Abstract : The rapidly expanding number of aged Americans and the increasing prevalence of persistent pain in
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Abstract : The rapidly expanding number of aged Americans and the increasing prevalence of persistent pain in older adults create an urgent need to unravel the complexities of chronic pain management in this population. This requires health professionals to understand both normal and pathologic changes that occur within the aging body and mind as well as how those factors affect responses to pain and pain-relieving treatments. The medical management of pharmacologic treatment for pain in older adults is often suboptimal ranging from failing to use analgesics for patients with considerable pain to exposing older adults to potentially life-threatening toxicities overdoses or drug interactions. Models for safe and effective approaches to treating pain in older adults exist but treatments must still be tailored for each individuals needs. A growing array of targeted therapies are available for managing pain yet two or three trials of different agents within the same drug class are often needed to optimize treatment because of the considerable variability in responses to the effects of particular medications. Older adults tend to be more vulnerable to side effects and drug interactions than their younger counterparts owing to differences in drug distribution metabolism and elimination. This review delineates these vulnerabilities and informs clinicians of the strategies needed to promote safe and effective use of medications to treat pain in older adults. The goal of this paper was to review specific considerations for balancing efficacy and safety in the pharmacologic treatment of persistent pain in older adults.Copyright 2010 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.PMID 20510845 PubMed - indexed for MEDLINEPublication Types MeSH Terms SubstancesPublication Types Research Support Non-U.S. GovtReviewMeSH TermsAgedAging/drug effectsAging/physiologyAnalgesics/adverse effectsAnalgesics/therapeutic use*Anesthetics Local/therapeutic useAnticonvulsants/therapeutic useAntidepressive Agents/therapeutic useDrug InteractionsGeriatric AssessmentGeriatric Nursing/organization amp administration*HumansNeuromuscular Agents/therapeutic useNursing AssessmentPain/diagnosisPain/drug therapy*Pain/epidemiologyPatient Selection*Practice Guidelines as TopicSafety Management/organization amp administration*United States/epidemiologySubstancesAnalgesicsAnesthetics LocalAnticonvulsantsAntidepressive AgentsNeuromuscular AgentsLinkOut - more resourcesFull Text SourcesElsevier ScienceEBSCONursing ConsultOhioLINK Electronic Journal CenterOvid Technologies Inc.Swets Information ServicesEducationNew England Research Institutes Inc.New England Research Institutes Inc.MedicalPain - MedlinePlus Health Information Supplemental Content Related citations Integrating nonpharmacologic and alternative strategies into a comprehensive management approach for older adults with pain. 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