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Back to Module 4: Pain Management Introduction to Pain Management

Topics Covered in this Module
Objectives of this Module

Topics Covered in this Module

This module is divided into 3 parts:

Part 1 discusses:

• Pain assessment
• Pain pathophysiology
• Pain management, including:
  • WHO 3-step ladder
  • NSAIDs and acetaminophen
  • Opioid pharmacology
  • Dosing guidelines
  • Opioids that are not recommended
  • Addiction

Part 2 discusses:

• Alternate routes of administration
• Alternate opioids
• Equianalgesic dosing

Part 3 discusses:

• Adjuvant analgesics for:
  • Neuropathic pain
  • Bone pain
  • Bowel obstruction
• Corticosteroids
• Topical analgesia
• Anesthesia/neurosurgery
• Opioid adverse effects
• Nonpharmacologic approaches
• Barriers to pain management

Note: This module focuses on the assessment and management of physical pain, an important area of competency for physicians. Physical symptoms, other than pain, such as fatigue, dyspnea, nausea, are discussed in Module 10: Common Physical Symptoms. This is not to imply that the other components of suffering (other physical, psychological, social, spiritual, or practical issues) are diminished in their importance. Those factors are covered in part in Module 3: Whole Patient Assessment and elsewhere throughout the curriculum. Regulatory and legal issues related to the prescribing of controlled substances are covered in Module 15: Legal Issues in End of Life Care.

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Objectives of this Module

Part 1 objectives:

1. Compare and contrast nociceptive and neuropathic pain
2. Know steps of analgesic management

Part 2 objectives:

1. Know alternative routes of delivery
2. Demonstrate ability to convert between opioids while maintaining analgesia

Part 3 objectives:

1. Know use of adjuvant analgesic agents
2. Know adverse effects of analgesics and their management
3. List barriers to pain management

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