癌痛的护理(英文版).pptVIP

Pharmacological Interventions Opioids: for moderate or severe pain Agonists Agonists-antagonists Nonopioids: Used alone or in conjunction with opioids for mild to moderate pain Acetaminophen NSAIDS(Non-Steroid Anti-Inflammtory Drugs. NSAIDS ) Adjuvants: Used for analgesic reasons and for sedation and reducing anxiety. Multipurpose Tri-cyclic antidepressants Anticonvulsants Pharmacologic interventions Non-opioids:Used alone or in conjunction with opioids for mild to moderate pain Acetominophen (Tylenol) Aspirin NSAIDs (Advil) Opioids :for moderate or severe pain Weak ? Strong Codeine ? Hydromorhone Oxycodone ? Morphine Vicodin ? Merperidine Adjuvants:Used for analgesic reasons and for sedation and reducing anxiety. Primary function is not pain relief but provide relief May modify mood so patient feels better Pain Management Routes of medication administration Oral Injection Intravenous (includes PCA) Epidural Rectal Topical Pain Management Concepts of WHO Pain Ladder By the mouth By the clock By the ladder For the individual With attention to detail Pain Management SEVERE PAIN: Keep giving mild pain medication and add a strong opioid such as morphine or Fentanyl MODERATE PAIN: Keep giving mild pain medication and add a mild Opioid such as codeine MILD PAIN: Aspirin, ibuprophen Acetominophen, naprosyn W.H.O. ANALGESIC LADDER +/- adjuvant Non-opioid Weak opioid Strong opioid Pain persists or increases By the Clock W.H.O. ANALGESIC LADDER +/- adjuvant +/- adjuvant 1 2 3 Non-opioid analgesics Pharmacologic interventions Transdermal routes: Fentanyl Transdermal System the fentanyl transdermal therapeutic system dosing interval is usually 72 hours Pharmacologic interventions Pain Management Opioid analgesics fentanyl and buprenorphine are the opioids for transdermal administration. The system has been demonstrated to be effective in post-operative pain and cancer pain the fentanyl transdermal therapeutic system dosing interval is u