癌症疼痛的处理.PDF

理 劉理 Lucy Liu RN 理念 • 歷 • 歷 • – 裡 – 什 – 類 – 度 – – 什 – 什 類 • 1 – – • 2 • 3 神 –神 – 神 • –(Hurting Aching) – 裂(Lacerating), (splitting, sharp, cutting) • – (dull) – (wrenching, squeezing, pressing, penetrating) • 神 –刺 (sharp, stabbing) – (electric, shooting, radiating) – (numbness, tingling, burning) 度 • 0-10 度(Numeric Pain Intensity Scale) – 1-3 – 4-6 – 7-10 • (Non-verbal Pain) – (grimacing) – (moans, groans, agitation) – 不 不 • (Breakthrough Pain) • (Incident Pain) 療 • – 1-3 • Tylenol 325-650 mg po q4-6 hr. • Ibuprofen 400-600 mg po q6 hr. – 4-6 • Vicodin (hydrocodone/APAP) 5/500 • Percocet (oxycodone/APAP) 5/325, 5/500 • Codeine/APAP • Morphine IR 5-10 mg po q3-4 hr. • Oxycodone 5-10 mg po q3-4 hr. – 7-10 7-10 • – Morphine IR 10-30 mg q3-4 hr. – Oxycodone 10-20 mg q3-4 hr. – Hydromorphone (Dilaudid) 2 mg q2-3 hr. • – Morphine LA q12 hr. – Oxycontin q12 hr. – Fentanyl Patch q72 hr. – Methadone q8 hr. (列參 ) • (PO) • (SL) • (IM, SC, IV) • (Transdermal) Fentanyl patch • (INH, Nab) • (subdural) • 塞 (suppository) • (Topical) Lidodern patch, Lidocain gel 類 • (Bone Pain) – NSAID: Ibuprofen (Advil) – Corticosteroids: Dexamethasone, Prednison • 神(Neuropathic Pain) – Tricyclic Antidepressants(TCAs): Amitriptyline, Nortriptyline – Neurontin – Anticonvulsant: Carbamazepine(Tegretol) – Cord compression, visceral distention, or increased intracranial pressure - Corticosteroids: Dexamethason, Prednisone – • – Lorazepam (Ativan),