain people. My pain plan will be NSAIDS, adjuncts,v limited opiods. It's not just not wanting to be a dumping ground, I just think that if someone has a high opioid requirement, they are better served by a trained pain specialist.

 

[deleted185747]

Practice medicine in a manner which is responsible, and treat people with the expertise you would treat your own family. Nothing more, nothing less.

 

[Donal1987]

THanks for your reply. I'm going to get the handbook and try to get over my fear of prescribing things I have not before.
I don't plan on being a dumping ground- will be at an academic place where there are plenty of pain people. My pain plan will be NSAIDS, adjuncts,v limited opiods. It's not just not wanting to be a dumping ground, I just think that if someone has a high opioid requirement, they are better served by a trained pain specialist.

See:
Pain Killers Comparison Chart
Painkiller Summary
http://www.vaughns-1-pagers.com/medicine/painkiller-comparison.htm

Here's a *very* brief one:

Is There a Limit to the Analgesic Effect of Pain Medications?
http://www.medscape.com/viewarticle/574279

If you're interested, the following go into guidelines, etc. in a lot more detail:

Pain Management
http://www.healingchronicpain.org/content/introduction/conv_pharm.asp

Tennant's articles are useful for patients
Pain and Pain Management
http://foresttennant.com/
INTRACTABLE PAIN PATIENT'S INSTRUCTIONMANUAL
http://foresttennant.com/pdfs/intractable-pain-patients-instruction-manual.pdf

Practice Guidelines for Chronic Pain Management: An Updated Report by the American Society of Anesthesiologists Task Force on Chronic Pain Management and the American Society of Regional Anesthesia and Pain Medicine
http://journals.lww.com/anesthesiology/Fulltext/2010/04000/Practice_Guidelines_for_Chronic_Pain_Management_.13.aspx

Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain
http://www.jpain.org/article/S1526-5900(08)00831-6/fulltext

Pain Treatment - Position/Policy/Consensus Statements
http://pain-topics.org/guidelines_reports/PositionPolicyConsensus.php

From British Journal of Anaesthesia
An Update on Analgesics
http://www.medscape.com/viewarticle/745129

Pharmacological Management of Persistent Pain in Older Persons
http://www.americangeriatrics.org/files/documents/2009_Guideline.pdf

Assessment and Management of Chronic Pain
Guideline Summary
http://www.icsi.org/pain__chronic__assessment_and_management_of_14399/pain__chronic__assessment_and_management_of__guideline_summary_.html

ANALGESICS

http://www.hospiceworld.org/book/analgesics.htm
Gives a very brief summation of the common drugs in hospice use

 

[Sanchik]

THANKS so much!