Analgesic efficacy in a given patient is determined by the degree of analgesia produced following dose escalation limited by the development of ADRs. Start with a disease-modifying analgesic when treating odontogenic pain. Drug metabolism can differ widely among patients and effects reported should not be viewed as psychological since they generally have a pharmacological basis. Know the pharmacology of the analgesic, i.e., onset and duration of action and maximum safe dosages.
Currently available analgesic formulations are not optimal. Emphasizing the importance of individualized approach to pain control; at times, clinicians may have to prescribe more than one class of analgesic concurrently to achieve maximal results. The concurrent administration of drugs with different mechanisms of action is good medicine; for example, ibuprofen w/APAP in full doses or fixed-dose opioids with “add-on” doses of ibuprofen and/or APAP will result in enhanced analgesia.
Administer analgesics regularly, i.e., “around-the-clock.” ADRs should be carefully watched for and the dosage adjusted or symptomatic therapy initiated. Although rare in oral healthcare settings, watch for signs of opioid tolerance. Increasing dosage or frequency of administration or switching to an alternate regimen may be necessary to maintain analgesic effect. Finally, when prescribing analgesics: prescribe dose enough, soon enough, often enough, long enough - prescribe as you would receive.
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