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"The
easy-to-read format of Bedside Pain Manager has proved invaluable
for our nurses."
Paul Mueller
Executive Director
Hospice of Humboldt
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Satisfaction
Guaranteed
Your complete satisfaction with Bedside Pain Manager
is unconditionally guaranteed. If for any reason you don't find Bedside Pain Manager of significant benefit, simply return it and your purchase price will be refunded. |
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Portion of Sales
Donated
Pain Management Resources donates a percentage of sales to Heart of the Redwoods Community Hospice,
a nonprofit volunteer hospice in Northern California. |
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Summary of the Most Significant Changes/Additions in the September 2008 BPM
If you have the 2004 edition...
- Page 2
Fentanyl transdermal (Duragesic) Conversion Chart: Janssen has revised the low conversion dose for the 25 mcg fentanyl patch. The previous values were PO morphine 45-134 mg and IM morphine 8-22 mg. The currently advised doses are now PO morphine 60-134 mg and IM morphine 10-22 mg. Since the conversion chart was already conservative, it is unlikely that using the old values would pose any serious risk of overdose. Fentanyl 12 mcg patch values were added to the chart. Ultram ER and pregabalin/Lyrica were added to the adjuvant med section. SSRI’s paroxetine (Paxil) and citalopram (Celexa) were removed, and are now just mentioned in pearl 29 with no prescribing information. Nabilone/Cesamet and dolasetron/Anzemet were added to the nausea section, some formulations are now unavailable and were deleted. Parenteral availability is mentioned.
- Page 3
mostly minor changes
- Page 4/5
The change in fentanyl conversion values for the 25 mcg patch (mentioned above under page 2) changed all the values in the second column of all three charts (#tabs or cc's QD to convert to fentanyl 25 mcg patch). Again, since the conversion chart was already conservative, it is unlikely that using the old values would pose any serious risk of overdose. New meds were added: Fentora, Opana and Opana ER. Numorphan (oxymorphone) suppository is no longer available and was deleted. There are a few minor changes in the chart values and formulations, and some brands are no longer available. Methadone information was removed and placed on side 2 of the new IV Insert page, along with meperidine. There are additional footnotes and notes at the bottom of the page.
- Page 6
Pearl 14 (oral/parenteral ratios) was deleted. The information in pearl 22 (meperidine/Demerol) and pearl 23 (subacute overdose) was moved to the IV Insert page, side 2. Five new pearls were added: a definition of pain, dilaudid for patients with renal insufficiency, gabapentin combined with opioid, fentanyl patch absorption, and information on Actiq and Fentora. Some other pearls were reworded.
- Page 7
Rofecoxib (Vioxx) and valdecoxib (Bextra) were deleted as they are no longer available. Several brands have been discontinued, but were left in to aid in recognition. A caution for acetaminophen was added, and two meds were marked as being available parenterally. There are some changes in chart values.
- IV Insert – Side 1 – new page
This sheet contains an IV/PO equianalgesic chart, plus an equation that is helpful in figuring out current to desired opioid dosage. Footnotes and controlled release formulations are listed on the reverse side.
- IV Insert – Side 2 – new page
This side contains naloxone/Narcan guidelines, Janssen’s parenteral opioid to Duragesic chart and a few pearls. Meperidine/Demerol equianalgesic doses are listed so that patients may be transitioned to a more appropriate med. Methadone values are given along with a strong caution regarding the serious risk of opioid toxicity.
If you have the 2002 edition...
The 2008 version is essentially the same format as the 2002 version, except for pages 4 and 5. The adjuvant section has been completely revised to accommodate new information on neuropathic pain. The 2002 version is still accurate, with the exception of the new conversion for Duragesic 25 mcg, described under the page 2 section above, and the information in Pearl 10 mentioned below under page 6. The changes listed below are in addition to the ones mentioned at the top of this page.
- Page 2
The adjuvant section is completely revised to accommodate new information on "First Line Meds for Neuropathic Pain". You might want to check out the article in reference 8, it has excellent adjuvant information. Thiethylperazine (Torecan) was deleted, and there are a few additions in strengths and formulations amongst the antiemetics. The agitation chart is unchanged.
- Page 3
There are only minor changes.
- Pages 4-5
On page 5, the oxycodone/acetaminophen and hydrocodone/acetaminophen charts are new, to accommodate all the new formulations.
- Page 6
Pearl 10 has been deleted (Roxanol droppers are not uniform in size, hence the dosage varies).
- Page 7
Choline salicylate (Arthropan) was deleted, and ketorolac (Toradol) was added. There are changes in the column info for several meds. The information in the Notes at the bottom has changed. You might want to read the article in reference 11, it has excellent info on the selective Cox-2 drugs.
If you have the 1999 edition...
The 2008 version incorporates the 4 pages with the How to Use BPM document, and then adds 4 more pages. The analgesic chart is now 2 pages and the NSAID chart is a full page. There are more pearls, and more adjuvant meds. The Pros and Cons page is essentially unchanged. An IV page has been added, see more detailed information above. This document is still essentially accurate with two exceptions:
- Page 2
there are new conversion values for Duragesic 25 mcg, mentioned under page 2 in the first section at the top of this page.
- Pearl 13
has been deleted (Roxanol droppers are not uniform in size, hence the dosage varies).
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