Clinical management of the elderly patient in pain / Gary McCleane, Howard Smith editors.

Format:

Book

Contributor:

McCleane, Gary.

Smith, Howard S., 1956-

Series:

Haworth series in clinical pain and symptom palliation

Language:

English

Subjects (All):

Pain in old age--Treatment.

Pain in old age.

Geriatric pharmacology.

Pain--drug therapy.

Aging--physiology.

Aged.

Medical Subjects:

Pain--drug therapy.

Aging--physiology.

Aged.

Physical Description:

xvii, 304 pages : illustrations ; 23 cm.

Place of Publication:

New York : Haworth Medical Press, [2006]

Summary:

Providing effective treatment for pain-especially to elderly clients-can be a vexing problem for even the most knowledgeable clinician. In Clinical Management of the Elderly Patient in Pain, some of the world's leading authorities describe the unique difficulties that arise when trying to provide pain relief to elderly patients. They examine conventional treatment with opioid and non-steroidal anti-inflammatory drugs along with a broad range of alternatives to consider when frontline drugs fail. Non-drug options for pain relief from the fields of physical medicine and psychology are also explored.

Contents:

Chapter 1 Pain and the Elderly Patient / Gary McCleane 1

An Aging Population 1

Neural Differences in the Aged 2

Effect of Age in Animal Pain Models 3

Effect of Age on Human Experimental Pain 4

Effect of Age on Clinical Pain 6

Chapter 2 Acute and Chronic Pain in the Elderly / Pradeep Chopra, Howard Smith 11

Acute Pain 13

Chronic Pain 14

Cancer Pain 16

Chapter 3 Pain Management and Pharmacological Differences in the Elderly Patient / Peter Passmore, David Craig 23

External Factors 23

Pharmacokinetic Alterations 24

Pharmacodynamic Changes 26

Chapter 4 Acetaminophen for the Elderly / Pradeep Chopra, Howard Smith 29

Clinical Pharmacology 29

Adverse Effects 30

Laboratory Values Affected 31

Overdosage 31

Dosage and Administration 32

Chapter 5 Opioids / Gary McCleane 35

Does Age Influence the Dose of Opioid Required to Achieve Analgesia? 36

Pain and Its Responsiveness to Opioids 36

Types of Opiod 37

Side Effects of Opioid Analgesics 43

Clinical Use of Opioids in the Elderly 48

Chapter 6 NSAIDs and the Elderly / Jennifer A. Elliott 57

Mechanism of Action and Physiological Effects of NSAIDs 57

Classification of NSAIDs and Individual Agents of Particular Concern in the Elderly 61

Potential Adverse Drug Interactions with NSAIDs in the Elderly 65

Chapter 7 Tramadol for the Elderly / Pradeep Chopra, Howard Smith 69

Clinical Pharmacology 69

Adverse Events 70

Dosage and Administration 71

Guidelines for Using Tramadol in the Elderly 72

Chapter 8 Topical Local Anesthetics / Charles Argoff 75

The Use of Topical Local Analgesics for Neuropathic Pain 80

The Use of Targeted Peripheral Analgesics for Pain Associated with Soft Tissue Injury and Osteoarthritis 83

The Use of Targeted Peripheral Analgesics for the Treatment of Low Back Pain and Myofascial Pain 84

Other Uses of Topical Analgesics 85

Chapter 9 Nitrates, Capsaicin, and Tricyclic Antidepressants / Gary McCleane 91

Nitrates 91

Capsaicin 95

Tricyclic Antidepressants 99

Chapter 10 Topical Opioids / Gary McCleane 107

Peripheral Opioid Receptors 107

Effect of Peripheral Application of Opioids for Acute Pain 108

Transdermal Fentanyl 109

Topical Morphine 110

Transdermal Buprenorphine 111

Other Modes of Administration of Strong Opioids 111

Chapter 11 Tricyclic Antidepressants As Analgesics in the Elderly / Mary E. Lynch, Jana Sawynok 117

Systemic Tricyclic Antidepressants As Analgesics 118

Other Antidepressants As Analgesics 122

Comorbid Pain and Depression 124

Mechanisms of Action of Antidepressants As Analgesics 124

Topical Antidepressants As Analgesics in Clinical Studies 128

Chapter 12 Antiepileptics / Gary McCleane 133

Neuropathic Pain 134

Selecting an AED 135

Specific AEDs 136

Side Effects of AEDs 139

Examples of Conditions That May Respond to Use of an AED 140

Chapter 13 Spinal Analgesia in the Elderly / Thomas M. Larkin, Steven P. Cohen 149

Physiological Considerations 150

Anatomical Considerations 151

Neuraxial Analgesics in Perioperative and Chronic Pain Conditions 151

Local Anesthetics 152

Opioids 152

Alpha-2 Adrenergic Agonists 155

N-Methyl-D-Aspartate Receptor Antagonists 157

Calcium Channel Blockers 159

Adenosine 160

Cholinergic Agonists 161

Gamma-Aminobutyric Acid Agonists 163

Somatostatin 165

Neuroleptics 166

Aspirin and NSAIDs 168

Chapter 14 Oral and Intravenous Local Anesthetics / Gary McCleane 179

Oral Local Anesthetics 180

Intravenous Local Anesthetics 181

Conditions Benefiting from Intravenous Lidocaine 187

Suggested Clinical Use 190

Chapter 15 Muscle Relaxants / Howard Smith 197

Pharmacological Considerations for the Use of Muscle Relaxants in the Elderly 198

Muscle Relaxant Agents 201

Other Agents and Treatments 204

Chapter 16 Physical Therapy and Pain Management with the Elderly / Dennis Martin 207

Function 207

Context 208

Consequences of Pain in the Elderly 209

Models of Pain Management 210

Role of the Physical Therapist 210

Physical Therapy Treatments 212

Goal Setting 213

Chapter 17 Psychosocial Factors in Pain Management of the Older Patient / Edmund J. Burke 219

Age Differences in Prevalence Rates of Chronic Pain 220

The Nature of Pain States 221

Physical Differences in Pain Perception 221

Sociocultural Factors in the Experience and Report of Pain in Older Patients 223

Emotional and Psychological Factors Influencing Pain Experience 224

Practical Issues in the Assessment and Treatment of the Elderly Pain Patient 228

Chapter 18 Use of Psychotropic Medications in Geriatric Pain Management / Guerman Ermolenko 239

Antidepressants 239

Antipsychotics 248

Significant Side Effects and Interactions of the Antidepressants 252

Strategies for Combined Psychiatric and Pain Syndromes 253

Chapter 19 Treatment of Common Conditions / Gary McCleane 263

Central Poststroke Pain 263

Cervical Radiculopathy 264

Fibromyalgia 265

Fracture Pain 266

Metastatic Bone Pain 267

Muscle Spasm 267

Osteoarthritis-Monoarticular 268

Osteoarthritis-Polyarticular 269

Painful Diabetic Neuropathy 270

Peripheral Vascular Disease 272

Postherpetic Neuralgia 273

Sciatica 275

Skin Ulcers 275

Tendonitis 276

Trigeminal Neuralgia 277

Visceral Pain 277

Appendix Drug Interactions 279.

Notes:

Includes bibliographical references and index.

ISBN:

0789026198

0789026201

OCLC:

61285531

Publisher Number:

9780789026194

9780789026200