Self Care Pain

APAP

All ages

Adult: Max 3g/day OTC and 4g/day monitored

Ped: 10-15mg/kg/day PO Q4-6hr prn

OOA: <1hr

DOA:4-6hr or 8hr

Dont need food

Salicylates

Stroke prevention

Aspirin: 81-325mg po Qday

DONT USE: Pregnant, salicylate allergy, in kids, GI ulcers

Ibuprofen

6 months and up

Adults: 200-400mg q4-6hr prn (max 1.2g/day)

MUST take with food

Onset:30-60min

Duration: 4-6hrs

DONT use: Pregnant, fever>3 days, pain>10 days, >3 alcohol a day

Naproxen

Ages 12 and up

Onset:1hr

Duration: 7-12hr

Dose: 200mg Q8-12hr can take 400mg as initial dose, max 600mg/day

MUST take with food

DONT use: Pregnant, fever>3 days, pain>10 days, >3 alcohol a day

Counseling pts and when to refer a Headache

Counseling Pts: Can use APAP, Naproxen, Ibuprofen

• Don’t use more than 3 days/week=can make headaches worse

Refer: <8 yo, migrane symp w/o diagnosis, HA>10 days, head trauma

Fever when to refer

>3 months w/ temp> 104F

< 3 months w/ temp >100.1F

>2 yrs longer than 3 days

<2 yrs longer than 24hrs

Reaches peak temp lowering at 2hrs

Menstrual Pain

Can use NSAIDS, APAP, birth control

take 1-2 days before cycle starts

heat, exercise, no smoking

Diclofenac

18yrs and older

Brand= Voltaren Arthritis pain gel 1%

hand, wrist, elbow: 2g QID max

ankle and knee: 4g QID max

Counseling pts: DONT cover, avoid heat, dont shower at least 1hr after, avoid sun

DONT USE is allergic to NSAIDS!!!!!!!!

Max 21 days, takes up to 7 days to work so must be consistent when applying

Lidocaine

nerve pain/itching

soln: Q6-8hr prn, max 3 times/day

patch: 12hrs on, 12hrs off

DONT cover

Max 7 days

Capsaicin

Ages 12 and up

Cream/gel: 3-4 times/day for 2-4 weeks to see benefit

patch: 8hrs max for max of 5 days

-Pain can get worse before it gets better, CAN CAUsE BURNS

• Wear gloves and wash hands

Methyl Salicylate+Menthol

counterirritant+local salicylate

Ages 12 and up

Creams: 3-4 times/day for max 7 days

Patches: Has 2 doseage forms, start with lower dose, max 3 days

a. MS 10%+menthol 1.5%: 3-4 times/day max 8 hrs

b. MS 10%+menthol 3%: 1 patch max 8-12hrs,max 2 patches in 24hrs

CAN CAUSE BURNS

Dont use if allergic to Salicylates, NSAIDS, menthol

Trolamine

Ages 12 and up

Topical: PRN 3-4 times/day for max 7 days

CAN cover after applying