| Tips for Relief |
- Use the 6 tips below to
achieve the best possible pain relief using oral
medications.
- Remember that it is
usually impossible to achieve 100% relief in this
way and that for chronic conditions 50% relief is
more realistic.
|
| Match the type
of medication to the type of pain |
- Try to discover which type of pain you have
(see Pain Types), and then select
the correct medication type:/
- Musculo-skeletal
pain is more responsive to a wide range
of common pain killers including acetaminophen,
codeine and anti-inflammatory medications.
- Sufferers with nerve
pain (sciatica, neuralgia) may find that
traditional pain killers are ineffective, and
therefore may need to consider specific nerve
pain medications, or may need to consider
injections or surgery.
- Visceral pain
is usually fairly morphine sensitive.
- Sympathetic
pain may partially respond to nerve pain
medications.
|
|
Match the release system of the
medication to the pattern of the pain |
- Normal Release
(NR) medications are absorbed from the gut
into the blood stream within about one hour, and
are effective for usually between 4 - 6 hours.
- Slow Release (SR)
medications have a built-in modified release
system, which allows the drug to be absorbed slowly
over 12 - 24 hours giving a much longer duration of
action.
- If the pain pattern is continuous, consider a
slow release medication, which produces fewer peaks
and troughs in blood levels and pain relief.
- If the pain pattern is intermittent, consider a
normal release medication avoiding over-medication
at times when there is no pain.
- If the pain pattern is continuous with
intermittent peaks, consider a combination of a SR
medication plus an intermittent NR medication for
break-through pain.
|
|
Match the strength of the
medication with severity of the pain |
- The strength of the medication should match the
severity of the pain if reasonable pain relief is
to be achieved. Look at the suggestions in the
Analgesic Flow Chart for more
information.
|
|
Review and adjust the dose and
interval between doses according to how the pain
responds to treatment |
- Medication is often prescribed as PRN or as
required. If the pattern of the pain is continuous,
then the result of taking medications as PRN is
often Pain Relief Nil i.e. the relief is poor.
- It is far better to take the medication
regularly throughout a 24 hour period, so that
medication levels in the blood stream are kept
above the level required to produce relief.
- Intermittent use of medication allows blood
levels to fall below the level required to produce
relief.
- If the prescribed dose of your medication fails
to give the desired effect, then it may mean that a
higher dose is required. This may mean a dose
increase of between 50% - 100% more.
- Increases of less than 50% are unlikely to
produce any noticeable affect.
- Please discuss all dose
increases with your doctor before making any
changes to your medication !!
|
|
Consider combinations of
medications instead of single drugs |
- Modern methods of pain relief suggest that
using combinations of drugs which act at different
pain receptors, have a greater chance of producing
acceptable relief than using single drugs
alone.
- Synergy is an apparent increase in drug pain
relieving effect using combinations, which is
greater than the sum of the individual effects of
the drugs used.
- Using a combination allows lower doses of each
drug to be taken, and therefore the lowers the risk
of developing a drug side effect also.
|
|
Consider other routes of
administration if you are not able to take drugs by the
usual oral route |
- If you are not able to take pain medications by
mouth because of nausea and vomiting or some other
reason, then there are a number of other routes to
consider e.g. under the tongue (sublingual), as a
suppository (per rectum), by injection
(subcutaneous, intramuscular, or intravenous) in
hospital or by GP's and district nurses only, or as
a skin patch (transcutaneous).
- Please discuss these options with your doctor
for more information. If nausea and vomiting is a
problem, then treating it effectively first will
then allow you to continue to take the medication
by mouth.
|
