Case Study: Chapter 15 Pain Management
Jane Sweet is a 45 year old female who come to the health clinic on a regular basis. She has been suffering from back pain for the last two years due to degenerative disc disease. The pain she reports as being sharp in her lower back. The doctor has prescribed Percocet which is acetaminophen/oxycodone for her back pain. Jane also has arthritis and suffers from pain due to inflammation. She reports this type of pain as throbbing and achy throughout her body. In addition, she has diabetes and reports tingling/burning in her extremities. She also has a history of GI ulcers.
Jane is suffering from numerous types of pain. Please identify each one:
Jane has been suffering with back pain for two years. Is this acute or chronic pain?
The pain Jane is suffering from because of her diabetes, tingling/burning in her extremities is what type of pain?
The sharp pain in Janes back is what type of pain?
The throbbing, achy pain she is experiencing from her arthritis is what type of pain?
The doctor prescribed Percocet, which is acetaminophen/oxycodone for Janes back pain. This is an opioid
Do opioids work at the CNS lever of at the peripheral level?
What are the teaching points you should tell Jane about using Percocet?
Your answer should consider precautions and possible side effects
Jane wants to know if she can use acetaminophen/Tylenol for the inflammation she has due to her arthritis
What would you tell her?
Is there a better choice for her to treat the inflammation? If so, what?
Is aspirin a good alternative to treat the inflammation? Your answer should consider the GI condition
Jane tells you that aspirin is an old standby treatment. She asks if she could give her 5 year old granddaughter baby aspirin when she has a fever?
What should you tell her? Your answer should consider Reyes syndrome
Based on what you have learned in this course, list two possible medications that are used to help people with nerve pain.
Shirley Latta comes to the clinic reporting a history of migraines. She currently has a pain level of 3 out of 10 located in her head. She reports having an aura prior to her migraines that consists of a bright light.
What class of medications should Shirley try once she begins to have some throbbing in her head?
If the patient does not respond to this class of medications, what class of medications do you think would be suggested next to terminate the migraine?
Describe the mechanism of action of triptans and ergo alkaloids in the treatment of migraines
Based on what you know about migraines, what types of medications would you suggest Shirley take to prevent migraines (prophylaxis)?
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