Once your pain management team is in place, you can work together to create a plan that anticipates every level of pain and institutes measures for alleviating it. Remember, the key to effective pain management is early intervention — and that starts with you. You need to inform your team when you’re hurting, where, and how much. This is why being able to talk with them comfortably and candidly is so important. (We’ve provided tools ahead that might help with this conversation.)
As you meet with your team members, you might want to share with them the following pain management model. It establishes a continuum of care to track with pain that ranges from mild to severe.
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Complementary and alternative therapies: We recommend CAM therapies as a starting point because they are the least toxic. Your body will be exposed to plenty of toxins during cancer treatment; it doesn’t need more. Also, with CAM therapies, you spare your body from the side effects of yet another medication. Acupuncture, chiropractic, hypnosis, massage, and meditation are among the options that have proven successful in controlling pain.
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Psychotropic drugs: Mediated via neurotransmitters, these medications help manage emotional distresses like depression and anxiety, both of which aggravate pain. Since scientists have determined that neurotransmitters inhabit the entire body, not just the brain, psychotropics have become some of the most frequently prescribed drugs for pain management.
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Over-the-counter medications: Among the most common OTC pain relievers are acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen. They may be enough to alleviate mild pain.
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Low-dose opioids: Seventy to 90 percent of cancer patients control moderate pain with oral opioids such as Darvon, Percodan, and Percocet. The long-term use of these medications has not been shown to worsen pain. If that should happen in individual cases, the patients may be advised to switch to an opioid other than the one they have been using.
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Slow-or fast-release opioids: Perhaps the best known of the opioids is morphine, which is sold under several brand names. It’s the most commonly prescribed medication for severe pain and is available in slow-or fast-release forms. Other slow-release opioids, which tend to have longer-lasting effects, include Fentanyl, Levorphanol, methadone, MS Contin, and Oramorph. In the fast-release category are codeine, hydromorphone, and oxycodone. When taken as prescribed, opioids — though quite potent — rarely lead to addiction.
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Invasive procedures: For acute pain and some chronic pain, a nerve block can provide temporary relief. In this procedure, the physician injects a local anesthetic into or around nerves or below the skin at the site of pain. The anesthetic interrupts the transmission of pain signals to the brain, providing relief for up to several hours. In some instances where drug therapy is ineffective, the pain pathways may be redirected or severed through surgery or controlled with implanted devices.
Reprinted from: When It’s Cancer: The 10 Essential Steps to Follow After Your Diagnosis by Toni Bernay, PhD, and Saar Porrath, MD (March 2006; $15.95US/$22.95CAN; 1-57954-823-7) © 2006 Toni Bernay, PhD Permission granted by Rodale, Inc., Emmaus, PA 18098. Available wherever books are sold or directly from the publisher by calling (800) 848-4735 or visit their website at www.rodalestore.com.
Watch the video related to drug therapy management
Chronic obstructive pulmonary disease (COPD) refers to chronic bronchitis and emphysema, a pair of two commonly co-existing diseases of the lungs in which the airways become narrowed. This leads to a limitation of the flow of air to and from the lungs causing shortness of breath. In contrast to asthma, the limitation of airflow is poorly reversible and usually gets progressively worse over time. COPD is caused by noxious particles or gases, most commonly from smoking, which trigger an abnormal inflammatory response in the lung. The inflammatory response in the larger airways is known as chronic bronchitis, which is diagnosed clinically when people regularly cough up sputum. In the alveoli, the inflammatory response causes destruction of the tissues of the lung, a process known as emphysema. The natural course of COPD is characterized by occasional sudden worsenings of symptoms called acute exacerbations, most of which are caused by infections or air pollution. The diagnosis of COPD requires lung function tests. Important management strategies are smoking cessation, vaccinations, rehabilitation, and drug therapy (often using inhalers). Some patients go on to requiring long-term oxygen therapy or lung transplantation. Worldwide, COPD ranked sixth as the cause of death in 1990. It is projected to be the third leading cause of death worldwide by 2020 due to an increase in smoking rates and demographic changes in many countries.[2] COPD is the 4th leading cause of death in the <b>…</b>
Help answer the question about drug therapy management
Can a therapist tell on you for drug use?I am 13 years old and recently started therapy. I really need to tell my therapist about my excessive drug use–which I recently quit, anyway. But I have to talk about it no matter what–but I'm afraid of her telling my mom. Does the patient-therapist confidentiality thing cover this?
She's a therapist at Waukesha Stress Management Clinic if that helps. Wellman-Krause is her name, if any of you know her :/
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