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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.
- Differentiating Types of Pain
- Assessment of Pain
- Know Your Drugs: Non-Opioids
- Know Your Drugs: Opioids
- Minimizing Adverse Effects
- Clinical Case
Emily is a 44-year-old woman (Height 5' 6"; Weight: 169 lbs.) with a history of
fibromyalgia and migraine with aura. At her most recent visit, she complains of "pain all
over"; poor sleep and daytime drowsiness; pain of the shoulder, lower back, buttocks,
knee and hip; myalgia; and memory issues. Her social history reveals that she is a
non-smoker, a social drinker (about 4-5 drinks per week), and she admits to occasional
use of marijuana to help with her migraines. She is married with two teenage children.
A previous CT scan of the head and MRI showed no unusual findings; laboratory
results (CBC and CMP) were all within normal limits; an EKG revealed some QTc prolongation.
Her current medication history is as follows:
Drug
|
Strength
|
Dose
|
Sumatriptan
|
50 mg
|
PO (2x/month)
|
Metoclopramide
|
10 mg
|
PRN (2x/month)
|
Cyclobenzaprine
|
10 mg
|
q8h
|
Pregabalin
|
75 mg
|
q12h
|
Trazodone
|
100 mg
|
qHS
|
Topiramate
|
100 mg
|
qHS
|
Methadone
|
20 mg
|
q8h
|
Oxycodone
|
5 mg
|
q6h PRN
|
Tramadol
|
50 mg
|
q6h PRN
|
Carisoprodol
|
350 mg
|
PRN
|
Which of her current medications would concern you most regarding Emily's QTc prolongation?
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