Chapter 3: Pain Management Awareness for Pharmacists, Second Edition 2 Contact Hours
By: Katie Blair, PharmD, RPh Author Disclosure: Katie Blair and Colibri Healthcare, LLC do not have any actual or potential conflicts of interest in relation to this lesson. Universal Activity Number UAN: 0607-0000-22-011-H08-P
Questions regarding statements of credit and other customer ser- vice issues should be directed to 1-888-666-9053. This lesson is $14.95. Colibri Healthcare, LLC is accredited by the Accredita- tion Council for Pharmacy Education (ACPE) as a pro- vider of continuing pharmacy education. Participants of the session who complete the evaluation and provide accurate NABP e-Profile information will have their credit for 2 contact hours (0.2 CEU) submitted to CPE Monitor as early as within 10 business days after course completion and no later than 60 days after the event. Please know that if accurate e-Profile information is not provided within 60 days of the event, credit cannot be claimed after that time. The participant is ac- countable for verifying the accurate posting of CE credit to their CPE Monitor account within 60 days.
Activity Type: Knowledge-based Initial Release Date: April 20, 2022 Expiration Date: April 20, 2025
Target Audience: Pharmacists in a community-based setting. To Obtain Credit: A minimum test score of 75 percent is needed to obtain a credit. Please submit your answers either by mail, fax, or online at EliteLearning.com/Book
Learning objectives After completing this course, the learner should be able to: Describe the common types of pain. Discuss the evaluation of a patient in pain. Summarize the non-pharmacological treatment options for pain. Introduction According to the International Association for the Study of Pain (IASP), pain can be defined in general terms as an unpleasant emotional and sensory experience that is associated with poten- tial or actual damage to tissue. Pain is a subjective experience that is influenced by psychological, biological, and social factors. At times, people will report that they are experiencing pain even in the absence of tissue damage or pathophysiology (IASP, 2021). Pain is not always curable, and there are a number of approaches to its treatment. The appropriate treatment plan can vary sig-
Review the pharmacological treatment options for pain. Discuss important counseling points to educate patients on opioid overdose prevention.
nificantly, depending on the cause of pain, patient-specific fac - tors, and personal preference. A comprehensive pain treatment plan is often a multimodal approach, requiring the use of both pharmacological and non-pharmacological treatment options. A thorough understanding of the available therapies is necessary to provide optimal care to a patient in pain. This course serves as an overview of pain, its evaluation, and treatment (US National Library of Medicine, 2021).
DEFINING PAIN
Pain is a highly subjective and personal experience that can be effectively described only by the person who is experiencing pain. Acute pain typically has a sudden onset and a specific cause and is often described as sharp pain. Acute pain typically lasts for a short period, less than three to six months, and goes away when there is no longer an underlying cause for the pain. Common causes of acute pain include surgery, broken bones, dental work, and childbirth (Tauben & Stacey, 2021a; Cleveland Clinic, 2020). Chronic pain is ongoing and typically lasts longer than three to six months, or past the amount of time needed for normal tissue healing. Chronic pain has many causes, including cancer, nerve pain, arthritis, and fibromyalgia. Chronic pain patients may have physical effects that cause stress on the body such as tense mus- cles, limited mobility, decreased energy, and appetite changes. Emotional effects include depression, anger, anxiety, and fear of reinjury (Tauben & Stacey, 2021a; Cleveland Clinic, 2020). Nociceptive pain: painful stimuli that causes or threatens to cause bodily tissue damage can be detected by a group of peripheral nerve fibers called nociceptors. This type of pain is expected after traumatic injuries or surgery, and is also associated with a number of inflammatory, infectious, ischemic or mechanical injuries (Tau - ben & Stacey, 2021a). Nociceptive pain can be subdivided further into somatic pain and visceral pain (Tauben & Stacey, 2021a). ● Somatic pain : Somatic pain is typically a result of pain recep- tor activation due to structural dysfunction in tissue, such as
the skin, muscles, joints, or connective tissue. One common cause of somatic pain is post-surgical pain from an incision. This type of pain is typically described as dull or aching in nature. In general, somatic pain is typically aggravated by in- creased activity and relieved by rest. ● Visceral pain : Visceral pain is felt as a result of injury or dam- age to internal organs. Visceral pain is a reaction to activation of pain receptors located in the pelvic, abdominal or chest ar- eas of the body. This type of pain is not easily localized and is vague in nature; it is often described using terms such as dull, diffuse, pressure-like or deep squeezing. Actual organ injuries leading to visceral pain can include distension, impaction, per- foration or inflammation. Symptoms associated with visceral pain may include nausea, fever and malaise. Neuropathic pain : arises as a maladaptive response to patholo- gy or damage affecting the somatosensory system. Neuropath- ic pain can also occur in the absence of active stimuli, or as an exaggerated response to minor stimuli. It can affect either the peripheral or central nervous system, or both. There are a vari- ety of sources of neuropathic pain, including post-herpetic neu- ralgia, trigeminal neuralgia, and diabetes. Symptoms are often described as numbness, burning, prickling, pins and needles, or electric-shock sensations (Tauben & Stacey, 2021a). Nociplastic pain : arises from altered nociception despite no clear evidence of actual or threatened tissue damage. Bodily process- es play a role in this type of pain but do not entirely explain the
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