TY  - CHAP
M1  - Book, Section
TI  - Pain Management
A1  - Herndon, Chris M.
A1  - Strickland, Jennifer M.
A1  - Ray, James B.
A2  - DiPiro, Joseph T.
A2  - Talbert, Robert L.
A2  - Yee, Gary C.
A2  - Matzke, Gary R.
A2  - Wells, Barbara G.
A2  - Posey, L. Michael
PY  - 2017
T2  - Pharmacotherapy: A Pathophysiologic Approach, 10e
AB  - Patient  Care  Process  for  the  Management  of  PainCollectPatient-specific  characteristicsPain  and  symptom-specific  history  (e.g.,  onset,  location,  duration,  characteristics,  aggravating  factors,  alleviating  factors,  timing,  and  severity).Patient  history  including  current  and  past  medications,  allergies  or  medication  intolerance,  and  pertinent  social  history  (e.g.,  tobacco,  alcohol,  or  recreational  drug  use)Family  history  of  illness,  focusing  on  symptoms  and  social  behavior  (e.g.,  alcoholism,  recreational  drug  use)Objective  data  including  vital  signs,  pertinent  labs,  targeted  physical  exam,  and  drug  screen  resultsAssessPresence  of  co-occurring  mental  health  conditions  (i.e.,  depression,  anxiety,  or  bipolar)  which  may  confound  treatment  decisionsAberrant  drug  taking  behaviors  as  evidenced  by  prescription  drug  monitoring  programs  (PDMP),  urine  drug  screen  results,  and  validated  risk  screening  toolsRelative  or  absolute  contraindications  to  the  use  of  opioids,  acetaminophen,  antidepressants,  anticonvulsants,  nonsteroidal  anti-inflammatory  drugs,  or  skeletal  muscle  relaxantsPotential  drug  interactions  with  any  additions  or  deletions  to  drug  therapyChronicity  of  pain  symptom  (e.g.,  acute  or  chronic),  likely  etiology  (e.g.,  neuropathic,  musculoskeletal,  or  visceral),  and  severity  (Figure  60-2)Determine  patient's  insurance  coverage/ability  to  pay  before  making  modifications  to  therapy.PlanPatient  and  symptom-specific  lifestyle  modification  (e.g.,  weight  loss,  smoking  cessation,  self-pacing,  and  pain-trigger  avoidance)Nonpharmacologic  treatment  modalitiesDrug  therapy  regimen  including  dose,  route,  frequency,  and  duration  (Figure  60-3)Monitoring  drug  therapy  regimen  including  efficacy,  toxicity,  misuse,  and  ongoing  necessity  using  tools  such  as  urine  drug  screening,  PDMP,  and  risk  assessment  toolsPatient  education  on  safe  use,  storage,  disposal,  and  risk  mitigation  following  formal  risk  evaluation  and  mitigation  strategies  when  availableImplementEducate  patient  and/or  caregiver  regarding  all  elements  of  disease  process  and  treatment  plan,  ensuring  patient  and/or  caregiver  understandingInformed  consent,  including  pain  or  treatment  agreements  when  necessarySchedule  follow-upFollow-up:  Monitor  and  EvaluateAssess  attainment  of  treatment  goals  (e.g.,  improved  activity,  improved  sleep,  improved  work  attendance)Presence  of  adverse  effects  or  aberrant  drug  taking  behaviorsCompletion  of  validated  risk  assessment  toolsFrequent  review  of  PDMPPatient  adherence  to  all  facets  of  treatment  plan,  including  nonpharmacologic  modalities  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - accesspharmacy.mhmedical.com/content.aspx?aid=1148575483
ER  -