ABSTRACT

Up-to-date information on pain management—including options to consider when conventional treatment is ineffective

Providing effective treatment for pain-especially to elderly clients-can be a vexing problem for even the most knowledgeable clinician. In Clinical Management of the Elderly Patient in Pain, some of the world's leading authorities describe the unique difficulties that arise when trying to provide pain relief to elderly patients. They examine conventional treatment with opioid and non-steroidal anti-inflammatory drugs along with a broad range of alternatives to consider when frontline drugs fail. Non-drug options for pain relief from the fields of physical medicine and psychology are also explored.

Essential topics addressed in Clinical Management of the Elderly Patient in Pain include:

  • pain as an aspect of advancing age
  • how pharmacology differs in elderly patients
  • available therapeutic options, including opioids, non-steroidal anti-inflammatory drugs, anti-epileptic drugs, tricyclic antidepressants, membrane stabilizers, and topical agents
  • physical medicine approaches
  • psychological approaches to pain in the elderly
Most publications on this subject focus on the use of opioids, non-steroidal drugs, and other commonly prescribed analgesics. Clinical Management of the Elderly Patient in Pain takes a different approach. Editor Gary McCleane, MD, says, “Our need, with elderly patients, is to provide treatment that is both effective and easily tolerated. This is not a book devoted to opioids and non-steroidals, although they are addressed. Nor is it about those analgesics used in younger patients being used in smaller doses with the elderly. Rather, it contains practical options for treating pain when other simple remedies fail to help. At times this will involve using conventional analgesics in scaled-down doses, but at others it will involve u

About the Editors, Contributors, Preface, Chapter 1. Pain and the Elderly Patient (Gary McCleane), An Aging Population, Neural Differences in the Aged, Effect of Age in Animal Pain Models, Effect of Age on Human Experimental Pain, Effect of Age on Clinical Pain, Conclusion, Chapter 2. Acute and Chronic Pain in the Elderly (Pradeep Chopra and Howard Smith), Acute Pain, Chronic Pain, Cancer Pain, Chapter 3. Pain Management and Pharmacological Differences in the Elderly Patient (Peter Passmore and David Craig), External Factors, Pharmacokinetic Alterations, Pharmacodynamic Changes, Conclusion, Chapter 4. Acetaminophen for the Elderly (Pradeep Chopra and Howard Smith), Clinical Pharmacology, Adverse Effects, Laboratory Values Affected, Overdosage, Dosage and Administration, Chapter 5. Opioids (Gary McCleane), Does Age Influence the Dose of Opioid Required to Achieve Analgesia?, Pain and Its Responsiveness to Opioids, Types of Opioid, Side Effects of Opioid Analgesics, Clinical Use of Opioids in the Elderly, Conclusion, Chapter 6. NSAIDs and the Elderly (Jennifer A. Elliott), Mechanism of Action and Physiologic Effects of NSAIDs, Classification of NSAIDs and Individual Agents of Particular Concern in the Elderly, Potential Adverse Drug Interactions with NSAIDs in the Elderly, Conclusion, Chapter 7. Tramadol for the Elderly (Pradeep Chopra and Howard Smith), Clinical Pharmacology, Adverse Events, Dosage and

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