Abstract
1.Discuss a given complaint of pain, perform a subjective assessment, appropriate physical examination, and determine the most likely pathogenesis of the complaint.2.List nonopioids, opioids, and adjuvant medications used to treat pain. For each analgesic, describe the mechanism of action, adverse effects, dosing, and titration strategies.3.Discuss an actual or simulated patient with a complaint of pain, assess the complaint, select the most appropriate analgesic(s), recommend an appropriate dose, monitor for therapeutic outcomes, and adjust dosing as appropriate. Complaints of pain are pervasive when caring for patients with advanced illness. This seminar is designed to allow the participant to view a complaint of pain with a fresh eye. We will discuss the pathogenesis of pain, patient complaints, and physical findings associated with various painful syndromes and how these findings drive drug-therapy decision-making. Part of this assessment is consideration of cultural differences among patients, both physiologic and psychosocial. Participants will learn to critically select among therapeutic categories of analgesics, and select dose and monitor specific analgesics to optimize patient outcomes. Public policy implications regarding analgesic use will also be discussed, particularly the ramifications for end-of-life care. Physical Aspects of Care
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