Challenges in Medicating the Senior Patient Choosing an appropriate dosage form of analgesic drug is essential to successfully manage pain in the older patient. Beyond the clinical recommendations, the pharmacist can be instrumental in providing information on products that will optimize pain relief in this patient population. Swallowing difficulties secondary to other medical conditions, such as Parkinson’s disease, dementia, or stroke, may preclude the use of large tablets or sustained-release medications that cannot be crushed. Liquid medications provide an acceptable alternative for administering analgesics. Unfortunately, few analgesic preparations are available in liquid form. Ibuprofen and naproxen suspensions are the few NSAIDs available as liquids …
[ Continue Reading... ]Category: Pain Management
Drugs Used in Pain Management Pharmacologic options for pain management range from simple analgesics, such as acetaminophen or low-dose nonsteroidal anti-inflammatory agents (NSAIDs) for the relief of mild to moderate chronic pain, to opioids for more severe pain (Table 1). Simple Analgesics: Acetaminophen is useful for the relief of mild to moderate osteoarthritic pain in scheduled, divided doses not exceeding 4 g/day.NSAIDs may also be used in appropriate doses, for short periods of time. COX-2 inhibitors may be less likely to be associated with gastrointestinal bleeding and may be administered once daily, reducing nursing time for medication administration or the likelihood of missed doses. All NSAIDs …
[ Continue Reading... ]Managing Pain Clinical assessment of elderly patients must attempt to ascertain the presence of pain through both verbalized and nonverbalized symptoms. Selecting an optimal therapy depends on patient-specific criteria, including medical history, previous medications utilized, drug allergies, swallowing ability, and response to therapy. A description of the pain is also useful in determining initial therapy. Nociceptive pain, often the result of chronic or other conditions arising from actual tissue damage as in osteoarthritis, can be described as aching or soreness, rather than sharp pain. Neuropathic pain, arising from damaged nerve tissue, is usually described as burning, stinging or stabbing pain. To adequately manage chronic pain, the clinician should …
[ Continue Reading... ]Older patients have a variety of chronic illnesses that may result in pain. However, the daily presence of pain often goes unrecognized and, therefore, untreated in both the community-dwelling and institutionalized elderly. Chronic pain may be the result of comorbidities, including osteoarthritis, osteoporosis, cancer, peripheral vascular disease, or neuropathies secondary to complications of diabetes. Procedures such as surgery, open wounds and pressure ulcers can also be a source of pain. Identifying and adequately managing pain in the elderly patient presents unique challenges for the pharmacist and the entire healthcare team. The lack of recognition and consequent undertreatment of pain in all patient populations has resulted in new …
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