OPIOID ANALGESICS

CLASSIFICATIONEQUIANALGESIC DOSESOPIOID SUBSTITUTIONOPIOID OVERDOSEADVERSE EFFECTSTOLERANCE, PHYSICAL DEPENDENCEAND PSYCHOLOGICAL DEPENDENCEOPIOPHOBIAWEAK OPIOIDSSTRONG OPIOIDSThe opioid analgesics are...

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NON-OPIOID ANALGESICS

NSAIDsACETAMINOPHEN (PARACETAMOL)NSAIDsThe non-steroidal anti-inflammatory drugs (NSAIDs) are a structurally diverse group of medications that share the ability to inhibit the enzyme prostaglandin synthetase...

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PRINCIPLES OF USING ANALGESICS FOR CHRONIC PAIN

☛   the use of analgesics for the treatment of acute pain is the same as for non-palliative care patients☛   it is the treatment of chronic pain that is often poorly managed and requires...

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GENERAL PRINCIPLES OF TREATMENT

Acute pain☛   treatment of acute pain in palliative care is the same as for patients not requiring palliative care☛   palliative care patients may recover more slowly and require analgesics for longer periods if their general condition is poorIncident pain☛   occurs only in certain circumstances,...

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PAIN ASSESSMENT

Comprehensive clinical assessment is fundamental to successful treatment☛   accept the patient’s description↳ pain is always subjective and patients’ pain is what they say it is and not what...

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FACTORS THAT MODIFY THE PERCEPTION OF PAIN

Pain is always subjective and the perception of pain may be modified by problems or influences related to other physical or psychosocial causes of suffering Pain caused by the disease or treatment...

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CAUSES OF PAIN

In palliative care, there are many different possible causes of painExamples of the causes of pain in palliative care patients include pain☛   due to the primary disease e.g.↳ tumour infiltration↳ nerve compression☛   associated with treatment e.g.↳ diagnostic and staging procedures↳ surgery☛  ...

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TYPES OF PAIN

Definitions☛   Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Pain is always subjective. (International Association for the Study of Pain).☛   Pain is what the patient says hurts. It is what the patient...

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PAIN - INTRODUCTION

Pain is one of the most common symptoms in palliative care. The aim of palliative care is to allow patients to be pain-free or for their pain to be sufficiently controlled that it does not interfere with their ability to function or detract from their quality of life. In palliative care, the treatment of pain needs to...

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JUSTICE AND RESOURCE ALLOCATION

 Justice☛   refers to the equitable allocation of health care resources according to need↳ not according to wealth, class, creed or colour☛   all patients with active, progressive, far-advanced disease and a short life expectancy, for whom the focus of care is the relief and prevention of suffering...

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ETHICS IN RESEARCH

Should terminally ill patients be recruited into clinical trials?☛   Yes, if the trial objective is to improve the quality of life and↳ there is possible benefit↳ the potential for harm is low↳ the patient is fully informed of all that is involved☛   No, if it is a phase 1 trial of an experimental...

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EUTHANASIA AND PHYSICIAN ASSISTED SUICIDE

Euthanasia is a deliberate intervention undertaken with the express intention of ending a life so as to relieve intractable suffering☛   if performed at the person’s request or with their consent, it is voluntary☛   otherwise it is non-voluntaryPhysician-assisted suicide: the physician provides the...

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ARTIFICIAL NUTRITION

The question is whether or not a particular treatment or intervention will restore or enhance the quality of life for a particular patient☛   if the answer is yes, and it can be justified on the best clinical grounds, then it is ethically right to do it☛   if not, it should not be done☛  ...

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ARTIFICIAL HYDRATION

The question is whether or not a particular treatment or intervention will restore or enhance the quality of life for a particular patient☛   if the answer is yes, and it can be justified on the best clinical grounds, then it is ethically right to do it☛   if not, it should not be done☛  ...

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