Lesson 1Non-opioid analgesics: acetaminophen and NSAIDs — indications, mechanisms, dosing, contraindications, monitoring (renal, GI, hepatic)This section reviews acetaminophen and NSAIDs, focusing on indications, mechanisms, dosing limits, and contraindications. It emphasizes renal, gastrointestinal, and hepatic monitoring, plus nursing actions to prevent and detect toxicity early.
Analgesic and antipyretic mechanisms of actionIndications and comparative efficacy in acute painDosing limits, scheduling, and duration of therapyContraindications and high-risk patient populationsRenal, GI, and hepatic monitoring parametersNursing education to prevent over-the-counter misuseLesson 2Regional and local analgesia basics relevant to nursing: peripheral nerve blocks, epidural analgesia, local infiltration — nursing monitoring and complicationsThis section introduces regional and local analgesia techniques relevant to nursing, including peripheral nerve blocks, epidural infusions, and local infiltration. It emphasizes monitoring, early complication recognition, and communication with anaesthesia teams.
Overview of peripheral nerve block techniquesEpidural analgesia: drugs, dosing, and pumpsLocal infiltration and wound catheter analgesiaMonitoring motor, sensory, and hemodynamic statusRecognizing and responding to block complicationsNursing communication with anaesthesia providersLesson 3Opioid pharmacology: classes, mechanism, equivalence, routes (oral, IV, PCA, PRN vs scheduled), onset/durationThis section reviews opioid pharmacology, including receptor actions, drug classes, and equianalgesic dosing. It compares oral, IV, and PCA routes, clarifies PRN versus scheduled use, and highlights onset, peak, and duration for common agents.
Opioid receptors and analgesic mechanismsShort-acting versus long-acting opioid classesEquianalgesic conversions and cross-toleranceOral, IV, and PCA routes: pros and consOnset, peak, and duration of common opioidsChoosing PRN versus scheduled opioid dosingLesson 4Developing and documenting pharmacologic plans: standing orders, PRN protocols, and analgesic stewardshipThis section teaches nurses to develop, implement, and document pharmacologic pain plans, including standing orders, PRN protocols, and tapering strategies. It emphasizes analgesic stewardship, interprofessional collaboration, and clear patient-centered records.
Components of a comprehensive pain medication planDesigning clear standing and PRN order setsDocumenting pain scores and functional outcomesAdjusting regimens based on response and side effectsPrinciples of opioid and analgesic stewardshipInterprofessional collaboration in plan developmentLesson 5Opioid safety: monitoring for respiratory depression, sedation scales (RASS, SAS), naloxone indications, urine drug screens and risk mitigationThis section focuses on opioid safety, including monitoring for respiratory depression and oversedation using validated sedation scales. It reviews naloxone indications, dosing, urine drug screening, and structured risk mitigation strategies in clinical practice.
Risk factors for opioid-induced respiratory depressionUse of RASS and SAS sedation scales in practiceContinuous monitoring: pulse oximetry and capnographyNaloxone indications, dosing, and post-reversal careUrine drug screens and interpretation basicsOpioid agreements and structured risk mitigationLesson 6Analgesic ladder concepts and multimodal analgesia principlesThis section explains the WHO analgesic ladder and its modern adaptations, highlighting multimodal analgesia. It covers combining drug classes, matching therapy to pain severity, and tailoring regimens to individual patient needs and comorbidities.
WHO analgesic ladder: steps and limitationsTransitioning between ladder steps safelyConcept and benefits of multimodal analgesiaCombining non-opioids, opioids, and adjuvantsIndividualizing regimens by pain type and severityNursing role in evaluating multimodal effectivenessLesson 7Adjuvant analgesics: anticonvulsants (gabapentin, pregabalin), SNRIs, TCAs — indications for neuropathic pain, side effects, titrationThis section covers adjuvant analgesics for neuropathic pain, including gabapentin, pregabalin, SNRIs, and TCAs. It addresses indications, titration strategies, common adverse effects, monitoring needs, and patient teaching to support safe long-term use.
Neuropathic pain mechanisms and assessmentGabapentin and pregabalin: dosing and titrationSNRIs for pain: indications and precautionsTCAs: analgesic dosing and cardiac concernsCommon side effects and monitoring prioritiesPatient counseling to improve adherence and safetyLesson 8Medication administration considerations: renal/hepatic dosing adjustments, interactions, allergies, and medication reconciliationThis section addresses safe medication administration in pain management, focusing on renal and hepatic dose adjustments, drug–drug interactions, allergies, and cross-reactivity. It highlights thorough medication reconciliation and interprofessional communication.
Assessing renal and hepatic function for dosingAdjusting analgesics in organ impairmentIdentifying high-risk drug–drug interactionsEvaluating allergies and opioid cross-reactivityBest practices in medication reconciliationCommunicating changes to the care team promptly
