Quote from Periwinkle Finkle
I have need for any suggestions - I have a pt in chronic pain who it has been an issue to get her pain meds increased. I was able to get her 3mg Dilaudid q3, but her pain is never under control and she asks for her next dose at least an hour before she is due. (Pinched nerve pain and possible beginning of CA pain).
She is allergic to morphine, ASA, percocet and I think NSAIDs also. Can anyone think of some alternative pain therapy that might help? I can't think of anything to suggest to the MDs - I feel like I only harass the MDs about her uncontrolled pain.
My first question would be what are her reactions to all these meds she is "allergic" to? To many times patients list allergies to meds that they aren't actually allergic to, but only have had mild side effects to those medicines.
Anyways adjunct treatments for chronic pain: topicals like capascin, peripheral/central blocks, gabapentin, tricyclic antidepressants, pregablin, anticonvulsants (carbamazepine, dilantin, divalproex sodium etc.), sodium channel blockers (mexilitine, lidocaine), GABA agonists (baclofen, clonazepam), Alpha agonists/antagonists (clonidine, tizanidine), long lasting opiates, skeletal muscle relaxants, Ultram, Benzos, sleep aids etc.
We just had a chronic pain lecture and these are straight off of my notes.
Also, if she has is having that much pain it might be time for referal to pain specialist.
Hope that helps.