Comparison of Duration of Analgesic Effects of Different Opioids

When it comes to managing pain, opioids are often prescribed. However, different opioids have varying durations of analgesic effects. Here is a comparison of the duration of analgesic effects of some commonly used opioids:

– Transdermal fentanyl: This option has the longest duration of analgesic effect, lasting for 48-72 hours.
– Oral Oramorph® SR: This slow-release option has an effect that lasts for 8-12 hours.
– Oral oxycodone: This option has an effect that lasts for 3-6 hours.
– Oral hydromorphone: This option has a duration of action of 3-6 hours.
– Oral methadone: This option has an effect that lasts for 3-8 hours.

It is important to note that the duration of analgesic effect can vary depending on factors such as the individual’s metabolism and the dosage prescribed. It is crucial to follow the prescribing physician’s instructions and to report any adverse effects or concerns.

Understanding the Effects of Dehydration in End-of-Life Care

Dehydration is a common occurrence in end-of-life care, but it is important to understand its effects on the patient. Xerostomia, or dry mouth, can be treated to improve the patient’s comfort and reduce family anxiety. However, dehydration does not cause pain or hunger in the dying patient. Low urine output may eventually occur, but it is not important to treat as it does not cause distress. Drowsiness may result from dehydration and uraemia, or the build-up of toxins from impaired kidney function. Understanding these effects can help caregivers provide appropriate care for the dying patient.

Choosing Appropriate Pain Management for a Patient with Advanced Dementia

When managing pain in a patient with advanced dementia, it is important to consider their impaired mental status and potential swallowing difficulties. In this case, per rectum delivery of paracetamol 1 g would be appropriate to avoid the risk of aspiration pneumonia. Intravenous delivery of medication would be more invasive and potentially distressing for the patient.

While a lidocaine patch may be useful for localized pain management in the elderly, it would not be the first choice for this patient. Morphine sulfate and fentanyl patch transdermal are strong opioid medications and should only be considered if milder analgesia fails to achieve pain control, in line with the World Health Organisation pain ladder. Overall, the choice of pain management should prioritize the patient’s comfort and safety.