* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Pain Management clinical protocol MMC.docx
Survey
Document related concepts
Compounding wikipedia , lookup
Neuropharmacology wikipedia , lookup
Pharmacognosy wikipedia , lookup
Pharmaceutical industry wikipedia , lookup
Drug interaction wikipedia , lookup
Prescription drug prices in the United States wikipedia , lookup
Prescription costs wikipedia , lookup
Drug design wikipedia , lookup
Drug discovery wikipedia , lookup
Pharmacovigilance wikipedia , lookup
Theralizumab wikipedia , lookup
Pharmacogenomics wikipedia , lookup
Transcript
Nurse Practitioner CLINICAL PROTOCOL Pain management Murray Medical Centre Mandurah will adopt the following guidelines from the RACGP: 1. Medical Care of older persons in Residential Aged Care facilities: pain management. NOTE: References to the prescription and administration of Schedule 8 medication in any of these protocols are outside the scope of practice of a Nurse Practitioner. Patients requiring these medications will be referred to their current GP for further advice and treatment options. Goals of Treatment • Relief of symptoms • Prevention of recurrence • Prevention of complications Drug Formulary FORMULARY PARACETAMOL Drug (generic name): Paracetamol Drug: Ibuprofen IBUPROFEN Therapeutic class: Analgesic, antipyretic Therapeutic class: Analgesic, antipyretic, NSAID (non - Dosage range: 500mg – 1G selective) Route: Oral Dosage range: 200-400mg Frequency of administration: 4-6 hourly, max 4G in 24 hours Route: Oral Duration of order: as required Frequency of administration: 6 hourly, max 2400mg in 24 Contraindications for use: nil – caution in pt. with liver disease hours Adverse drug reactions: Rare – rash, drug fever, mucosal Duration of order: as required lesions, neutron/pancyto/thrombocytopenia Contraindications: care with asthmatic pts., may reduce the antiplatelet activity of aspirin (choose an alternative if long term therapy required). Adverse drug reactions: bronchospasm, GI bleeding, nausea, HT Nurse Practitioner CLINICAL PROTOCOL Pain management PANADOL OSTEO Drug: paracetamol PANADEINE FORTE Drug: Paracetamol and Codeine Therapeutic class: Slow release analgesic, antipyretic Therapeutic class: non-opioid analgesic Dosage range: 665mg / tab. 2 tablets. Max 3990mg/day Dosage range: paracetamol 500mg / codeine 30mg per Route: Oral tablet. 1-2 tabs, max 8 tablets daily Frequency of administration: 6-8 hourly Route: Oral Duration of order: As required Frequency of administration: 4-6 hourly if required Contraindications: chronic liver disease Duration of order: as required Adverse drug reactions: Rare – rash, drug fever, mucosal Contraindications: chronic liver disease lesions, neutron/pancyto/thrombocytopenia, Adverse drug reactions: Rare – rash, drug fever, mucosal lesions, neutron/pancyto/thrombocytopenia, drowsiness, dizziness. VOLTAREN NAPROXEN Drug: Diclofenac Drug:NSAID Therapeutic class: NSAID - nonselective Therapeutic class: Analgesic, anti –inflammatory, antipyretic. Dosage range: 75mg – 150mg daily (in divided doses), max Dosage range: 250mg – 500mg OR 750mg-1000mg SR 200mg/day. Route: Oral Route: Oral Frequency of administration: Twice daily OR SR - daily Frequency of administration: 2-3 times daily Duration of order: As required Duration of order: As required Indications: Rheumatoid arthritis, osteoarthritis, acute gout, Indications: Rheumatoid arthritis, osteoarthritis, soft tissue pain due to inflammation. and inflammatory pain. Contraindications: May increase risk of bronchospasm or Contraindications: increased cardiovascular risk. cardiovascular events, not advised in pts. with active GI Adverse drug reactions: GIT bleeding, oedema, HT, CCF, bleeding. bronchospasm Adverse drug reactions: GIT bleeding, oedema, HT, CCF, bronchospasm Nurse Practitioner CLINICAL PROTOCOL Pain management BUSCOPAN Drug: hyoscine Butylbromide ENDEP Drug: Amitriptyline Therapeutic class: analgesic, anticholinergic, antispasmodic. Therapeutic class: Tricyclic antidepressant. Mode of action: reduces GI motility and spasm, smooth Dosage range: 10-25mg nocte, titrate to a maximum of 150mg muscle relaxant. for pain Dosage range: 10mg-20mg Route: Oral Route: Oral Frequency of administration: daily at night Frequency of administration: 3 – 4 times daily. Duration of order: as required. Duration of order: As required Indications: Neuropathic pain Indications: GI spasm, renal/biliary spasm Contraindications: closed angel glaucoma, hyperthyroidism, Contraindications: GI or urinary obstruction, myasthenia Adverse drug reactions: Anticholinergic effects, hypotension, gravis, closed angle glaucoma. tachycardia, hyperglycaemia, gynaecomastia, breast Adverse drug reactions: Generally dose related. Dry mouth, enlargement and galactorrhoea in females. constipation, dry eyes. Unexpected representation NP Clinical Practice Evaluative strategies Review Patient Notes. Full audit clinical events. NP Clinical Practice/Medical Report Audit Key Terms NP – Nurse Practitioner CP – Clinical Protocol GP – General Practitioner S4 – Schedule of the drug administration act References 1. Australian Medicines handbook (2011). Australian Medicines Handbook Pty Ltd, SA; 2011 2. etg complete (internet). Melbourne: Therapeutic Guidelines Limited; 2011 Nov. Accessed 2011 Dec 15th at http://etg.tg.com.au/ref/ref 3. RACGP (2011). Medical care of older persons in Residential Aged Care Facilities: Pain management. Accessed 20 Dec 2011 at: www.racgp.org.au Nurse Practitioner CLINICAL PROTOCOL Pain management Authorship, Endorsement and acknowledgement This CP was originally written by: Reviewed and authorised by: Carol Jones Dr. Frank Reedman Jones Nurse Practitioner MBBCh, DCH, DRCOG, FRACGP, FACRRM Murray Medical Centre Mandurah Murray Medical Centre: Primary Care Physician We acknowledge the authorship of: Dr. Eileen Bristol MBChB,MRCGP,DRCOG,FRACGP Murray Medical Centre: Primary Care Physician Carol Jones RN, RM, PGradDipNursePractitioner, NP Nurse Practitioner Date Written: December 2011 Review Date: December 2013