Analgesics
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Analgesics. Those who do not feel pain seldom think it is felt. Samuel Johnson. Pain. Pain is subjective and difficult to quantify Pain scale, 1-10 McGill Pain Q. Analog scale. Patient Responses. MD & ATC must accept patients response to pain Must be observant

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Analgesics


Those who do not feel painseldom think it is felt

Samuel Johnson


Pain

  • Pain is subjective and difficult to quantify

    • Pain scale, 1-10

    • McGill Pain Q.

    • Analog scale


Patient Responses

  • MD & ATC must accept patients response to pain

    • Must be observant

    • Does injury match pain level reported?

    • Know athlete & personality


Pain Management

  • Must be individualized to patient based on:

    • Cause

    • Severity of pain

    • Chronicity


Chronic Pain Syndrome

  • Must evaluate especially non-athletes

    • workers comp

  • Emotional state

  • Personality


Non-Pharm Alternatives

  • TENS

  • Electric Stimulation

  • Relaxation Therapy

  • Nerve Block


Analgesics

  • MILD - TX of mild to moderate pain

    • Dec. sensitivity of pain receptors

    • Minor side effects

  • STRONG - TX of moderate to severe pain

    • Inc pain tolerance


Contain different compounds for short and long lasting relief

Strong Anagelsics will produce pain tolerance and dependence w/n 1 week

Anagelsics


Admin Methods

  • Oral

  • Injection

  • IV - Continuous or intermittent


Narcotic

Morphine

Codeine

Propoxyphene

Oxycodone

Meperidine

Pentazocine

Non-Narcotic

Aspirin

Acetaminophen

Ibuprofen

Common Analgesics


Acetaminophen

  • Tylenol or Datril

  • Antipyretic & analgesic effects

  • Minimal AI activity

  • Minimal side effects


Narcotic Analgesics

  • Pharmacologically similar to opium or morphine

  • Primary analgesics but can be used for cough suppressants and control diarrhea

  • Provides analgesia w/o antipyretic effect

  • Common error - overestimation of the drug needed for analgesia


Peak Analgesia

  • Oral Dose

    • 1-2 hours

  • Duration of Action

    • 3-6 hours

  • Tissue build-up normally does not occur

  • Metabolized in the liver


Codeine

  • Given in combination w/ aspirin or acetaminophen

  • Tylenol 3 or Tylenol 4

  • Provides enhanced pain relief

  • Used as cough suppressant


Pain Relief

30-60 mg

Cough Suppressant

15-30 mg

Codeine Dosage


Nausea

Vomiting

Dizziness

Mental clouding

Dysphoria

Constipation

Delirium

Addiction

Withdrawal

Seizures

Adverse Effects


Drug seeking behavior

Lacrimation

Phinorrhea

Yawning

Sweating

Restlessness

Mydriasis

Tremors

Nausea

Tachycardia

MM cramps/spasms

General CNS hyperexcitability

Potential CV collapse

Withdrawal Symptoms


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