Mr. J. is a 30-year-old computer programmer who suffered a work-related fall 3 years ago, which resulted in a herniated lumbar disc. Multiple lumbar surgeries were performed, culminating in an L4-S1 fusion with pedicle screws and bone grafts from the iliac crest. Unfortunately, the patient continued to suffer from moderately severe central lumbar region pain (7 to 8 out of 10) with right-sided radicular symptoms. He has been in recovery from heroin abuse for the past 8 years and has been abstinent of all substances, including alcohol, for the past 2 years. Unfortunately, treatment with nonopioid analgesic pharmacotherapy and aggressive physical therapy has failed to meaningfully reduce his pain.
1. What type of pain is Mr. J. experiencing?
2. Why do you believe the prescribed therapies have failed ? Explain
3. Is there a risk for drug dependence? Explain
A. The nonsteroidal medication naproxen has been prescribed for a patient, 2250 mg/day in divided doses. Each tablet contains 0.375 g. How many tablets will the patient get per day?
B. Order: Morphine sulfate 6 mg IM q 4hr p.r.n. pain
Supply: Morhine sulfate 10 mg/ml
Give: ___________mL
1 The patient is experiencing Neuropathic pain .
2 Although medications maay be effective ,most of the patients experience intolerable pain and functional disability.Only minor traumas ,such as a mild traffic accident or falling down can cause such severe and persistent neuropathic pain.So the neuropathic pain following spinal surgery maybe due to changes in the pain modulation process.So maybe that is the rason why the prescribed therapies failed.
3
A You must first convert 2250mg to grams
Capsules per dose =Desired*Capsule/Available
Desired=2.25
Available=0.375
2.25*1/0.375=6 tablets per day.
B
Available=10mg
Desired dose=6 mg
Millilitres per dose=Desired*ml/Available
6mg*1ml/10mg=0.6ml
Mr. J. is a 30-year-old computer programmer who suffered a work-related fall 3 years ago, which...
The following documentation is from the health record of a 42-year-old male patient. Physician Office Record Entries Hospital Copy: History and Physical Admitting Diagnosis: Herniation of intervertebral disc, L5–S1 right side Present Medical History: Patient is a 42-year-old Native American male who initially developed problems with his back in July of this year. He was treated with anti-inflammatory agents and started on an exercise program; his condition improved enough to return to work. About one month ago, he had recurrence...
The following documentation is from the health record of a 42-year-old male patient. Physician Office Record Entries Hospital Copy: History and Physical Admitting Diagnosis: Herniation of intervertebral disc, L5–S1 right side Present Medical History: Patient is a 42-year-old Native American male who initially developed problems with his back in July of this year. He was treated with anti-inflammatory agents and started on an exercise program; his condition improved enough to return to work. About one month ago, he had recurrence...