Long-Term Care Medicine by Pamela Ann Fenstemacher & Peter Winn

Author:Pamela Ann Fenstemacher & Peter Winn
Language: eng
Format: epub
Publisher: Humana Press, Totowa, NJ

Opioid Analgesics

Opioids are both appropriate and effective for the treatment of moderate to severe acute or chronic pain not relieved by other analgesics or modalities. Judicious prescribing can provide effective pain management in the various patient populations served by LTC medicine with a low likelihood of psychological dependency or addiction. Scheduled low doses of opioids can be very effective in the treatment of chronic pain associated with various chronic musculoskeletal conditions that afflict the elderly. Be aware that physical dependency, characterized by withdrawal symptoms, can occur when regularly scheduled opioids are abruptly discontinued. Gradual dose reduction can prevent this if an opioid is to be discontinued.

General guidelines to the use of opioids include:

For acute pain: start by prescribing an immediate-release opioid preparation (see Table 8.8 for suggested equianalgesic starting doses).Table 8.8.Suggested equianalgesic starting doses for selected oral opioids

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