Pain Management Pharmacological
Contents
What is pharmacological and non-pharmacological management of pain?
INTRODUCTION – Pain management among neonates presents a challenge to clinical practice. Although neonates are able to process nociceptive stimuli, painful procedures are commonly performed in neonatal care units without adequate treatment. ( 1 ) Repeated and untreated pain experiences during hospitalization at such early stages of life might lead to neurodevelopmental and behavioral damage, with detrimental consequences over both the short and long term.
- 2, 3 ) Avoiding painful interventions should be the best strategy to manage neonatal pain.
- However, numerous diagnostic and therapeutic procedures are needed in neonatal intensive care units (ICUs) because they promote the stability and clinical recovery of the neonate; thus, this environment is hostile to the neonate and his or her family.
In addition, frequent handling and excessive light and noise increase the amplitude of the initial painful stimulus, which can negatively affect the clinical outcome. Thus, neonates must be spared from interventions whose benefits do not outweigh the harmful effect inherent to the procedure.
- 4 – 6 ) The multidisciplinary team, especially the nursing team, is responsible for the use of neonatal pain-relief strategies.
- Thus, assessing, preventing, and managing pain are important actions and should be considered during care through the adoption of pharmacological and nonpharmacological strategies.
( 7 ) Despite evidence of the deleterious effects of pain among neonates and the efficacy of pharmacological and nonpharmacological pain-relief strategies, recently published national studies have confirmed that analgesic measures are infrequently implemented in neonatal ICUs.
4, 8, 9 ) Pharmacological strategies consider the use of drugs to treat and relieve pain. ( 10 ) Nonpharmacological strategies favor other modalities of care, especially during the modulation stage of the painful experience. ( 7, 10, 11 ) Internationally established protocols subsidize the efficacy and safety of using these strategies among neonates.
( 12, 13 ) Given that the management of neonatal pain remains a challenge for healthcare practitioners, the present study aimed to describe and quantify the pharmacological and nonpharmacological strategies used to relieve pain and promote neonate comfort during their hospitalization in neonatal ICUs.
What is meant by non-pharmacological management?
3. Final Remarks – As stated before, the definition of non-pharmacological is any intervention intended to improve the health or the well-being of individuals that do not involve the use of any drugs or medicine. Healthcare providers and users might lack education or awareness about the benefits of NPIs for different health conditions.
What are the three pharmacological classification of drugs?
Pharmacologic class is a group of active moieties that share scientifically documented properties and is defined on the basis of any combination of three attributes of the active moiety:
Mechanism of Action (MOA) Physiologic Effect (PE) Chemical Structure (CS)
An FDA “Established Pharmacologic Class” (EPC) text phrase is a pharmacologic class associated with an approved indication of an active moiety that the FDA has determined to be scientifically valid and clinically meaningful. The Physician Labeling Rule regulations require the following statement to appear under the Indications and Usage heading in the Highlights of Prescribing Information if a drug is a member of an EPC : (Drug) is a (FDA EPC text phrase) indicated for,
- To find the FDA EPC text phrase for an approved active moiety click on the “Highlights of Prescribing Information” heading on the Prescribing Information Resources website and then find the “FDA EPC Text Phrases for Indications and Usage Heading in Highlights” document.
- The list is regularly revised to ensure that the most up-to-date FDA EPC text phrases are available to the public.
For more information about how FDA determines the EPC for a drug product, see:
Determining Established Pharmacologic Class for Use in the Highlights of Prescribing Information guidance MAPP 7400.13: Determining the Established Pharmacologic Class for Use in the Highlights of Prescribing Information
Source: The codes are from the National Drug File Reference Terminology (NDF-RT) maintained by the Department of Veterans Affairs. National Drug File Reference Terminology OID: 2.16.840.1.113883.3.26.1.5 The full list of NDF-RT codes can be found on the NCI web site at: ftp://ftp1.nci.nih.gov/pub/cacore/EVS/NDF-RT/
What is non-pharmacological management of breakthrough pain?
Third, use of specific non-pharmacological or pharmacological interventions for breakthrough pain. Non-pharmacological interventions include physiotherapy, cognitive techniques and orthopedic procedures. Pharmacological management is usually in the form of supplemental analgesia also known as rescue medication.
What is the most commonly used medication in pain management?
Acetaminophen – Acetaminophen is usually recommended as a first line treatment for mild to moderate pain. It might be taken for pain due to a skin injury, headache, or conditions that affect the muscles and bones. Acetaminophen is often prescribed to help manage osteoarthritis and back pain. It also may be combined with opioids to reduce the amount of opioid needed.
- Generic (brand) names. Acetaminophen (Tylenol, others).
- How it works. Acetaminophen is thought to block the production of prostaglandins in the central nervous system. Prostaglandins are hormonelike substances that are involved in pain and inflammation. Unlike NSAIDs, acetaminophen doesn’t target inflammation at the site of injury — only pain.
- Benefits and risks. Acetaminophen is generally considered safer than other pain relievers. It doesn’t cause side effects such as stomach pain and bleeding. However, taking more than the recommended dose or taking acetaminophen with alcohol increases the risk of kidney damage and liver failure over time.
- Bottom line. Acetaminophen is generally a safe option to try first for many types of pain, including chronic pain. Ask your health care provider for guidance about other medications to avoid while taking acetaminophen. Acetaminophen is not as effective as NSAIDs for the treatment of knee and hip pain related to osteoarthritis.
What are examples of non pharmacological interventions?
Those may include, but are not limited to, mental health assessment, therapy, skills building, parenting assistance or family therapy.
