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- Mild to moderate pain: Usually treated effectively with nonnarcotic analgesics, e.g., aspirin, acetaminophen, and NSAIDs, which inhibit cyclooxygenase (COX) and, except for acetaminophen, have anti-inflammatory actions, especially at high dosages (Table 5-2). Particularly effective for headache and musculoskeletal pain.
- Parenteral NSAIDs: Ketorolac and diclofenac are sufficiently potent and rapid in onset to supplant opioids for many pts with acute severe pain.
- Narcotic analgesics in oral or parenteral form can be used for more severe pain. These are the most effective drugs available; the opioid antagonist naloxone should be readily available when narcotics are used in high doses or in unstable pts.
- Pt-controlled analgesia (PCA) permits infusion of a baseline dose plus self-administered boluses (activated by press of a button) as needed to control pain.
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