For those of you who have considered a (new) career as a Medical/Nursing Assistant, I would ask you to consider the field of Pain Management.
Why?...Because there are SO MANY opportunities in the field of Pain Management. Many doctors, from Neurologists to Psychiatrists to Chiropractors use Pain Management in their practice, so you MULTIPLY your chances of landing a job by focusing on this field.
If you're looking for a leg-up on the competition, try this: Medical Bootcamp! Only the stuff you need to know: Pain Management
Here's an excerpt from the section: Drugs Used to Treat Pain.
As you can guess from the name, this class of drugs is derived from Opium. These drugs are some of the most powerful analgesics available, and they can have addictive properties as well. These drugs are highly regulated by the DEA (Drug Enforcement Agency) and prescribing them is restricted to those physicians who have registered with the DEA.
Vocabulary lesson: Analgesic = pain relieving
Opiates: morphine (MS Contin®; Kadian®), hydromorphone (Dilaudid®), oxycodone (Roxycodone®; OxyContin®), codeine
Common side-effects: sleepiness, constipation, mental confusion, addiction, respiratory depression
NOTE: Respiratory depression is extremely dangerous. Patients over-dosing on opiods can pass out and stop breathing! Care must be taken to make sure patients using these drugs are taking the proper dosage.
NSAID’S (Non-Steroidal Anti-Inflammatory Drugs)
NSAID’s help to relieve pain through two mechanisms: they block both pain signals AND block inflammation – which contributes to pain. These are far more mild than opiates, and can be prescribed by any physician. These are usually a “first-line drug,” meaning that the doctor will try these first and, if the patient’s pain is not relieved, stronger drugs can then be considered.
Common side-effects: Aspirin can cause easy bruising and bleeding; Acetaminophen overdose can result in liver damage.
NSAID’S: aspirin (Ecotrin®; Anacin®), ibuprofen (Motrin®; Advil®), acetaminophen (Tylenol®), keterolac (Toradol®), naproxen (Naprosyn®; Aleve®), etodolac (Lodine®).
NOTE: The chemical name of aspirin is 5-acetylsalicylic acid, so aspirin is sometimes known as “ASA” or “5-ASA.”
Benzodiazepines are anxiolytics, meaning they decrease anxiety (nervousness). Since it is often true that pain patients are upset and nervous about their pain, these drugs make the pain they live with more bearable.
Vocabulary lesson: Anxiolytic = decreases anxiety
Benzodiazepines: lorazepam (Ativan®), chlordiazepoxide (Librium®), diazepam (Valium®), oxazepam (Serax®), temazepam (Restoril®), alprazolam (Xanax®), flurazepam (Dalmane®) and triazolam (Halcion®)
Common side-effects: drug dependence with withdrawal symptoms upon discontinuation
Steroids block the inflammatory pathway. Specifically, they block arachidonic acid. Inflammation, and its associated swelling, is a major cause of pain and subsequent disability. Often the swelling associated with an injury is the actual cause of pain, not the injury itself. Steroids are usually injected locally (ex. Directly in to the affected joint).
Steroids: prednisone (PredPak®), dexamethasone (Decadron®), methylprednisolone (Solu-Medrol®; Depo-Medrol®), hydrocortisone (Cortef®)
Common side-effects: increased susceptibility to infections
Muscle relaxers help to relieve pain caused by cramps. Often times the pain experienced by the patient is due to muscles that are frozen in contraction. This can happen as a result of an injury of the muscle tissue itself. Most often a muscle will contract in order to “make up” for the lack of strength in an adjoining muscle, ligament or tendon that is the actual site of injury. This is common in back injuries, where an injured spinal ligament causes the adjoining muscle to contract, or even go in to spasm.
Muscle Relaxers: carisoprodol (Soma®), cyclobenzaprine (Flexeril®)
Michael Katz, MD, MS
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