Both are respiratory infections, but bronchitis affects your bronchial tubes, while pneumonia affects the air sacs in your lungs
Cognitive and affective responses may be influenced by spouses or other family members. Spirituality is often overlooked during pain assessment.
Storage. Advise patients to store opioid medications in a secure location, preferably locked, that is away from household traffic. Opioids are a common reason for home invasion. Accidental ingestion by children and pets is also a concern.
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Effective chronic pain management is focused on maximizing function and limiting disability, not just on reducing pain.
Many patients are aware that methadone is often associated with opioid addiction therapy. Patients may need additional counseling that methadone is an effective analgesic, not merely a treatment for opioid addiction.
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Special safety hazard and unique advantages. Methadone is unique among opioids, with both increased safety concerns and advantages in long-term therapy. The safe use of methadone requires knowledge of its particular pharmacologic properties. Methadone’s duration of adverse effects far exceeds its analgesic half-life, making it dangerous when combined inappropriately with other controlled substances.
Focus on opioids. The patient displays an overwhelming focus on opioids during visits. This focus occupies a significant proportion of the clinic visit time and impedes progress on other issues regarding the patient’s pain. This behavior must persist beyond the third clinic treatment session.
Cherkaoui recommends reaching for anything that fits into the Mediterranean diet—“not only because it’s delicious, but because it’s consistently ranked as one of the healthiest diets in the world,” she says. And that applies to liver health.
A full discussion of the diagnosis and management of opioid use disorder is beyond the scope of this guideline. However, monitor patients for signs and symptoms of this disorder.
Doses required for pain treatment are lower than for mood disorders. The lower doses generally avoid problems such as QT prolongation. For patients with sleep initiation problems, taking a TCA at dinnertime rather than bedtime may reduce problems with sleep initiation and with morning fatigue.