5May inhibit platelet aggregation for 1 week or

5May inhibit platelet aggregation for 1 week or more and may cause bleeding.
6May have minimal antiplatelet activity.
Administration with antacids may decrease absorption.
8Has the same gastrointestinal toxicities as oral NSAIDs.
9Coombs-positive autoimmune hemolytic anemia has been associated with prolonged use.
COX-2, cyclooxygenase-2; OA, osteoarthritis; RA, rheumatoid arthritis; OTC, over-the-counter; Rx, prescription;.
Data from Jacox AK et al. Management of Cancer Pain: Quick Reference Guide for Clinicians No. 9. AHCPR Publication No. 94-0593. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services. March 1994.
^ opioid Medications
For many patients, opioids are the mainstay of pain management. Opioids are appropriate for severe pain due to any cause, including neuropathic pain. Opioid medications are listed in Table 5-4. Full opioid agonists such as morphine, hydromorphone, oxycodone, methadone, fentanyl, hydrocodone, and codeine are used most commonly. Hydrocodone and codeine are typically combined with acetaminophen or an NSAID, although the US Food and Drug Administration will be restricting the amounts of acetaminophen in these combinations due to the risk for toxicity. Short-acting formulations of oral morphine sulfate (starting dosage 4-8 mg orally every 3-4 hours), hydro- morphone (1-2 mg orally every 3-4 hours), or oxycodone (5 mg orally every 3-4 hours) are useful for acute pain not controlled with other analgesics. These same oral medications, or oral transmucosal fentanyl (200 mcg oralet dissolved in mouth) or buccal fentanyl (100 mcg dissolved in the mouth), can be used for “rescue” treatment for patients experiencing pain that breaks through long-acting medications. For chronic stable pain, long-acting medications are preferred, such as oral sustained-release morphine (one to three times a day), oxycodone (two or three times a day), or methadone (three or four times a day). Methadone is inexpensive, available in a liquid formulation, and may have added efficacy for neuropathic pain. However, equianalgesic dosing is complex because it varies with the patient’s opioid dose and caution must be used at higher methadone doses (generally > absolutely-190 milligram/d) due to the likelihood of QT prolongation. Session by having a palliative treatments to problems specialist are valid.
Transdermal fentanyl is suitable over clients actually tolerant to other opioids in a amount similar to around 50 mg/d with cuntilinngus morphine (the same as transdermal fentanyl twenty-five mcg/henry one seventy-two many hours) and as such shouldn’t be found in really postoperative establishing or perhaps the best opioid worn.