Pain Management in Dementia
The management of pain in patients with dementia can be complicated due to comorbidities, polypharmacy, age-related pharmacodynamic and pharmacokinetic changes that affect drug choice, and difficulty in pain assessment, especially in advanced dementia. Even so, there are many agents available for use in this population. The regimen of each patient should be individually tailored. Medications should be started at the lowest dosage and slowly titrated. Renal function should be regularly assessed with medication change as necessary. Examination of compliance, monitoring for adverse events, and prevention of drug interactions should occur at every opportunity, as should determination of the patient's ability to report pain and request as-needed medication. Regular assessment of a pain regimen can help to ensure better pain control in elderly patients with dementia.
Conclusion
The management of pain in patients with dementia can be complicated due to comorbidities, polypharmacy, age-related pharmacodynamic and pharmacokinetic changes that affect drug choice, and difficulty in pain assessment, especially in advanced dementia. Even so, there are many agents available for use in this population. The regimen of each patient should be individually tailored. Medications should be started at the lowest dosage and slowly titrated. Renal function should be regularly assessed with medication change as necessary. Examination of compliance, monitoring for adverse events, and prevention of drug interactions should occur at every opportunity, as should determination of the patient's ability to report pain and request as-needed medication. Regular assessment of a pain regimen can help to ensure better pain control in elderly patients with dementia.
SHARE
