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Other analgesic drugs Lactation Dosage adjustment in renal disease Pregnancy Category Maintenance pediatric dose Maintenance adult dose Route Initial adult dose Initial pediatric dose Medication Trade name B Safe if CrCl < 60 ml/min 10–15 mg/kg q4–8 h Tylenol PO 650 mg 10–15 mg/kg 325–1000 mg q4–6 h Acetaminophen (paracetamal) Anticonvulsants C Unknown If CrCl < 60 ml/min 5 mg/kg TID (limited data) 300 mg BID day 2, then 300 mg TID (further titration to 600 mg TID) Gabapentin Neurontin PO 300 mg 5 mg/kg for age > 3 yrs (limited data) C Unknown If CrCl < 60 ml/min Pregabalin Lyrica PO 75–100 mg 100–300 mg divided BID–TID None 100 mg BID D Probably safe 200–400 mg QD–BID Carbamazepine Tegretol PO 100 mg 100 mg for age > 6 yrs (limited data) Antidepressants If CrCl < 25 ml/min Duloxetine Cymbalta PO 60 mg 60 mg QD or BID C Possibly unsafe None 50 mg qHS 1 mg/kg qHS D Probably safe Nortriptyline Pamelor PO 50 mg 1 mg/kg for age > 5yrs
If CrCl < 70 ml/min Venlafaxine Effexor PO 75 mg 75 mg QD–BID C Possibly unsafe Hormones Undefined C Possibly unsafe 200 IU QD (limited data) Calcitonin Fortical IN 200 IU 200 IU (limited data) Undefined C Possibly unsafe May repeat 200 IU dose once 200 IU (limited data) Miacalcin IV 200 IU over 20 min None C Possibly unsafe Acthar IM 40–80 units 40–80 units q8– 12 h to total of 2–3 doses Corticotropin (ACTH) Muscle relaxants 5–10 mg TID 5 mg TID B Unknown None Cyclobenzaprine Flexeril PO 5 mg 5 mg for age > 14 yrs None D Possibly unsafe 2–10 mg TID 0.12–0.8 mg/kg per day div q6h Diazepam Valium PO 2–10 mg 0.12–0.8 mg/ kg per day divided QID Cardiovascular agents C Unknown None Not applicable to ED Nitrostat SL 0.4 mg q5 mins x3 Nitroglycerin (glyceryl trinitrate) C Unknown None Titrate to maximum usual dose of 5 μg/kg per min Titrate to maximum usual dose of 100 μg/ kg per min 0.25–0.5 μg/ kg per min, titrated Tridil IV 5 μg/min, titrated None Metoprolol Lopressor PO 25–50 mg 50–200 mg BID C Probably safe None IV 5 mg IV C Probably safe
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Emergency Department Analgesia An E
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Contents List of contributors page
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Tension-type headache 384 Trigemina
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Michel Galinski, MD Attending Physi
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Benjamin A. White, MD Resident, Har
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xiv Foreword code to light up the p
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xvi Foreword The authors of the boo
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Preface A typical shift in the Emer
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Acknowledgments Many thanks to this
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General considerations
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4 Introduction and general approach
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10 Assessment of pain CATHERINE A.
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12 Assessment of pain n Pain assess
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14 Assessment of pain The Face, Leg
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16 Assessment of pain 3. Silka P, R
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18 Assessment of pain 33. Melzack R
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20 Prehospital analgesia and protoc
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22 Prehospital analgesia prehospita
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24 Prehospital analgesia care provi
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26 Prehospital analgesia EMS settin
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28 Prehospital analgesia 18. Kurtz
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30 Prehospital analgesia 48. Helm M
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32 Epidemiologic overview of ED pai
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42 Geriatric analgesia ULA HWANG AN
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44 Geriatric analgesia physiologic
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46 Geriatric analgesia Analgesic ap
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48 Geriatric analgesia The common e
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50 Geriatric analgesia 12. Hohl C,
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52 Chronic pain DAVID CLINE AND STE
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54 Chronic pain care providers, it
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56 Chronic pain the agent’s monoa
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58 Chronic pain be in the ED record
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60 Chronic pain 7. Freynhagen R, Bu
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62 NSAIDs and opioids applicable sa
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64 NSAIDs and opioids We believe th
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66 NSAIDs and opioids well-demonstr
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68 NSAIDs and opioids 5. Navascues
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70 Nonstandard medication delivery
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78 Reflections on ED analgesia of u
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80 Reflections on ED analgesia para
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82 Reflections on ED analgesia chem
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Chief complaints and diagnoses
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88 Abdominal aortic aneurysm occurs
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90 Abdominal aortic aneurysm 19. Le
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92 Aortic dissection Citing sedativ
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94 Arthritis TODD M. LISTWA AND STE
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96 Arthritis NSAIDs may be safer th
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98 Arthritis for patients with high
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100 Arthritis rofecoxib, ordiclofen
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102 Arthritis For breakthrough pain
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104 Arthritis Pediatric: NSAID (e.g
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106 Arthritis 13. Hur C, Chan AT, T
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108 Arthritis 38. Curtis SP, Ko AT,
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110 Arthritis 63. Bliddal H, Tersle
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112 Biliary tract pain A retrospect
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114 Biliary tract pain n Summary an
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116 Biliary tract pain 20. Malesci
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118 Bites and stings - marine enven
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120 Bites and stings - marine jelly
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122 Bites and stings - marine 11. C
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124 Bites and stings - terrestrial
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134 Breast pain COX-2 selective NSA
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136 Breast pain Pregnancy: acetamin
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138 Burns JEREMY ACKERMAN AND ADAM
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140 Burns for moderate-to-severe bu
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142 Burns References 1. Singer AJM,
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144 Burns 30. Patterson DR, Ptacek
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146 Bursitis and periarticular infl
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152 Cancer and tumor pain bony (or
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154 Cancer and tumor pain (20 mg ev
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156 Cancer and tumor pain existing
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158 Cancer and tumor pain n Summary
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160 Cancer and tumor pain 21. Carac
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162 Cardiac chest pain KALANI OLMST
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164 Cardiac chest pain has traditio
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166 Cardiac chest pain Practice Gui
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168 Chest wall trauma MICHEL GALINS
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170 Chest wall trauma NSAIDs. As is
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172 Chest wall trauma n Summary and
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174 Chest wall trauma 21. Seltzer J
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176 Chronic low-back pain limited t
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178 Chronic low-back pain n Summary
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180 Cluster headache SOHAN PAREKH A
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182 Cluster headache n Summary and
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184 Corneal abrasion LISA CALDER n
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186 Corneal abrasion 6. Patrone G,
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188 Cystitis, urethritis, and prost
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194 Dysmenorrhea to that achieved w
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196 Dysmenorrhea 12. Fine PG. The r
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198 Endometriosis by 50-74% compare
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200 Esophageal spasm KALANI OLMSTED
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202 Esophageal spasm via central mo
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204 Fibromyalgia MICHAEL WALTA AND
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206 Fibromyalgia A multicenter plac
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208 Fibromyalgia n Summary and reco
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210 Fibromyalgia 15. Sayar K, Aksu
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212 Fibromyalgia 41. Russell IJ, Mi
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214 Gastritis and peptic ulcer dise
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226 Gastroesophageal reflux disease
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232 Hemorrhoids and perianal pain B
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234 Hemorrhoids and perianal pain a
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236 Hemorrhoids and perianal pain t
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238 Hemorrhoids and perianal pain C
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240 Hemorrhoids and perianal pain 9
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242 Hemorrhoids and perianal pain 3
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244 Migraine and undifferentiated h
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254 Mucositis and stomatitis KELLY
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256 Mucositis and stomatitis eviden
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258 Mucositis and stomatitis above)
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260 Mucositis and stomatitis 5. Dem
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262 Mucositis and stomatitis 30. Mu
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264 Neck and back pain - mechanical
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266 Neck and back pain - mechanical
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268 Neck and back pain - radicular
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274 Neck and back pain - spinal spo
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276 Neck and back pain - spinal spo
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278 Neuropathy - complex regional p
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280 Neuropathy - diabetic DAVID CLI
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282 Neuropathy - diabetic n Summary
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284 Neuropathy - diabetic 16. Lesse
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286 Neuropathy - HIV related 3600 m
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288 Neuropathy - HIV related 12. Le
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290 Neuropathy - overview OVER-THE-
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292 Neuropathy - overview The TCAs,
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294 Neuropathy - overview Gabapenti
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296 Neuropathy - overview However,
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298 Neuropathy - overview Reference
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300 Neuropathy - overview 27. Wiffe
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302 Neuropathy - phantom limb pain
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304 Neuropathy - phantom limb pain
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306 Ocular inflammation STEPHEN H.
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308 Ocular inflammation Other RCT d
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310 Ocular inflammation Pregnancy:
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312 Ocular inflammation 20. Frucht-
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314 Odontalgia MICHAEL T. SCHULTZ A
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316 Odontalgia 100 mg caffeine and
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318 Odontalgia TOPICAL THERAPY Topi
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320 Odontalgia 4. Cooper SA, Engel
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322 Odontalgia 32. Sveen OB, Yaekel
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324 Orthopedic extremity trauma inf
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326 Orthopedic extremity trauma The
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328 Orthopedic extremity trauma fem
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330 Orthopedic extremity trauma 35.
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332 Osteoporotic vertebral compress
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334 Osteoporotic vertebral compress
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336 Otitis media and externa benefi
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338 Otitis media and externa 5. Var
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340 Pancreatitis (which lacks effec
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342 Pancreatitis 5. Hubbard GP, Wol
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344 Pharyngitis KELLY YOUNG n Agent
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346 Pharyngitis complete pain relie
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348 Pharyngitis 7. Blagden M, Chris
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350 Pharyngitis 31. Shi Y, Gu R, Li
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352 Postdural puncture headache Cas
Page 378 and 379: 354 Post-herpetic neuralgia JEREMY
Page 380 and 381: 356 Post-herpetic neuralgia virtual
Page 382 and 383: 358 Post-herpetic neuralgia 11. Raj
Page 384 and 385: 360 Renal colic scores. 3 The Cochr
Page 386 and 387: 362 Renal colic References 1. O’C
Page 388 and 389: 364 Sialolithiasis n Summary and re
Page 390 and 391: 366 Sickle cell crisis concluded th
Page 392 and 393: 368 Sickle cell crisis One potentia
Page 394 and 395: 370 Sickle cell crisis titrated in
Page 396 and 397: 372 Sickle cell crisis but acute ca
Page 398 and 399: 374 Sickle cell crisis treatment ti
Page 400 and 401: 376 Sickle cell crisis 3. Dunlop RJ
Page 402 and 403: 378 Sickle cell crisis Disease-rela
Page 404 and 405: 380 Temporomandibular disorders NAT
Page 406 and 407: 382 Temporomandibular disorders n S
Page 408 and 409: 384 Tension-type headache SOHAN PAR
Page 410 and 411: 386 Tension-type headache for TH, b
Page 412 and 413: 388 Tension-type headache 18. Lance
Page 414 and 415: 390 Trigeminal neuralgia as the ini
Page 416 and 417: 392 Undifferentiated abdominal pain
Page 422 and 423: Tables
Page 424 and 425: Selected nonsteroidal anti-inflamma
Page 426 and 427: Selected opioids Maintenance pediat
Page 430 and 431: Other analgesic drugs (cont.) Lacta
Page 432: Other analgesic drugs (cont.) Lacta
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