Educate patients, family, and friends. When intranasal naloxone is prescribed, educate the patient and the patient’s family and friends about when and how to use intranasal naloxone and steps after administration.
Neuropathic pain: pain caused by abnormal neural activity that arises secondary to injury, disease, or dysfunction of the nervous system
Expected functional benefits of opioid use should be clear, with the continuation of opioid therapy dependent on achieving them. While improved sleep and mood are somewhat subjective and should be noted, seek more objective evidence of benefit in order to prescribe and continue opioid therapy.
Another option for opioid tolerant patients is buprenorphine, transdermal or buccal. Compared to full agonist therapy, buprenorphine has pelo ceiling on respiratory depression, generally provides good analgesia, gives consistent serum plasma levels, and does not lead to hyperalgesia or tolerance with the same frequency.
Chronic pain has little in common with acute pain and should be considered as a separate medical condition. Some differences are:
The experts recommend following basic pillars for healthy living to maintain a strong liver. Those include:
Substance use disorders. Obtain a substance use history in all patients with chronic pain, including the use of alcohol, illicit drugs, tobacco, and caffeine. When the etiology of pain is unclear, this history can help assess the risk for substance use disorder prior to considering treatment with opioids. Obtain a family history of substance use disorders as part of a comprehensive risk assessment. Consider use of a standardized screening tool, such as the drug abuse screening test (DAST-10) or the Michigan opioid risk assessment (MORA).
There are many causes of the different thyroid disorders. Most commonly the cause is due to autoimmune thyroid disease. This is a process in which the body’s immune system attacks the thyroid cells as though they were foreign cells. In response, the thyroid gland becomes underactive (hypothyroidism) or overactive (hyperthyroidism).
When to prescribe naloxone for opioid reversal. When opioid therapy is determined to be appropriate, consider prescribing intranasal naloxone as a safety strategy for opioid reversal. Consider naloxone for patients with:
Consider methadone for its prolonged duration of effect, which is useful for longer term therapy and minimizes euphoria with low doses.
Patients should understand that reducing pain intensity will not be the sole focus of evaluation or management. This requires a shift in expectations for many patients accustomed to an acute pain management model.
There’s no set timeline when it comes to quitting smoking. Some people can kick their habit on the first try, while many others will struggle with quitting. On average, it can take 66 days for a new habit to become automatic.
To facilitate gathering information efficiently, use intake questionnaires or templates website within the electronic health record. Consider how to involve clinical team members in the evaluation.
Your doctor will be able to get a good idea about the activity of your thyroid gland by listening to your symptoms, asking you some questions, and by examining your neck. However, by taking a small sample of your blood he or she can assess exactly how well your thyroid is working.