This article discusses the pathophysiology of David’s lower back pain and the effectiveness of NSAIDs for pain management in older people. It explores the adverse outcomes of NSAIDs in older individuals and suggests alternative analgesics for pain relief.
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1BODY INTEGRITY Pathophysiology of David’s lower back pain. David is an old man of age 71 years and is a very active person who actively practices walking, cycling and other physical activities. But for past 2 months he has been experiencing severe pain in his lower back portion and it has been increasing gradually with increasing time. he consulted his general physician and found out acute tenderness over the T12-L1 but did not find any other clinical symptoms or signs. He was then asked to perform MRI of his spine and after which he found out that he has been suffering from metastatic lesions in thoracic and lumbar vertebrae. Before he was diagnosed with spine metastasis, the general physician administered him with non-steroidal anti-inflammatory medication. The medication as prescribed can cause severe side effect for a person of his age, but a he was witnessing sever pain, he was provided with the drug by his GP.
2BODY INTEGRITY The effectiveness of NSAIDS for pain management in older people The effectiveness of NSAIDS for pain management in older people can show an adverse outcome. An older person experiencing lower back pain has a high risk of side effects of all drugs and medications provided with which includes analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs also are not preferred for people suffering from any kind of kidney, liver or heart disorders and must not be consumed without the recommendation of the doctor (Reid, Eccleston& Pillemer,2015). As these analgesic doses do not adjust with the age and the physiology of elder people therefore, the best way to prescribe these medications are to start with low dosage and titrate according to the need of the medication. The NSAIDs are found to induce adverse side effects in older people after administration such as hypertension, GI toxicity, renal malfunction, heart failure and adverse CV events (Arnstein & Herr, 2017). Effective Analgesics Morphinealongwithacetaminophen,ibuprofenisfoundtohaveeffectiveresultas Analgesics (Raffa et al., 20180. These drugs are found to have lesser side effects when compared to other painkillers and drugs for older people. These drugs do have some side effects such as vomiting, nausea and dizziness. Morphine is found to be the most effective drugs among all as a painkiller for metastasis in spine and other bones in older people and is found to have effective outcome (Rizkalla et al., 2018).
3BODY INTEGRITY References: Arnstein, P., & Herr, K. A. (2017). Persistent pain management in older adults.Journal of gerontological nursing,43(7), 20-31. Raffa, R. B., Pawasauskas, J., Pergolizzi, J. V., Lu, L., Chen, Y., Wu, S., ... & Devarakonda, K. (2018). Pharmacokinetics of oral and intravenous paracetamol (acetaminophen) when co-administered with intravenous morphine in healthy adult subjects.Clinical drug investigation,38(3), 259-268. Reid, M. C., Eccleston, C., & Pillemer, K. (2015). Management of chronic pain in older adults.bmj,350, h532. Rizkalla, N., Zane, N. R., Prodell, J. L., Elci, O. U., Maxwell, L. G., DiLiberto, M. A., & Zuppa, A. F. (2018). Use of Intravenous Acetaminophen in Children for Analgesia After Spinal Fusion Surgery: A Randomized Clinical Trial.The Journal of Pediatric Pharmacology and Thera