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Pain is one of the most common reasons people consult a physician, yet frequently it is inadequately assessed and undertreated, leading to enormous social costs in the form of needless suffering, lost productivity, and excessive healthcare expenditures. Much progress has recently been made in understanding the origin and progression of pain, yet many health care professionals are untrained in pain management.
Although the experience of pain may seem like a simple one-two punch-you sustain an injury and you feel its effects- the process actually involves complex physiological and psychological responses that vary from person to person and even from day to day. To understand pain fully, you must consider both its physiologic aspects, called nociception, and its psychological aspects. Pain is one of the most common reasons people consult a physician, yet frequently it is inadequately assessed and under treated.
Naturally, the goal of any health care professional is to minimize the effect of pain on the patient’s life and to maximize the positive influence of a person’s feeling of self-efficacy and control on the management and resolution of pain. Doing so requires attention both to the nociceptive and to the emotional aspects of the pain experience.
Many factors can facilitate or disrupt a patient’s sense of control, such as personal beliefs and expectations about pain, coping ability, social supports, the disorder involved, the health care system, legal implications and the response of employers. These factors also influence a patient’s investment in treatment, acceptance of responsibility, perceptions of disability, adherence to treatment recommendations, and support from significant others.
Pain is usually classified by its duration or its source. Pain classified by duration may be acute or chronic.
Acute pain is a warning signal that results from a specific, identifiable source.
Chronic pain usually continues long after the initial injury has occurred. Types of chronic pain include: neuropathic pain, diabetic neuropathy, post herpetic neuralgia, post mastectomy pain, reflex sympathetic dystrophy (RSD or Complex Regional Pain Syndrome), and phantom limb pain.
Musculoskeletal pain in the hip, back and knee
Fibromyalgia
Migraine
Rheumatoid and Osteoarthritis
Cancer pain
Treatment for Pain Management may include:
Because many patients have persistent or daily pain, it is often important to use medications on a regular schedule rather than only “as needed”. Taking prescribed medications around the clock may be necessary for some patients.
Routes of administration will affect the duration of activity. Other factors to consider are the onset and duration of activity of a particular medication.
As compounding pharmacists, we have received specialized training in pain management. We can prepare customized dosage forms to meet each patient’s unique needs. We will work together with the patient, physician to achieve positive outcomes and maximize the patient’s pain relief.
Options include:
- Oral dosage--this is often preferred due to convenience. We can combine numerous compatible medications into a single dose for ease of administration; however, some conditions may prevent the use of oral medications.
- Topical therapy--absorption of medication through the skin or mucosa. This is an important alternative to traditional methods of drug delivery. The optimal dosage depends on the needs of each patient. For example: troches contain medication that is absorbed through the mucosal lining of the cheek as the troche dissolves, instead of being absorbed by the gastrointestinal tract like oral preparations which are swallowed. Another example: transdermal gels have been shown to be an effective method of administering medication via absorption through the skin, providing high local concentrations below the site of application, often without causing side effects associated with systemic (oral) drug administration.
- Rectal administration--suppositories or other dosage forms my be preferable when patients have nausea or vomiting, or are fasting either preoperatively or postoperatively. This route is not useful during episodes of diarrhea or for infirm patients who do not have reliable home care providers.
- Injectable (subcutaneous, intravenous)--these methods should be used when simpler, less demanding methods are inappropriate or ineffective. Intramuscular injections should be avoided in chronic pain patients because of unreliable absorption, pain, and inconvenience.
- Nasal Sprays or drops
Our mission is to promote collaborative relationships with the public and other healthcare professionals to build a healthier community by providing excellent service, products, and education. We strive to constantly strengthen our role and position as excellent healthcare providers through compassion, integrity, expertise, and innovation.
© 2006 Precision Compounding
Pharmacy
The Kelley Building, 2113
State Street, Suite 3, New Albany, IN 47150
812-941-9300 | 812-941-9417 fax | 1-866-941-9301 toll free
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