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) |
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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 orMorphine 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 poor (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
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Regular Paracetamol 1g po/pr qdsPRNIbuprofen 400mg tds poor (if pr route is considered)Diclofenac 50mg tds pr
Codeine 30-60mg tds po or as 2nd line² Tramadol 50-100mg qds po |
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Ensure Naloxone is prescribed with all strong opioids The use of Tramadol as 2nd line is only if Codeine is not tolerated or appropriate For nausea and vomiting refer to Nausea and Vomiting guidelines For patients on Step 2 or 3, consider regular laxatives, eg. Senna 2 tabs nocte 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
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