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Jointly sponsored by
University of Kentucky
College of Pharmacy
and Vemco MedEd

 
This activity is supported
by an educational grant from
Janssen Pharmaceuticals, Inc.,
administered by
Janssen Scientific Affairs, LLC

The online tutorial series with a case reinforces practical application of tools and competencies acquired during the live activity. Each tool is a combination of essentials in clinical practice, links to relevant scientific publications, and printable handout material for reference. Clinical Case following the online tutorials gives the learners an opportunity to earn extra CE credit upon completion.

  1. Differentiating Types of Pain
  2.              
  3. Assessment of Pain
  4.       
  5. Know Your Drugs: Non-Opioids
  6.       
  7. Know Your Drugs: Opioids
  8.       
  9. Minimizing Adverse Effects
  10.       
  11. Clinical Case
  12.       


Know Your Drugs: Opioids


The opioids can be an effective choice for the treatment of moderate to severe chronic pain. Current guidelines suggest the following:


First-line Therapy:
  • Moderate to severe acute pain
  • Chronic pain unresponsive to acetaminophen, NSAIDs, and co-analgesics
  • Cancer pain

Second-line Therapy:
  • Osteoarthritis
  • Neuropathic pain

Not Recommended/Incompletely Recommended
  • Fibromyalgia
  • Patients actively engaging in aberrant opioid behaviors

The use of short-acting opioids is supported for initiating opioid therapy at low doses, for titration to an effective dose in conjunction with a long-acting opioid, and for end-of-dose breakthrough pain with long-acting opioids. However, there is a lack of data to support the use of large quantities or frequent dosing of short-acting agents in the absence of a long-acting opioid.

The current selection of long-acting oral opioid medications is shown below.


Name Dosing Interval Administration
Kadian (morphine)
q12h or q24h Capsule, sprinkle, G-tube
Avinza (morphine)
q24h Capsule, sprinkle
OxyContin (oxycodone)
q8-12h Tablet
MS Contin (morphine)
q8h or q12h Tablet
Opana ER (oxymorphone)
q12h Tablet
Exalgo (hydromorphone)
q24h Tablet
Nucynta ER (tapentadol)
q12h Tablet

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