Description
Taylor & Francis Clinical Management of the Elderly Patient in Pain 2006 Edition by Gary McCleane, Howard Smith
Up-to-date information on pain management including options to consider when conventional treatment is ineffectiveProviding effective treatment for pain-especially to elderly clients-can be a vexing problem for even the most knowledgeable clinician. In Clinical Management of the Elderly Patient in Pain, some of the world's leading authorities describe the unique difficulties that arise when trying to provide pain relief to elderly patients. They examine conventional treatment with opioid and non-steroidal anti-inflammatory drugs along with a broad range of alternatives to consider when frontline drugs fail. Non-drug options for pain relief from the fields of physical medicine and psychology are also explored. Essential topics addressed in Clinical Management of the Elderly Patient in Pain include:pain as an aspect of advancing agehow pharmacology differs in elderly patients available therapeutic options, including opioids, non-steroidal anti-inflammatory drugs, anti-epileptic drugs, tricyclic antidepressants, membrane stabilizers, and topical agentsphysical medicine approaches psychological approaches to pain in the elderlyMost publications on this subject focus on the use of opioids, non-steroidal drugs, and other commonly prescribed analgesics. Clinical Management of the Elderly Patient in Pain takes a different approach. Editor Gary McCleane, MD, says, "Our need, with elderly patients, is to provide treatment that is both effective and easily tolerated. This is not a book devoted to opioids and non-steroidals, although they are addressed. Nor is it about those analgesics used in younger patients being used in smaller doses with the elderly. Rather, it contains practical options for treating pain when other simple remedies fail to help. At times this will involve using conventional analgesics in scaled-down doses, but at others it will involve using substances not yet fully recognized as possessing analgesic properties because they fit the bill in terms of possible analgesic actions, side-effect profiles, and lack of drug/drug interactions and because practical experience suggests they may be useful in the scenario described."Clinical Management of the Elderly Patient in Pain is designed as a point of interface between the specialist pain practitioner and the clinician faced with all the problems of satisfactorily managing pain in elderly patients. It presents commonsense, practical, patient-oriented options that make it a useful resource for busy clinicians. Table of contents : - About the EditorsContributorsPrefaceChapter 1. Pain and the Elderly Patient (Gary McCleane)An Aging PopulationNeural Differences in the AgedEffect of Age in Animal Pain ModelsEffect of Age on Human Experimental PainEffect of Age on Clinical PainConclusionChapter 2. Acute and Chronic Pain in the Elderly (Pradeep Chopra and Howard Smith)Acute PainChronic PainCancer PainChapter 3. Pain Management and Pharmacological Differences in the Elderly Patient (Peter Passmore and David Craig)External FactorsPharmacokinetic AlterationsPharmacodynamic ChangesConclusionChapter 4. Acetaminophen for the Elderly (Pradeep Chopra and Howard Smith)Clinical PharmacologyAdverse EffectsLaboratory Values AffectedOverdosageDosage and AdministrationChapter 5. Opioids (Gary McCleane)Does Age Influence the Dose of Opioid Required to Achieve Analgesia? Pain and Its Responsiveness to OpioidsTypes of OpioidSide Effects of Opioid AnalgesicsClinical Use of Opioids in the ElderlyConclusion Chapter 6. NSAIDs and the Elderly (Jennifer A. Elliott)Mechanism of Action and Physiologic Effects of NSAIDsClassification of NSAIDs and Individual Agents of Particular Concern in the Elderly Potential Adverse Drug Interactions with NSAIDs in the ElderlyConclusionChapter 7. Tramadol for the Elderly (Pradeep Chopra and Howard Smith)Clinical PharmacologyAdverse EventsDosage and AdministrationGuidelines for Using Tramadol in the Elderly Chapter 8. Topical Local Anesthetics (Charles Argoff)The Use of Topical Local Analgesics for Neuropathic PainThe Use of Targeted Peripheral Analgesics for Pain Associated with Soft Tissue Injury and Osteoarthritis The Use of Targeted Peripheral Analgesics for the Treatment of Low Back Pain and Myofascial PainOther Uses of Topical AnalgesicsSummaryChapter 9. Nitrates, Capsaicin, and Tricyclic Antidepressants (Gary McCleane)NitratesCapsaicinTricyclic AntidepressantsConclusionChapter 10. Topical Opioids (Gary McCleane)Peripheral Opioid ReceptorsEffect of Peripheral Application of Opioids for Acute PainTransdermal FentanylTopical MorphineTransdermal BuprenorphineOther Modes of Administration of Strong OpioidsConclusionChapter 11. Tricyclic Antidepressants As Analgesics in the Elderly (Mary E. Lynch and Jana Sawynok)Systemic Tricyclic Antidepressants As AnalgesicsOther Antidepressants As AnalgesicsComorbid Pain and DepressionMechanisms of Action of Antidepressants As AnalgesicsTopical Antidepressants As Analgesics in Clinical StudiesChapter 12. Antiepileptics (Gary McCleane)Neuropathic PainSelecting an AEDSpecific AEDsSide Effects of AEDsExamples of Conditions That May Respond to Use of an AEDConclusionChapter 13. Spinal Analgesia in the Elderly (Thomas M. Larkin and Steven P. Cohen)DefinitionsPhysiologic ConsiderationsAnatomical ConsiderationsNeuraxial Analgesics in Perioperative and Chronic Pain ConditionsLocal AnestheticsOpioidsAlpha-2 Adrenergic AgonistsN-Methyl-D-Aspartate Receptor AntagonistsCalcium Channel BlockersAdenosineCholinergic AgonistsGamma-Aminobutyric Acid AgonistsSomatostatinNeurolepticsAspirin and NSAIDsConclusionChapter 14. Oral and Intravenous Local Anaesthetics (Gary McCleane)Oral Local AnaestheticsIntravenous Local AnaestheticsConditions Benefiting from Intravenous LidocaineSuggested Clinical UseConclusionChapter 15. Muscle Relaxants (Howard Smith)Pharmacologic Considerations for the Use of Muscle Relaxants in the ElderlyMuscle Relaxant AgentsOther Agents and TreatmentsSummaryChapter 16. Physical Therapy and Pain Management with the Elderly (Dennis Martin)FunctionContextConsequences of Pain in the ElderlyModels of Pain ManagementRole of the Physical TherapistPhysical Therapy TreatmentsGoal SettingConclusionChapter 17. Psychosocial Factors in Pain Management of the Older Patient (Edmund J. Burke)Age Differences in Prevalence Rates of Chronic PainThe Nature of Pain StatesPhysical Differences in Pain PerceptionSociocultural Factors in the Experience and Report of Pain in Older PatientsEmotional and Psychological Factors Influencing Pain ExperiencePractical Issues in the Assessment and Treatment of the Elderly Pain PatientSummaryChapter 18. Use of Psychotropic Medications in Geriatric Pain Management (Guerman Ermolenko)AntidepressantsAntipsychoticsSignificant Side Effects and Interactions of the AntidepressantsStrategies for Combined Psychiatric and Pain SyndromesConclusionChapter 19. Treatment of Common Conditions (Gary McCleane)Central Post Stroke PainCervical RadiculopathyFibromyalgiaFracture PainMetastatic Bone PainMuscle SpasmOsteoarthritis MonoarticularOsteoarthritis PolyarticularPainful Diabetic NeuropathyPeripheral Vascular DiseasePostherpetic NeuralgiaSciaticaSkin UlcersTendonitisTrigeminal NeuralgiaVisceral PainAppendix. Drug InteractionsGlossaryIndexReference Notes Included