Pain control: Difference between revisions
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| Acetaminophen | | [[Acetaminophen]] | ||
| 650mg q4-q6h prn or 1000mg q6h prn | | 650mg q4-q6h prn or 1000mg q6h prn | ||
| - | | - | ||
|- | |- | ||
| Aspirin | | [[Aspirin]] | ||
| 650mg q4-6h prn or 1000mg q6h prn | | 650mg q4-6h prn or 1000mg q6h prn | ||
| - | | - | ||
|- | |- | ||
| Ibuprofen<span class="Apple-tab-span" style="white-space:pre"> </span> | | [[Ibuprofen]]<span class="Apple-tab-span" style="white-space:pre"> </span> | ||
| 400-800mg q6-8h prn | | 400-800mg q6-8h prn | ||
| - | | - | ||
|- | |- | ||
| Gabapentin (neuropathic Pain) | | [[Gabapentin]] (neuropathic Pain) | ||
| Start 300mg qhs | | Start 300mg qhs | ||
| - | | - | ||
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|- | |- | ||
| Hydrocodone (5mg/Acetaminophen 325mg) | | Hydrocodone (5mg/[[Acetaminophen]] 325mg) | ||
| 1-2 tabs PO q4-6h prn | | 1-2 tabs PO q4-6h prn | ||
| - | | - | ||
|- | |- | ||
| Oxycodone (5mg/ | | [[Oxycodone]] (5mg/A[[cetaminophen]] 325mg) | ||
| 1-2 tabs PO q4h prn | | 1-2 tabs PO q4h prn | ||
| - | | - | ||
|- | |- | ||
| Oxycodone(Oxycontin) | | [[Oxycodone]] (Oxycontin) | ||
| 5mg q4-6h | | 5mg q4-6h | ||
| - | | - | ||
|- | |- | ||
| Tramadol | | [[Tramadol]] | ||
| 50-100mg q4-6h (max 400mg/day) | | 50-100mg q4-6h (max 400mg/day) | ||
| - | | - | ||
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| Morphine | | [[Morphine]] | ||
| 10-30mg q3-4h | | 10-30mg q3-4h | ||
| 0.1-0.2 mg/kg(up to 15mg q4h) | | 0.1-0.2 mg/kg(up to 15mg q4h) | ||
|- | |- | ||
| Morphine(controlled release) | | [[Morphine]] (controlled release) | ||
| Start 30mg q8-12h , increase prn to 90-120mg q12h | | Start 30mg q8-12h , increase prn to 90-120mg q12h | ||
| - | | - | ||
|- | |- | ||
| Fentanyl | | [[Fentanyl]] | ||
| - | | - | ||
| 0.1mg q1-3h | | 0.1mg q1-3h | ||
|- | |- | ||
| [[Hydromorphone]](Dilaudid) | | [[Hydromorphone]] (Dilaudid) | ||
| 2-4mg q4-6h | | 2-4mg q4-6h | ||
| 1-4mg q4-6h<br> | | 1-4mg q4-6h<br> | ||
Revision as of 14:53, 10 June 2015
| Agent | Oral | Parenteral |
|---|---|---|
| Step1. Mild Pain, Nonopiod, +/- Adjuvant | ||
| Acetaminophen | 650mg q4-q6h prn or 1000mg q6h prn | - |
| Aspirin | 650mg q4-6h prn or 1000mg q6h prn | - |
| Ibuprofen | 400-800mg q6-8h prn | - |
| Gabapentin (neuropathic Pain) | Start 300mg qhs | - |
| Step2. Mod Pain, Opiod for mild/mod pain, +/-nonopiod, +/-Adjuvant | ||
| Hydrocodone (5mg/Acetaminophen 325mg) | 1-2 tabs PO q4-6h prn | - |
| Oxycodone (5mg/Acetaminophen 325mg) | 1-2 tabs PO q4h prn | - |
| Oxycodone (Oxycontin) | 5mg q4-6h | - |
| Tramadol | 50-100mg q4-6h (max 400mg/day) | - |
| Step3. Severe Pain, Opiod for mod/sev pain, +/- nonopiod, +/-Adjuvant | ||
| Morphine | 10-30mg q3-4h | 0.1-0.2 mg/kg(up to 15mg q4h) |
| Morphine (controlled release) | Start 30mg q8-12h , increase prn to 90-120mg q12h | - |
| Fentanyl | - | 0.1mg q1-3h |
| Hydromorphone (Dilaudid) | 2-4mg q4-6h | 1-4mg q4-6h |
| Levorphanol | 2mg q6-8h |
2mg q6-8h |
^In elders had a bulk laxative & instructions regarding activity, hydration and close f/u
References
- World Health Organization 3-Step Analgesia Ladder for Cancer & Washington Manual Intership Survival Guide, 2008