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Prescribing analgesia

Prescribing analgesia. Objectives. By the end of the session you will be able to: Describe the WHO stepwise approach to pain control Identify which patients most commonly require opioid analgesia Explain how to start and titrate analgesia

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Prescribing analgesia

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  1. Prescribing analgesia

  2. Objectives • By the end of the session you will be able to: • Describe the WHO stepwise approach to pain control • Identify which patients most commonly require opioid analgesia • Explain how to start and titrate analgesia • Demonstrate safe and effective analgesic prescribing for a patient

  3. Activity How much do you know about the WHO analgesic ladder?

  4. Step 1

  5. Step 2

  6. Step 3

  7. Opioids • Who needs opioid analgesia?

  8. Opioids Starting an opioid... What do we need to consider?

  9. Breakthrough pain “Brief self-limiting exacerbation of severe pain” Prescribe rescue doses of immediate release morphine for breakthrough pain 1/10th – 1/6th total daily dose of morphine when required Maximum dose?

  10. Side effects Nausea and vomiting Constipation Drowsiness Dry mouth Pruritis

  11. Prescribing case • Patrick Jessop is a 50 year old man admitted with increasing back pain. You see from his medical notes that the pain is a result of an RTA a year ago. • PMH: Asthma • DH: Salbutamol MDI 2p QDS Paracetamol 1g QDS Codeine 30mg QDS PRN • Prescribe his regular medicines and review his pain relief

  12. Part 2 You have started Patrick on analgesia from step 2 of the analgesic ladder but he is still scoring 8/10 on a pain score Review his analgesia and prescribe appropriately

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