Managing Chronic Pain

Course overview

RX/NP Objectives 1.Describe the differences among chronic pain classifications. Describe the general treatment approach for noncancer pain. 2. Describe how COX selectivity relates to the potential toxicity of different NSAIDs and list major precautions for all NSAIDs. 3. Name 4 antidepressants and 3 anticonvulants that may be effective for certain types of chronic pain; list precautions and potential side effects for each. 4.Explain how different chemical structures of opioids contribute to their clinical effects. Advise other providers and patients regarding opioid side effects, drug-drug interactions, pharmacogenomic variability, and opioid rotation. Tech Objectives 1. Describe the side effects all nonsteroidal anti-inflammatory drugs (NSAIDs) share. Provide an example of an NSAID that is a COX-2 selective inhibitor. List the side effects that may be more likely with this NSAID compared with a non-COX-2 selective NSAID. 2. List 2 commonly used tricyclic antidepressants (TCAs) and 2 serotonin-norepinephrine reuptake inhibitors (SNRIs) used for neuropathic pain; describe common side effects of each. 3. State the generic and brand names of the 2 anticonvulsants most commonly prescribed for neuropathic pain. List 2 side effects of each. 4. List the generic and brand names of opioids used for chronic pain. Describe the side effects that are common to all opioids, including potentially serious effects. Recognize major drug interactions that can increase the toxicity of some opioids.