SlideShare a Scribd company logo

Meds For Pain And Inflammation

•
•
P
pmrjulio
1 of 37
Medications for Pain and Inflammation Julio A. Martinez-Silvestrini, MD Outpatient Medical Director Physical Medicine and Rehabilitation Baystate Medical Center
Objectives ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pain ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
More Pain ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
Pain Ladder ,[object Object],[object Object]
 
Non-Steroidal Anti-Inflammatories ,[object Object],[object Object],[object Object],[object Object]
Copyright © 2007 Elsevier Inc. All rights reserved. Figure 15.2 Inflammatory cascade and action of NSAIDs and corticosteroids. Cellular membrane injury will promote the release of phospholipids. By influence of phospholipase, phospholipids will convert into arachidonic acid which in turn converts to prostaglandins or leukotrienes mediated by cyclooxygenase or lipoxygenase, respectively.
NSAIDs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NSAIDs ,[object Object]
NSAID Classes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NSAID Classes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Adverse Effects ,[object Object],[object Object]
Adverse Effects ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Acetaminophen ,[object Object],[object Object],[object Object],[object Object],[object Object]
Acetaminophen ,[object Object],[object Object]
Adverse Effects ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Tramadol ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Anti-epileptic drugs ,[object Object]
Anti-epileptic drugs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Anti-epileptic drugs ,[object Object],[object Object],[object Object],[object Object],[object Object]
Tricyclic antidepressants (TCA) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Tricyclic antidepressants (TCA) ,[object Object],[object Object],[object Object],[object Object]
Muscle relaxants (relaxers) ,[object Object],[object Object],[object Object],[object Object],[object Object]
Muscle relaxants (relaxers) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Topical Agents ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Topical NSAIDs ,[object Object],[object Object],[object Object],[object Object],[object Object]
Topical NSAIDs ,[object Object],[object Object],[object Object]
Opiates ,[object Object],[object Object],[object Object],[object Object],[object Object]
Preferred Analgesic Agents Hydromorphone Hydrocodone Methadone Oxycodone Oxycontin Codeine Fentanyl Patch Morphine Sulfate IR Morphine Sulfate ER Kadian Short acting Long Acting
Protocol ,[object Object],[object Object]
Protocol ,[object Object],[object Object]
Red Flag Behavior ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Red Flag Behavior ,[object Object],[object Object],[object Object],[object Object],[object Object]
Toxicology Screen ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 

Recommended

Managing Acute Pain
Managing Acute PainManaging Acute Pain
Managing Acute Painpmrjulio
 
Glucocorticoids for optimizing its use 2021( f )
Glucocorticoids for optimizing its use 2021( f )Glucocorticoids for optimizing its use 2021( f )
Glucocorticoids for optimizing its use 2021( f )SafwatElaraby
 
Pain control in ED 2010
Pain control in ED 2010Pain control in ED 2010
Pain control in ED 2010ACMC EM Residency
 
Theramine for the Management of Chronic Pain
Theramine for the Management of Chronic PainTheramine for the Management of Chronic Pain
Theramine for the Management of Chronic PainTargeted Medical Pharma
 
Responsible Pain Management with Theramine
Responsible Pain Management with TheramineResponsible Pain Management with Theramine
Responsible Pain Management with TheramineTargeted Medical Pharma
 
Chronic Pain After Surgery Molecules
Chronic Pain After Surgery MoleculesChronic Pain After Surgery Molecules
Chronic Pain After Surgery Moleculesepicyclops
 
Natural Options for Sleep Disorders
Natural Options for Sleep Disorders Natural Options for Sleep Disorders
Natural Options for Sleep Disorders Targeted Medical Pharma
 
Pain Management Education - WakeMed Pharmacy
Pain Management Education - WakeMed PharmacyPain Management Education - WakeMed Pharmacy
Pain Management Education - WakeMed PharmacyWakeMed Health & Hospitals
 

Recommended

Managing Acute Pain
Managing Acute PainManaging Acute Pain
Managing Acute Painpmrjulio
 
Glucocorticoids for optimizing its use 2021( f )
Glucocorticoids for optimizing its use 2021( f )Glucocorticoids for optimizing its use 2021( f )
Glucocorticoids for optimizing its use 2021( f )SafwatElaraby
 
Pain control in ED 2010
Pain control in ED 2010Pain control in ED 2010
Pain control in ED 2010ACMC EM Residency
 
Theramine for the Management of Chronic Pain
Theramine for the Management of Chronic PainTheramine for the Management of Chronic Pain
Theramine for the Management of Chronic PainTargeted Medical Pharma
 
Responsible Pain Management with Theramine
Responsible Pain Management with TheramineResponsible Pain Management with Theramine
Responsible Pain Management with TheramineTargeted Medical Pharma
 
Chronic Pain After Surgery Molecules
Chronic Pain After Surgery MoleculesChronic Pain After Surgery Molecules
Chronic Pain After Surgery Moleculesepicyclops
 
Natural Options for Sleep Disorders
Natural Options for Sleep Disorders Natural Options for Sleep Disorders
Natural Options for Sleep Disorders Targeted Medical Pharma
 
Pain Management Education - WakeMed Pharmacy
Pain Management Education - WakeMed PharmacyPain Management Education - WakeMed Pharmacy
Pain Management Education - WakeMed PharmacyWakeMed Health & Hospitals
 
Percura, Improve Pain and Numbness Associated with Peripheral Neuropathy
Percura, Improve Pain and Numbness Associated with Peripheral NeuropathyPercura, Improve Pain and Numbness Associated with Peripheral Neuropathy
Percura, Improve Pain and Numbness Associated with Peripheral NeuropathyTargeted Medical Pharma
 
The Dietary Management of Chronic Pain with Medical Foods
The Dietary Management of Chronic Pain with Medical FoodsThe Dietary Management of Chronic Pain with Medical Foods
The Dietary Management of Chronic Pain with Medical FoodsTargeted Medical Pharma
 
Recent advances in pain management
Recent advances in pain managementRecent advances in pain management
Recent advances in pain managementKrishna Kishore
 
What To Do When Opioids Fail
What To Do When Opioids FailWhat To Do When Opioids Fail
What To Do When Opioids FailBCAGCP
 
Pain drugs
Pain drugsPain drugs
Pain drugsNhelia Santos Perez
 
Paracetamol - widening the horizon in pain managment
Paracetamol - widening the horizon in pain managmentParacetamol - widening the horizon in pain managment
Paracetamol - widening the horizon in pain managmentGiridhar Panpalia
 
ANALGESICS PRESENTATION
ANALGESICS PRESENTATION ANALGESICS PRESENTATION
ANALGESICS PRESENTATION GAMANDEEP
 
Pharmacotherapy of Fibromyalgia
Pharmacotherapy of FibromyalgiaPharmacotherapy of Fibromyalgia
Pharmacotherapy of FibromyalgiaHSK College of Pharmacy
 
dr.Husni - paracetamol iv as a safety analgesic
dr.Husni - paracetamol iv as a safety analgesicdr.Husni - paracetamol iv as a safety analgesic
dr.Husni - paracetamol iv as a safety analgesicDepartment of Anesthesiology, Faculty of Medicine Hasanuddin University
 
Neuropathic agents
Neuropathic agentsNeuropathic agents
Neuropathic agentsyury
 
Analgesics in dentistry
Analgesics in dentistryAnalgesics in dentistry
Analgesics in dentistryDr Saheer Abbas
 
Neuropathic Pain
Neuropathic PainNeuropathic Pain
Neuropathic PainSrirama Anjaneyulu
 
Current concept for management of neuropathic pain
Current concept for management of neuropathic painCurrent concept for management of neuropathic pain
Current concept for management of neuropathic painNeurologyKota
 
Ketamine for Acute Pain
Ketamine for Acute PainKetamine for Acute Pain
Ketamine for Acute PainCasey Glass, MD
 
Opioid Hyperalgesia
Opioid HyperalgesiaOpioid Hyperalgesia
Opioid HyperalgesiaChief Anesthesiology Treviso Hub Hospital, Italy
 
Medical management of neuropathic pain
Medical management of neuropathic painMedical management of neuropathic pain
Medical management of neuropathic painSudhir Kumar
 
Opioid pain surgery2010
Opioid pain surgery2010Opioid pain surgery2010
Opioid pain surgery2010Suzana Makowski, MD MMM FACP
 
Ketamine and Intranasal Esketamine in Depression
Ketamine and Intranasal Esketamine in DepressionKetamine and Intranasal Esketamine in Depression
Ketamine and Intranasal Esketamine in DepressionSawsan Aboul-Fotouh
 
Analgesics i
Analgesics iAnalgesics i
Analgesics iHumera Shokat
 
Acute pain management
Acute pain managementAcute pain management
Acute pain managementMai Nguyen Thi Ngoc
 
Donor Acquisition - Lessons from the frontline of the meltdown
Donor Acquisition - Lessons from the frontline of the meltdownDonor Acquisition - Lessons from the frontline of the meltdown
Donor Acquisition - Lessons from the frontline of the meltdownDamian O'Broin
 
Dolor musculo-esquelético
Dolor musculo-esquelético Dolor musculo-esquelético
Dolor musculo-esquelético Sergio Zavala Plaza
 

More Related Content

What's hot

Percura, Improve Pain and Numbness Associated with Peripheral Neuropathy
Percura, Improve Pain and Numbness Associated with Peripheral NeuropathyPercura, Improve Pain and Numbness Associated with Peripheral Neuropathy
Percura, Improve Pain and Numbness Associated with Peripheral NeuropathyTargeted Medical Pharma
 
The Dietary Management of Chronic Pain with Medical Foods
The Dietary Management of Chronic Pain with Medical FoodsThe Dietary Management of Chronic Pain with Medical Foods
The Dietary Management of Chronic Pain with Medical FoodsTargeted Medical Pharma
 
Recent advances in pain management
Recent advances in pain managementRecent advances in pain management
Recent advances in pain managementKrishna Kishore
 
What To Do When Opioids Fail
What To Do When Opioids FailWhat To Do When Opioids Fail
What To Do When Opioids FailBCAGCP
 
Paracetamol - widening the horizon in pain managment
Paracetamol - widening the horizon in pain managmentParacetamol - widening the horizon in pain managment
Paracetamol - widening the horizon in pain managmentGiridhar Panpalia
 
ANALGESICS PRESENTATION
ANALGESICS PRESENTATION ANALGESICS PRESENTATION
ANALGESICS PRESENTATION GAMANDEEP
 
Neuropathic agents
Neuropathic agentsNeuropathic agents
Neuropathic agentsyury
 
Current concept for management of neuropathic pain
Current concept for management of neuropathic painCurrent concept for management of neuropathic pain
Current concept for management of neuropathic painNeurologyKota
 
Medical management of neuropathic pain
Medical management of neuropathic painMedical management of neuropathic pain
Medical management of neuropathic painSudhir Kumar
 
Ketamine and Intranasal Esketamine in Depression
Ketamine and Intranasal Esketamine in DepressionKetamine and Intranasal Esketamine in Depression
Ketamine and Intranasal Esketamine in DepressionSawsan Aboul-Fotouh
 

What's hot (20)

Percura, Improve Pain and Numbness Associated with Peripheral Neuropathy
Percura, Improve Pain and Numbness Associated with Peripheral NeuropathyPercura, Improve Pain and Numbness Associated with Peripheral Neuropathy
Percura, Improve Pain and Numbness Associated with Peripheral Neuropathy
 
The Dietary Management of Chronic Pain with Medical Foods
The Dietary Management of Chronic Pain with Medical FoodsThe Dietary Management of Chronic Pain with Medical Foods
The Dietary Management of Chronic Pain with Medical Foods
 
Recent advances in pain management
Recent advances in pain managementRecent advances in pain management
Recent advances in pain management
 
What To Do When Opioids Fail
What To Do When Opioids FailWhat To Do When Opioids Fail
What To Do When Opioids Fail
 
Pain drugs
Pain drugsPain drugs
Pain drugs
 
Paracetamol - widening the horizon in pain managment
Paracetamol - widening the horizon in pain managmentParacetamol - widening the horizon in pain managment
Paracetamol - widening the horizon in pain managment
 
ANALGESICS PRESENTATION
ANALGESICS PRESENTATION ANALGESICS PRESENTATION
ANALGESICS PRESENTATION
 
Pharmacotherapy of Fibromyalgia
Pharmacotherapy of FibromyalgiaPharmacotherapy of Fibromyalgia
Pharmacotherapy of Fibromyalgia
 
dr.Husni - paracetamol iv as a safety analgesic
dr.Husni - paracetamol iv as a safety analgesicdr.Husni - paracetamol iv as a safety analgesic
dr.Husni - paracetamol iv as a safety analgesic
 
Neuropathic agents
Neuropathic agentsNeuropathic agents
Neuropathic agents
 
Analgesics in dentistry
Analgesics in dentistryAnalgesics in dentistry
Analgesics in dentistry
 
Neuropathic Pain
Neuropathic PainNeuropathic Pain
Neuropathic Pain
 
Current concept for management of neuropathic pain
Current concept for management of neuropathic painCurrent concept for management of neuropathic pain
Current concept for management of neuropathic pain
 
Ketamine for Acute Pain
Ketamine for Acute PainKetamine for Acute Pain
Ketamine for Acute Pain
 
Opioid Hyperalgesia
Opioid HyperalgesiaOpioid Hyperalgesia
Opioid Hyperalgesia
 
Medical management of neuropathic pain
Medical management of neuropathic painMedical management of neuropathic pain
Medical management of neuropathic pain
 
Opioid pain surgery2010
Opioid pain surgery2010Opioid pain surgery2010
Opioid pain surgery2010
 
Ketamine and Intranasal Esketamine in Depression
Ketamine and Intranasal Esketamine in DepressionKetamine and Intranasal Esketamine in Depression
Ketamine and Intranasal Esketamine in Depression
 
Analgesics i
Analgesics iAnalgesics i
Analgesics i
 
Acute pain management
Acute pain managementAcute pain management
Acute pain management
 

Viewers also liked

Donor Acquisition - Lessons from the frontline of the meltdown
Donor Acquisition - Lessons from the frontline of the meltdownDonor Acquisition - Lessons from the frontline of the meltdown
Donor Acquisition - Lessons from the frontline of the meltdownDamian O'Broin
 
El dolor osteo-articular y músculo-esquelético
El dolor osteo-articular y músculo-esqueléticoEl dolor osteo-articular y músculo-esquelético
El dolor osteo-articular y músculo-esqueléticoInterbenavente
 
Progressive rehabilitation for low back pain
Progressive rehabilitation for low back painProgressive rehabilitation for low back pain
Progressive rehabilitation for low back painSpinePlus
 
Rehabilitation for back pain
Rehabilitation for back painRehabilitation for back pain
Rehabilitation for back painSpinePlus
 
LBP - Diagnostic Radiology UPR
LBP - Diagnostic Radiology UPRLBP - Diagnostic Radiology UPR
LBP - Diagnostic Radiology UPRE ML
 
Lumbar exam in patients with Chronic Pain
Lumbar exam in patients with Chronic PainLumbar exam in patients with Chronic Pain
Lumbar exam in patients with Chronic Painpmrjulio
 
Dolor: comprender la fisiopatología y clasificación. Dr Hugo A. Fornells
Dolor: comprender la fisiopatología y clasificación. Dr Hugo A. FornellsDolor: comprender la fisiopatología y clasificación. Dr Hugo A. Fornells
Dolor: comprender la fisiopatología y clasificación. Dr Hugo A. FornellsHugo Fornells
 

Viewers also liked (11)

Donor Acquisition - Lessons from the frontline of the meltdown
Donor Acquisition - Lessons from the frontline of the meltdownDonor Acquisition - Lessons from the frontline of the meltdown
Donor Acquisition - Lessons from the frontline of the meltdown
 
Dolor musculo-esquelético
Dolor musculo-esquelético Dolor musculo-esquelético
Dolor musculo-esquelético
 
El dolor osteo-articular y músculo-esquelético
El dolor osteo-articular y músculo-esqueléticoEl dolor osteo-articular y músculo-esquelético
El dolor osteo-articular y músculo-esquelético
 
Progressive rehabilitation for low back pain
Progressive rehabilitation for low back painProgressive rehabilitation for low back pain
Progressive rehabilitation for low back pain
 
Rehabilitation for back pain
Rehabilitation for back painRehabilitation for back pain
Rehabilitation for back pain
 
LBP - Diagnostic Radiology UPR
LBP - Diagnostic Radiology UPRLBP - Diagnostic Radiology UPR
LBP - Diagnostic Radiology UPR
 
Lumbar exam in patients with Chronic Pain
Lumbar exam in patients with Chronic PainLumbar exam in patients with Chronic Pain
Lumbar exam in patients with Chronic Pain
 
Low Back Pain
Low Back PainLow Back Pain
Low Back Pain
 
Miologia
MiologiaMiologia
Miologia
 
Dolor: comprender la fisiopatología y clasificación. Dr Hugo A. Fornells
Dolor: comprender la fisiopatología y clasificación. Dr Hugo A. FornellsDolor: comprender la fisiopatología y clasificación. Dr Hugo A. Fornells
Dolor: comprender la fisiopatología y clasificación. Dr Hugo A. Fornells
 
Tipos de dolor
Tipos de dolorTipos de dolor
Tipos de dolor
 

Similar to Meds For Pain And Inflammation

Presentation 1.pptx
Presentation 1.pptxPresentation 1.pptx
Presentation 1.pptxPoorIndian
 
Treatment of Neuropathic Pain
Treatment of Neuropathic PainTreatment of Neuropathic Pain
Treatment of Neuropathic PainLatoya King
 
Multimodal analgesia Al Razi hospital Kuwait
Multimodal analgesia Al Razi hospital KuwaitMultimodal analgesia Al Razi hospital Kuwait
Multimodal analgesia Al Razi hospital KuwaitFarah Jafri
 
Pain Management Current & Newer Modalities
Pain Management Current & Newer Modalities Pain Management Current & Newer Modalities
Pain Management Current & Newer Modalities Dr Sachin Pawar
 
Malik sedation
Malik sedationMalik sedation
Malik sedationEM OMSB
 
Clinical Pharmacology - Analgesics
Clinical Pharmacology - AnalgesicsClinical Pharmacology - Analgesics
Clinical Pharmacology - AnalgesicsSteven Sager
 
CHRONIC PAIN ----Management Update.ppt
CHRONIC PAIN ----Management Update.pptCHRONIC PAIN ----Management Update.ppt
CHRONIC PAIN ----Management Update.pptAHQMSBr
 
Acute pain management and preemptive analgesia
Acute pain management and preemptive analgesiaAcute pain management and preemptive analgesia
Acute pain management and preemptive analgesiaZIKRULLAH MALLICK
 
Antidepressants mood_stabilizers
Antidepressants mood_stabilizersAntidepressants mood_stabilizers
Antidepressants mood_stabilizersUniversity of Miami
 
Pharmacotherapeutics of anesthesia ppt
Pharmacotherapeutics of anesthesia pptPharmacotherapeutics of anesthesia ppt
Pharmacotherapeutics of anesthesia pptMuhammed Rashid Ak
 
pharmacology of Analgesics, pain and NSAIDs
pharmacology of Analgesics, pain and NSAIDspharmacology of Analgesics, pain and NSAIDs
pharmacology of Analgesics, pain and NSAIDsSreenivasa Reddy Thalla
 

Similar to Meds For Pain And Inflammation (20)

Presentation 1.pptx
Presentation 1.pptxPresentation 1.pptx
Presentation 1.pptx
 
Postanesthetic care
Postanesthetic carePostanesthetic care
Postanesthetic care
 
Treatment of Neuropathic Pain
Treatment of Neuropathic PainTreatment of Neuropathic Pain
Treatment of Neuropathic Pain
 
Multimodal analgesia Al Razi hospital Kuwait
Multimodal analgesia Al Razi hospital KuwaitMultimodal analgesia Al Razi hospital Kuwait
Multimodal analgesia Al Razi hospital Kuwait
 
Analgesic activity
Analgesic activityAnalgesic activity
Analgesic activity
 
Analgesic
AnalgesicAnalgesic
Analgesic
 
Pain Management Current & Newer Modalities
Pain Management Current & Newer Modalities Pain Management Current & Newer Modalities
Pain Management Current & Newer Modalities
 
Cancer pain
Cancer painCancer pain
Cancer pain
 
Malik sedation
Malik sedationMalik sedation
Malik sedation
 
Dextropropoxyphene pdf.
Dextropropoxyphene pdf.Dextropropoxyphene pdf.
Dextropropoxyphene pdf.
 
Dextropropoxyphene pdf.
Dextropropoxyphene pdf.Dextropropoxyphene pdf.
Dextropropoxyphene pdf.
 
Clinical Pharmacology - Analgesics
Clinical Pharmacology - AnalgesicsClinical Pharmacology - Analgesics
Clinical Pharmacology - Analgesics
 
CHRONIC PAIN ----Management Update.ppt
CHRONIC PAIN ----Management Update.pptCHRONIC PAIN ----Management Update.ppt
CHRONIC PAIN ----Management Update.ppt
 
NSAIDS
NSAIDSNSAIDS
NSAIDS
 
Acute pain management and preemptive analgesia
Acute pain management and preemptive analgesiaAcute pain management and preemptive analgesia
Acute pain management and preemptive analgesia
 
Antidepressants mood_stabilizers
Antidepressants mood_stabilizersAntidepressants mood_stabilizers
Antidepressants mood_stabilizers
 
Pharmacotherapeutics of anesthesia ppt
Pharmacotherapeutics of anesthesia pptPharmacotherapeutics of anesthesia ppt
Pharmacotherapeutics of anesthesia ppt
 
Fentanyl for perioperative pain management - Dr. Alex Yeo Sow Nam
Fentanyl for perioperative pain management - Dr. Alex Yeo Sow NamFentanyl for perioperative pain management - Dr. Alex Yeo Sow Nam
Fentanyl for perioperative pain management - Dr. Alex Yeo Sow Nam
 
ANTIPSYCHOTICS.pptx
ANTIPSYCHOTICS.pptxANTIPSYCHOTICS.pptx
ANTIPSYCHOTICS.pptx
 
pharmacology of Analgesics, pain and NSAIDs
pharmacology of Analgesics, pain and NSAIDspharmacology of Analgesics, pain and NSAIDs
pharmacology of Analgesics, pain and NSAIDs
 

Meds For Pain And Inflammation

  • 1. Medications for Pain and Inflammation Julio A. Martinez-Silvestrini, MD Outpatient Medical Director Physical Medicine and Rehabilitation Baystate Medical Center
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.  
  • 8.
  • 9. Copyright © 2007 Elsevier Inc. All rights reserved. Figure 15.2 Inflammatory cascade and action of NSAIDs and corticosteroids. Cellular membrane injury will promote the release of phospholipids. By influence of phospholipase, phospholipids will convert into arachidonic acid which in turn converts to prostaglandins or leukotrienes mediated by cyclooxygenase or lipoxygenase, respectively.
  • 10.
  • 11.
  • 12.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.
  • 31. Preferred Analgesic Agents Hydromorphone Hydrocodone Methadone Oxycodone Oxycontin Codeine Fentanyl Patch Morphine Sulfate IR Morphine Sulfate ER Kadian Short acting Long Acting
  • 32.
  • 33.
  • 34.
  • 35.
  • 36.
  • 37.