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Prescribing analgesics. How to improve function and avoid toxicity when treating chronic pain.
1Department of Anesthesia, Stanford University Medical Center, USA.
Geriatrics
|November 22, 2000
Summary
Pain management in older adults often relies on analgesic drugs. Careful prescription ensures safe use of these medications, including non-opioid and opioid analgesics, for chronic pain relief.
Area of Science:
- Geriatric Medicine
- Pain Management
- Pharmacology
Background:
- Analgesic drugs are frequently preferred over non-drug therapies for pain in older patients.
- While adverse reactions are a concern, analgesics can be safely administered for chronic pain in this population with careful physician oversight.
Purpose of the Study:
- To review the safe and effective use of analgesic and adjuvant medications for pain management in older adults.
- To highlight considerations for prescribing various classes of pain relievers in geriatric patients.
Main Methods:
- Review of current literature and clinical guidelines on pain management in the elderly.
- Categorization of analgesic and adjuvant drug classes relevant to older patients.
- Discussion of potential benefits, risks, and specific prescribing considerations for each drug class.
Main Results:
- Non-opioid analgesics (acetaminophen, aspirin, NSAIDs, COX-2 inhibitors) are common treatment options.
- Opioid analgesics require careful monitoring for side effects and functional improvement.
- Adjuvant medications like antidepressants and anticonvulsants may be beneficial, while benzodiazepines and muscle relaxants warrant caution due to potential harm and overuse.
Conclusions:
- Analgesics can be used safely in older patients with chronic pain when prescribed judiciously.
- A tailored approach considering drug class, patient-specific factors, and potential adverse effects is crucial for effective pain management in geriatrics.
- Topical agents show promise for specific neuropathic pain conditions in older adults.