This review is intended to improve the provider’s ability to safely treat chronic pain. The general concepts of pain management are summarized, with a focus on drug therapy options. Greater emphasis is placed on opioids due to the current opioid epidemic in the US, and the responsibility of healthcare providers to help prevent abuse and misuse.
Chronic pain management is a global health priority. Millions of adults (11%-19% of the US population) suffer daily from chronic, noncancer pain. A conservative estimate of the economic burden of pain in the US, including both healthcare costs and lost work productivity, is $560 - $635 billion annually. Most patients use a combination of non-drug approaches and medication to help alleviate pain. Although all drug treatments have risks that must be carefully weighed against the potential benefits, opioids carry the significant risks of addiction and respiratory depression. The increasing rate of opioid overdose deaths, which was 5 times higher in 2016 compared with 1999, has overwhelmed this country – and created pressure for providers to improve their knowledge of pain management...
- Pharmacy Technicians
CE activities for Pharmacists and Pharmacy Technicians:
This continuing education (CE) activity meets the requirements of all state boards of pharmacy for approved continuing education hours. CE credit is automatically reported to CPE Monitor.
The American Nurses Credentialing Center (ANCC) for formally approved continuing education (CE) hours, and CE hours of pharmacotherapeutics.
The American Academy of Nurse Practitioners Certification Program (AANPCP) for acceptable, accredited CE.
- The ANCC requires all advanced practice nursing certificants (CNSs and NPs) to complete 25 CE hours of pharmacotherapeutics as a portion of the required 75 continuing education hours.
- Pharmacology CE is recommended by the AANPCP and will be required for Certificants renewing certification starting January 2017.
- Most State Boards of Nursing require a minimum number of pharmacy contact hours to renew an advanced practice license.
Requirements for CE Credit
- Describe the side effects that may be caused by all nonsteroidal anti-inflammatory drugs (NSAIDs). Provide an example of an NSAID that is a COX-2 selective inhibitor. List the side effects that may be more likely with this NSAID compared with a non-COX-2 selective NSAID.
- List 2 commonly used tricyclic antidepressants (TCAs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) used for neuropathic pain; describe common side effects of each.
- State the generic and brand names of the 2 anticonvulsants most commonly prescribed for neuropathic pain. List 2 side effects for each.
- List the generic and brand names of opioids used for chronic pain. Describe the side effects that are common to all opioids, including the potentially serious effects. Recognize major drug interactions that can increase the toxicity of some opioids.
Brief Bio : Jeffrey Bettinger, PharmD is currently completing his PGY-2 Pain and Palliative Care Pharmacy Residency at the Stratton VA Medical Center in Albany NY.
Brief Bio : Jeffrey Fudin, BSPharm, PharmD, DAIPM, FCCP, FASHP, FFSMB is Chief Executive Officer and Chief Medical Officer for Remitigate, LLC in Delmar NY. He serves as an Adjunct Associate Professor at Western New England University College of Pharmacy in Springfield MA, and also at the Albany College of Pharmacy & Health Sciences in Albany NY. He is a Clinical Pharmacy Specialist and Pain/Palliative Care Pharmacy Residency Director at the Stratton VA Medical Center in Albany NY.