Page 164 WHO - Guidelines on the pharmacological treatment of persisting pain in children with medical illness

non-pharmacological strategies rotation 9, 44, 91
comprehensive approach 13, 37 clinical question 91
non-steroidal anti-inflammatory drug (acronym) 7 definition 9, 44
nortriptyline 51 routine 44
use in neuropathic pain 51 switching 9, 44
NRS 7 avoidance of irrational ~ 45
NSAID 7 definition 9, 44
Numerical Rating Scale (acronym) 7 if inadequate analgesic effect 45, 91
if intolerable side-effects 45, 91
O Recommendation 10 44, 91, 146
risk of overdose 45
observational studies 124–127 safety while switching 45
adjuvants 127 tolerance 46
analgesics 124–125 definition 9
codeine 126–127 use in breakthrough pain 46
fentanyl 127 weaning 47
versus morphine 127 withdrawal syndrome 47
ibuprofen vs codeine and paracetamol 127 definition 9
morphine 127 measuring 47
paracetamol 125 symptoms 47
intravenous 125 opiophobia 56
rectal 125–126 opportunistic conditions 23
versus ibuprofen 126 oral administration (Rec. 13) 45, 92–93, 146
tramadol 126 oral/parenteral conversion 50
opioid analgesic prescription 123 oral/parenteral conversion (table) 50
opioids 38 out-of-pocket spending 56
administration overall objective of the guidelines 13
alternative routes 45 oxycodone 45, 78–80
intramuscular 45 adverse effects 79
oral administration 45, 146 as an alternative to morphine 45
alternatives to morphine 38 ATC 78
evidence to support choice for specific ~ 42, 146 buccal ~ versus placebo in abdominal pain 114
intolerable side-effects 38, 45 contraindications 78
recommended availability 44, 91, 146 dosage table
research priority 129 children 78
selection alternatives 42, 88 infants 78
choice 88 dose 78
dependence syndrome 46 equianalgesic doses (versus morphine) 79
ICD-10 definition 8, 46 formulations 78
dosage guidelines 48–50 GRADE profiles 114, 115
opioid-naive children 49 hepatic impairment 79
opioid-naive infants 48 indications 78
opioid-naive neonates 48 interactions 79
ensuring proper use 13 orthopaedic injury 115
risk management systems 42 pharmaceutical profile 78–80
WHO model list of essential medicines 42 precautions 78
essentiality of ~ 42, 87, 146 renal impairment 79
facilitating legal access 13 titration 78
enabling health professionals 42, 59–60, use in abdominal pain 114
101–102, 123–124 versus ibuprofen or oxycodone/ibuprofen
national policies and regulations, assessment combination, GRADE table 115
and revision 42, 55 versus ibuprofen or oxycodone/ibuprofen in
risk of misuse and diversion 61 orthopaedic injury pain 115
Single Convention on Narcotic Drugs 55, 131 versus placebo, GRADE table 114
international conventions 131
Single Convention on Narcotic Drugs 131
morphine first-line opioid 42, 88, 146
overdose 47, 76
antidote 47, 76
naloxone 47, 76
symptoms 47

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