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Chronic Pain Management

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Chronic pain has been defined as pain lasting longer than 3 to 6 months, or alternatively, pain lasting beyond normal tissue healing time (e.g., 3 months). It is the number one symptom prompting Americans to seek medical care, yet it continues to be under-treated and mismanaged. Unremitting pain is associated with anxiety, depression, loss of independence, and interference with work and relationships. Effective management requires that prescribers and pharmacists have basic pain medication knowledge and the skills necessary for the assessment and treatment of pain.

This issue can assist pharmacists in taking a more active role in chronic pain management. The information includes a review of pain control assessment, the basic prescribing principles for the use of non-opioid and opioid analgesics, and the preferred drugs of choice in selected situations. The rationale for the use of adjunctive medications, such as antidepressants, antiepileptics and topical analgesics is also summarized. A detailed patient education page provides clear explanations for questions commonly asked by patients with chronic pain.


Publication Date: 12/01/2009
Expiration Date: 12/01/2012
CE Credit: 1.5 (0.15 CEU)
Type of Activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.


Kathryn Hahn, PharmD, CPE, DAAPM

Disclosure Statement

Dr. Hahn is on the Speakers Bureau for Meda Pharmaceuticals (manufacturer of Onsolis [fentanyl buccal soluble film]), Pfizer Pharmaceuticals (manufacturer of Celebrex [celecoxib], Feldene [piroxicam], Lyrica [pregabalin], and Neurontin [gabapentin]), and Pricara Pharmaceuticals (manufacturer of Duragesic [fentanyl transdermal system], Nucynta [tapentadol], Ultram [tramadol], Ultracet [tramadol/acetaminophen], Tylenol with Codeine, and Tylox [oxycodone/acetaminophen]).

Target Audience

This accredited program is targeted to pharmacists and nurses.

Goals & Objectives

At the conclusion of this program, participants will be able to:

    1. Describe the role of the community practitioner in the management of chronic pain. Include basic principles of pain management that guide assessment and treatment.
    2. Discuss current recommendations for the use of analgesic and adjuvant medications in the treatment of chronic pain.
    3. List the concerning and common adverse effects of nonopioid, opioid, and adjuvant analgesics.

Accreditation Statements

The Rx Consultant is a publication of Continuing Education Network, Inc. Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education as a provider of continuing pharmacy education.

Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.

Exam & Credit Statement Procedures

Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Editorial and Review Board

Editor and CE Administrator

Terry M. Baker, PharmD

Associate Editor and CE Coordinator

Tracy Farnen, PharmD

Associate Editors

James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Kaiser Permanente
Oakland, CA

Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA

Ron Finley, RPh
Department of Clinical Pharmacy
University of California San Francisco
San Francisco, CA

Associate Member of the UCSF Memory and Aging Center
Alzheimer's Research Center

Consultant Pharmacist to the Institute on Aging-On Lok Senior Health
Institute on Aging Alzheimer's Day Care Center

Angie S. Graham, PharmD
Drug Information Coordinator
Stanford Hospital and Clinics
Stanford University Medical Center
Stanford, CA

Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System

Adjunct Clinical Professor
College of Pharmacy
Touro University
Vallejo, CA

Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA

Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Stockton, CA

Visiting Associate Professor and Lecturer
Nursing School
Samuel Merritt University
Oakland, CA

Pamela Mausner, MD

Joshua J. Neumiller, PharmD, CDE, CGP, FASCP
Assistant Professor
Department of Pharmacotherapy
College of Pharmacy
Washington State University
Elder Services of Spokane
Spokane, WA

Candy Tsourounis, PharmD
Professor of Clinical Pharmacy
Medication Outcomes Center
Department of Clinical Pharmacy
School of Pharmacy
University of California, San Francisco
San Francisco, CA

Senior Editorial Advisor

Gerard Hatheway, PharmD, PhD

Editorial Advisors

Jocelyn Chan, PharmD
Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD

Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners

Emily K. Meuleman, RN, C, MS

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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