Workshop Manual - Faculty of pain medicine - Australian and New ...

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Where do analgesics work Local anaesthetics NSAIMs PAIN TREATMENT 22 ESSENTIAL PAIN MANAGEMENT
How do analgesics work Simple analgesics Paracetamol NSAIMs Change prostaglandin levels in the brain Mainly work by changing prostaglandin levels in the periphery, thereby reducing inflammation Opioid analgesics Codeine Morphine, pethidine Acts on opioid receptors in the brain and spinal cord Act on opioid receptors in the brain and spinal cord Other analgesics Amitriptyline Anticonvulsants Local anaesthetics Tramadol Ketamine Increases descending inhibitory signals in the spinal cord “Membrane stabilisers”, probably work by reducing abnormal firing of pain nerves Temporarily block signalling in pain nerves in periphery (e.g. infiltration or nerve block) or spinal cord (e.g. spinal block) Acts weakly on opioid receptors, also increases descending inhibitory signals in the spinal cord Blocks NMDA receptors in the brain and spinal cord (especially in dorsal horn) Clonidine Increases descending inhibitory signals in the spinal cord PAIN TREATMENT ESSENTIAL PAIN MANAGEMENT 23
Page 1: ESSENTIAL PAIN MANAGEMENT Workshop
Page 4 and 5: Essential Pain Management by Wayne
Page 6 and 7: INTRODUCTION Pain affects all of us
Page 8 and 9: WHY SHOULD WE TREAT PAIN CASE 1: Mr
Page 10 and 11: CLASSIFICATION OF PAIN Not all pain
Page 12 and 13: PHYSIOLOGY AND PATHOLOGY Understand
Page 14 and 15: The pain pathway 1. Periphery (Fig
Page 16 and 17: 2. Spinal cord (Fig 4) • The dors
Page 18 and 19: 4. Modulation (Fig 6) • The pain
Page 20 and 21: PAIN TREATMENT Because many factors
Page 22 and 23: Non-drug treatments Both physical a
Page 26 and 27: Drug effectiveness The effectivenes
Page 28 and 29: Possible barriers: • Patient fact
Page 30 and 31: 2. ASSESS To treat pain better, we
Page 32 and 33: 3. TREAT Treatment can be divided i
Page 34 and 35: PAIN MANAGEMENT EXAMPLES EXAMPLE 1:
Page 36 and 37: EXAMPLE 3: 24-year-old woman with a
Page 38 and 39: EXAMPLE 4: 12-year-old girl with bu
Page 40 and 41: EXAMPLE 5: 51-year-old man with 2 y
Page 42 and 43: EXAMPLE 6: 55-year-old woman with m
Page 44 and 45: CASE DISCUSSIONS CASE 1: A 22-year-
Page 46 and 47: CASE 3: A 5-year-old girl has advan
Page 48 and 49: DISCUSSION TOPICS TOPIC 1: Treatmen
Page 50 and 51: APPENDICES Appendix 1: WHO Essentia
Page 52 and 53: Appendix 2: Medicine Formulary for
Page 54 and 55: Pethidine Generally very safe As fo
Page 56 and 57: Appendix 3: Paediatric Medicine Dos
Page 58 and 59: Appendix 5: Using Morphine for Canc

Workshop Manual - Faculty of pain medicine - Australian and New ...

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