Mar 12 2019 31 mins 619
For a transcript of the podcast and show notes: https://www.coreimpodcast.com/2019/03/13/5-pearls-on-pain-management/
Time Stamps
* How effective are non-opioids? ( 3:17)
* Are NSAIDs contraindicated in patients with kidney, liver or heart disease? If not, how can we use them safely? (10:51)
* What are the best practices for patients who require opioid analgesia? (19:00)
* When prescribing opioids at discharge what can we do to minimize harm? (25:02)
* Throwback to mechanism of acetaminophen and NSAIDs (27:14)
* How do we believe tylenol works and how does that compare to NSAIDS? (28:27)
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References
* Calcaterra et al. Opioid prescribing at discharge contributes to chronic opioid use. J Gen Intern Med. 2016;31(5): 478-485.
* Herzig et al. Opioid utilization and opioid-related adverse events in nonsurgical patients in US hospitals. J Hosp Med. 2014 Feb;9(2):73-81.
* Sriperumbuduri et al. The case for cautious consumption: NSAIDs in chronic kidney disease. Curr Opin Nephrol Hypertens. 2018 Dec 5.
* Herzig et al. Safe opioid prescribing for acute noncancer pain in hospitalized adults: A systematic review of existing guidelines. J Hosp Med. 2018 Apr; 13(4) 256-262.
* Grennan et al. Dose response study with ibuprofen in rheumatoid arthritis: Clinical and pharmacokinetic findings. Br J Clin Pharmac 1983, 15, 311-316.
* Motov et al. Comparison of Ketorolac at three single dose regimens for treating acute pain in the Emergency Department: A randomized control trial. Ann Emerg Med 2016 Aug;70(2):177-184.
* Holdgate et al. Systematic review of the relative efficacy of non-steroidal anti-inflammatory drugs and opioids in the treatment of acute renal colic. BMJ. 2004 Jun 12;328(7453)
* Qaseem et al. Noninvasive treatments for acute, subacute, and chronic low back pain; a clinical practice guideline from the American college of physicians. Ann Intern Med. 2017 Apr 04; 166(7) 514-530
* Chang et al. Effect of a single dose of oral opioid and nonopioid analgesics on acute extremity pain in the emergency department: A randomized clinical trial. JAMA. 2017 Nov 07; 318(17) 1661-1667.
* Moore et al. Single dose oral analgesics for acute postoperative pain in adults – an overview of Cochrane reviews. Cochrane Database Syst Rev 2015 Sep 28;(9)
* Moore et al. Adverse events associated with single dose oral analgesics for acute postoperative pain in adults – an overview of Cochrane reviews. Cochrane Database Syst Rev 2015 Oct:13(10)
* Jones et al. Oral non-steroidal anti-inflammatory drugs versus other oral analgesic agents for acute soft tissue injury. Cochrane Database Syst Rev 2015 Jul 1;(7)
* Interagency Guideline on Prescribing Opioids for Pain. http://www.agencymeddirectors.wa.gov/Files/2015AMDGOpioidGuideline.pdf
* Felson, DT. Safety of Nonsteroidal Antiinflammatory Drugs. N Engl J Med 2016 Dec; 375:2595-2596.
* Bouck et al. Frequency and associations of nonsteroidal anti-inflammatory drug use among patients with a musculoskeletal disorder and hypertension, heart failure, or chronic kidney disease. JAMA Intern Med. 2018;178(11):1516-1525.
* Lanza et al. Guidelines for Prevention of NSAID-Related Ulcer Complications.
