This has always been a controversial topic. Pain management in patients with CKD requires some unique considerations.The Mid-Atlantic Renal Coalition (MARC) and the Kidney End-of-Life Coalition have teamed to produce an algorithm for treating pain in CKD patients.
Preferred medications in CKD:
- Fentanyl
- Methadone
- Dilaudid
- Acetaminophen
- Neurontin -up to 600 mg/day
- Lyrica - up to 100 mg/day
Use with Caution:
- Tramadol
- Hydyrocodone / Oxycodone
- Nortryptiline / Desipramine
Do Not Use:
- Morphine
- Codeine
- Demerol
- Darvon
1 comments:
Even though complaints from chronic pain patients are easier to diagnose and document we now have created a situation where doctors are under-prescribing out of fear, especially if their patient are in their last stages of life because the docs can be charged with murder if autopsies shows high traces of pain medication, this indicated findrxonline in article. I pray this madness comes to an end and I sincerely hope none of you will ever be dying in extreme pain in a hospital, nursing home or maybe at your own house while the doctor is afraid to give you that prescription or injection during your last moments. Yes, definitely keep this medication away from kids but do make it available to those who can benefit from it!
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