ADULT ANALGESIC GUIDELINE (NOT FOR NEUROPATHIC PAIN) BEWARE OF

PATIENT DATA FORM FOR ADULTS (AGED 15
03201 – CHAPTER 10 POLICY AND PROCEDURES MANUAL ADULT
1 (REDACCIÓN DEL 2008) ESCUELA DE ADULTOS LOS BOLINES

1 INTRODUCTION 11 THE MAGNET YOUNG ADULT CENTRE (THE
10149 CHAPTER 5 BUREAU OF ELDER AND ADULT SERVICES
11 PHARMACOKINETIC PARAMETERS IN ADULTS AND CHILDREN—DOCUMENTATION OF A

WHO Pain ladder

ADULT ANALGESIC GUIDELINE (NOT FOR NEUROPATHIC PAIN) BEWARE OF

ADULT ANALGESIC GUIDELINE

(Not for neuropathic pain)

Beware of medicine cautions or interactions

STEP III

Severe Pain

Pain Score 7 – 10

(For cancer pain, consider referral to

Palliative Care Team)


STEP II

Moderate Pain

Pain Score 4 – 6

Regular

Paracetamol 1g qds po/pr/IV



Ibuprofen 400mg tds po

or (if pr route is considered)

Diclofenac 50mg tds pr



Morphine PCA1

Epidural infusion1


PRN (not with epidural or PCA)

Morphine 2-10mg IV titrated1

or

Morphine 10mg IM 1-2 hourly1

or

Morphine Sulphate Mixture 10-20mg 1 hourly po1

STEP I

Mild Pain

Pain Score 1 – 3

Regular

Paracetamol 1g qds po/pr

Ibuprofen 400mg tds po

or (if pr route is considered)

Diclofenac 50mg tds pr


Codeine 30-60mg qds po

or as 2nd line²

Tramadol 50-100mg qds po



PRN

Morphine Sulphate Mixture 10mg 2-4 hourly po1


Regular

Paracetamol 1g po/pr qds

PRN

Ibuprofen 400mg tds po

or (if pr route is considered)

Diclofenac 50mg tds pr


Codeine 30-60mg tds po

or as 2nd line²

Tramadol 50-100mg qds po

  1. Ensure Naloxone is prescribed with all strong opioids

  2. The use of Tramadol as 2nd line is only if Codeine is not tolerated or appropriate

  3. For nausea and vomiting refer to Nausea and Vomiting guidelines

  4. For patients on Step 2 or 3, consider regular laxatives, eg. Senna 2 tabs nocte

  5. This analgesic ladder is to be used as a guideline only, if you require further guidance please contact the Pain Management Team on


LISTER Bleep 1497 (9-5) or 1077 (after hours) OR QEII Bleep 0854 (9-5) or 0650 (after hours)


Approved by Therapeutics Policy Committee 4 October 2006. Review date October 2007.


110 CMR 23000 – PROPOSED NEW REGULATIONS YOUNG ADULT
16 TEMA 8 DESARROLLO SOCIAL DURANTE LA ADULTEZ Y
18 GENETICS REVIEW EXAMINATION FOR NURSES IN ADULT DISCIPLINES


Tags: adult analgesic, pain), adult, neuropathic, beware, analgesic, guideline