Bpm2011_flyer_print3.indd

BEDSIDE PAIN MANAGER Conversions & Information
for Pain and Symptom Control
Here’s a look at partial contents of some of the sections in the 2011 BEDSIDE PAIN MANAGER.
.6"(0/*4501*0*%
# Tabs or mLs
Equivalent
ANALGESIC CHART
to convert to
duragesic
duration: Onset:
Information in columns to the right is based on the ÀUVW GRVDJH LQ EROG
morphine 25 mcg patch
6000 mg Cost
OXYCODONE: (not available for injection)
2[\,5 JHQHULF ² oxycodone 5 mg (5, 10, 15, 20, 30 mg)
2[\&RQWLQ ² CR ² oxycodone 10 mg (10, 15, 20, 30, 40, 60, 80, mg ER)
Combunox, generic - oxycodone 5 mg/ibuprofen 400 mg
*710&26*"/"-(&4*$$)"35
analgesic
Starting
Duration:
Values are approximate; use only as a guideline.
HYDROMORPHONE: IV/IM/SC
'LODXGLG ² liquid ² 1 mg/1 mL
generic ² suppository ²  PJ
NSAID CHART
Generic name in bold (Brand name and how supplied in parentheses;
starting
schedule:
Half-life:
brands in color are discontinued, left in to aid with recognition) naproxen/esomeprazole DR (Vimovo 375/20, Vimovo 500/20) BID AC
esomeprazole (Nexium) is gastroprotective SELECTIVE COX-2 AGENT: less effect on bleeding mechanisms than
non-COX-2 drugs
celecoxib (Celebrex 50, 100, 200, 400 mg)
Starting
ADJUVANT MEDS:
Transmucosal Fentanyl Products
‡ tapentadol (Nucynta 50, 75, 100 mg) 50-100 mg q 4-6 h; also
available Nucynta ER 50, 100, 150, 200, 250 mg BID.$$$$ Onsolis - buccal strip200, 400, 600, 800, 1200 mcg PAIN MANAGEMENT PEARLS
1. “Pain is whatever the experiencing person says it is, existing whenever CAUTION: See pkg insert for individual dosing instructions. Half-life is dose related. Transmucosal fentanyl products are not bioequivalent; use
he says it does.” Margo McCaffery 3-McCaffery, p. 17
caution if switching between products. Strongly contraindicated for use 10. Hydromorphone (Dilaudid): better drug choice for patients with outside clinical setting for opioid-naive patients; respiratory depression may be severe and persist longer than analgesia.
UHQDO LQVXIÀFLHQF\ GXH WR LW·V VKRUW KDOIOLIH  KUV DQG QR DFWLYH
metabolites. 3-McCaffery, p. 226
Naloxone (Narcan) Guidelines
36. Steady state is achieved when the rate of excretion of a drug equals the rate of intake, usually after 5 doses. Half-life must be considered. ‡ naloxone (0.4 mg/mL, 1 mg/mL) - give 0.4 -2 mg IV q2-3 min prn The full effects of a change in dose will not be seen until 4-5 half-lifes up to 10 mg; give IM/SC if IV route not available; supplemental have occurred. Patients must be monitored closely during this time for IM doses last longer; may dilute 0.4 mg in 10 mL and give 0.5 mL signs of overdose: sedation and respiratory depression. 3-McCaffery, pp.
in q 1 minute increments to avoid abrupt cessation of pain control 169-170; 7-Wrede-Seaman, p. 183
NAUSEA – Consider:
40. Non-drug approaches to pain, consider: TENS unit (not recommended with pacemaker), heat or cold, or alternating heat and cold, massage, ‡ granisetron (Kytril).parenteral, liquid
bath/hot tub, changing position, meditation, acupuncture .
3. The Hopkins Opioid Program has a free and easy to use online transdermal (Sancuso 3.1 mg) 1 patch q 24 h.$$$$ opioid conversion tool. Sign-in is required. www.hopweb.org "/"-(&4*$.&%*$"5*0/4t1304$0/40'"7"*-"#-&3065&4
Oral – Long-Acting
PRO CON
‡ (DV\ WR WDNH SDWLHQW KDV WRWDO FRQWURO ‡ )UHTXHQWO\ FDXVHV QDXVHD DQG YRPLWLQJ IRU ÀUVW IHZ GD\V ‡ (YHQ DQDOJHVLD OHVV SHDN DQG WURXJK HIIHFW ‡ &DQ YDU\ WKH GRVH RQ D UHJXODU EDVLV ² ‡ &DQ EH XVHG UHFWDOO\ KHOSIXO LQ FULVHV

Source: http://bedsidepainmanager.com/PDFS/BPM2011_flyerpg2.pdf

anaesthesie.charite.de

Dr. Ruth Zaslansky Curriculum Vitae 2009 - Pain-Out Project Manager (Science), EU PF7 project, Klinik für Anaesthesiologie und operative Intensivmedizin, Universitätsklinikum Jena, Friedrich-Schiller-Universität, Jena. Research associate, Klinik für Anaesthesiologie und operative intesivmedizin, Freie Universität Berlin and Charité-Universitätsmedizin, Campus Benjamin Franklin, Berli

Esther

.growing followers of Jesus Esther “For such a time as this…” western blacktown presbyterian church .growing followers of Jesus For Western Blacktown Presbyterian Church The author mentions three separate times that the Jews did not lay their hands on their enemies' plunder. Why might the Jews have left the plunder despite the king's 13. Mordecai and Esther proclaime

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