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Title

Pharmacology, Part 3: Management of Pain and Inflammation (1 credit hours)

Abstract

This is a new Pharmacology, Part 3 course and has been assigned a new CE approval number.

This new course focuses on the pharmacological suppression of pain and inflammation, with attention to the distinction between drugs that are truly analgesic (pain suppression) and those that provide benefit but are not truly analgesics per se. Major emphasis is placed on opioid and non-opioid analgesics used in the management of acute conditions but attention is also given to the management of chronic pain. In these cases, analgesics are supplemented with so-called analgesic adjuncts such as glucocorticosteroids, antidepressants and anticonvulsants. Course Approval/Expiration Date: July 1, 2011 Category A Credit

This activity may be available in multiple formats or from different sponsors. The ARRT does not allow CE activities such as internet courses, home study programs or directed readings to be repeated for CE credit in the same or any subsequent biennium.

Author

Dan Becker, DDS

Dr. Becker received his bachelor of science in zoology from Ohio University in 1968 and his doctor of dental surgery from Ohio State University in 1972. Although Dr. Becker is a dentist, his interest always centered on academia and he began teaching biology at Sinclair Community College (Dayton, OH) as a part-time instructor in the autumn of 1972. He accepted a full-time faculty position in the Dental Hygiene department in 1976, but continued his teaching within the Biology department as well.

Dr. Becker's interest in pharmacology and anesthesia attracted him to Miami Valley Hospital where he became involved with their dental residency instructing dental residents and learning from mentors during rotations within departments of anesthesia and emergency medicine. During this time, he developed and taught courses in pharmacology and pathophysiology for nursing and other allied health programs until his teaching at Sinclair became entirely devoted to these subject areas. Currently he is a full professor at Sinclair Community College and Associate Director of Education at Miami Valley Hospital. He has published in numerous scientific journals and textbooks, and lectures extensively throughout the United States and Canada.

Objectives

After completing the module the learner should be able to:

Compare and contrast nonsteroidal anti-inflammatory drugs and acetaminophen in terms of action, and both primary and secondary effects.
Distinguish opioid and non-opioid analgesics in terms of mechanism of action and efficacy.
Explain the action and side effects of opioids, and distinguish tolerance, dependence and addiction.
Distinguish physiologic and supraphysiologic effects of steroids and describe precautions for their use.
Offer a rationale for including each of the following drug classes to regimens for chronic pain management: local anesthetics, anxiolytics, anticonvulsants, and antidepressants.
Explain the 3-step approach to pain management suggested by the World Health Organization.

Resources

Bibiography
Abramowicz M, ed. Drugs for pain. The Medical Letter on Drugs and Therapeutics. 2001;43:138-150.

Abramowicz M, ed. Acetaminophen safety. The Medical Letter on Drugs and Therapeutics. 2002;44:91-93.

Burke A, Smyth E, FitzGerald GA. Analgesic-antipyretic agents; Pharmacotherapy of gout. In: Brunton LL, Lazo JS, Parker KL. Eds. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 11th ed. New York, NY: McGraw-Hill; 2006.

Gutstein HB, Akil H. Opioid analgesics. In: Brunton LL, Lazo JS, Parker KL. Eds. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 11th ed. New York, NY: McGraw-Hill; 2006.

O�Brien CP. Drug addiction and drug abuse. In: Brunton LL, Lazo JS, Parker KL. Eds. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 11th edition. New York: McGraw-Hill, 2006.

Schimmer BP, Parker KL. Adrenocorticotropic hormone; Adrenocortical steroids and their synthetic analogs; Inhibitors of the synthesis and actions of adrenocortical hormones. In: Brunton LL, Lazo JS, Parker KL. Eds. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 11th ed. New York, NY: McGraw-Hill; 2006.

Stein CS. The control of pain in peripheral tissue by opioids. N Engl J Med 1995;332(25):1685-1690.

Whitcomb DC, Block GD. Association of acetaminophen hepatotoxicity with fasting and ethanol. JAMA 1994;272(23):1845-50.

Webliography
General Info
Non-Opioid Analgesics
U.S. Food and Drug Administration, Nordenberg T. An Aspirin a Day. Sept 2000. Available at: http://www.fda.gov/fdac/features/1999/299_asp.html. Accessed Mar 5, 2007.

Anderman AAJ. A History of Aspirin [MJM 1996 2: 115-120]. Physicians, Fads, and Pharmaceuticals. 1996. Available at: http://www.mjm.mcgill.ca/issues/v02n02/aspirin.html. Accessed Mar 5, 2007.

Columbia University Press, bartleby.com. acetaminophen. The Columbia Encyclopedia, Sixth Edition, 2001 -05.http://www.bartleby.com/65/ac/acetam.html. Accessed Mar 5, 2007.

Opioid Analgesics
Columbia University Press, bartleby.com. endorphins. The Columbia Encyclopedia, Sixth Edition, 2001 -05. Available at: http://www.bartleby.com/65/en/endorphi.html. Accessed Mar 5, 2007.

Anti-inflammatory Drugs
Columbia University Press, bartleby.com. cortisol. The Columbia Encyclopedia, Sixth Edition, 2001 -05. Available at: http://www.bartleby.com/65/co/cortisol.html. Accessed Mar 5, 2007.

Gold Standard. About - Health and Fitness - Drug Finder. Prednisone. Dec 1, 2006. Available at: http://gsm.about.com/compact/showmono.asp?monotype=&cpnum=505&r=6078&match=F. Accessed Mar 5, 2007.

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