NUR231 Case Study: Jack's Pain and Treatment Options

This case study analyzes the case of Mr. Jack, a 68-year-old construction worker presenting with lower back pain, which was later diagnosed with metastatic lesions. The assignment addresses the challenges of pain management in elderly patients, including the impact of pain on their quality of life and the factors influencing pain perception. The study compares the effectiveness of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and opioids in reducing pain, highlighting the potential benefits and risks of each treatment. The case study recommends treatments like chemotherapy and radiotherapy for cancer, along with analgesics such as Diclofenac, Ibuprofen, and Naproxen, and COX-2 inhibitors like Celecoxib and Etoricoxib. It also discusses the use of opioids, such as morphine and tramadol, when other medications fail, considering the potential side effects of prolonged NSAID usage. The assignment references key studies and surveys to support the recommended pain management strategies for elderly patients and the importance of considering individual patient needs and the progression of their conditions.

Running head: CASE STUDY
CASE STUDY
Name of the Student
Name of the University
Author Note

1CASE STUDY
It has been seen that pain in elderly patients is the most undertreated trouble in
elderly patients because of multiple factors and differs from one individual to another
depending on the diseases they have. Pain can lead to quite a few grave consequences by
affecting the health and the quality of life of individuals. It can also cause further
complications such as cognitive impairment, anxiety, depression, isolation from society, and
immobility. Other than this, they always tend to be irritated towards everything because of
continuous pain, which causes further agitation (Cavalieri, 2020). These behavioural changes
take place in elderly patients suffering from any sort of pain. A study was conducted to
deduce the efficiency of Non-Steroidal Anti-Inflammatory Drugs (NSAID) in reducing the pain
of elderly patients. In the study, a comparison was drawn between the effectivity of NSAID
and opioids. The results showed when patients suffering from pain were provided NSAID,
they showed better results, and their pain significantly got reduced and also showed much
lower toxicity withdrawal in the patients compared to the patients who were on opioids
(Smith et al., 2016).
Mr. Jack should be administered with treatments available for cancer like
chemotherapy and radiotherapy as his MRI report hint towards cancer. However, to reduce
the pain he is having continually, some analgesics can be administered to him for getting
relief. There are some analgesics that can be prescribed to him, such as Diclofenac,
Ibuprofen, and Naproxen, belonging to the NSAID group, which can significantly reduce his
pain and are the most widely used (Altman et al., 2015). COX-2 inhibitors like Celecoxib and
Etoricoxib can also be prescribed to the patient when there are no other options except
opioids (White, 2017). Various studies and surveys have shown that these NSAIDs are quite
useful as analgesics and resulted in a decrease of pain in elderly adults, but more prolonged

2CASE STUDY
usage of these drugs might lead to further complications, including cardiovascular diseases
and kidney issues (Pelletier et al., 2016). In case when any of the medications mentioned
above fail to reduce his pain, opioids can be prescribed to him. Depending on the degree of
his pain, the doctor can decide which opioid should be prescribed to him, the stronger or
the weaker ones, the examples of which are morphine and tramadol, respectively. Evidence
shows that when opioids are administered as analgesics to patients suffering from cancer
and pain, it shows excellent results in reducing the pain considerably (Jamison & Mao, 2015).
As Mr. Jack suffers from both the issues, opioids can help him overcome his pain.

3CASE STUDY
REFERENCES
Altman, R., Bosch, B., Brune, K., Patrignani, P. and Young, C., 2015. Advances in NSAID
development: evolution of diclofenac products using pharmaceutical
technology. Drugs, 75(8), pp.859-877.
Cavalieri, T. (2020). Management of Pain in Older Adults. Jaoa.org. Retrieved 12 March
2020, from https://jaoa.org/article.aspx?articleid=2093070.
Jamison, R. N., & Mao, J. (2015, July). Opioid analgesics. In Mayo Clinic Proceedings (Vol. 90,
No. 7, pp. 957-968). Elsevier.
Pelletier, J. P., Martel-Pelletier, J., Rannou, F., & Cooper, C. (2016, February). Efficacy and
safety of oral NSAIDs and analgesics in the management of osteoarthritis: Evidence
from real-life setting trials and surveys. In Seminars in arthritis and rheumatism (Vol.
45, No. 4, pp. S22-S27). WB Saunders.
Smith, S. R., Deshpande, B. R., Collins, J. E., Katz, J. N., & Losina, E. (2016). Comparative pain
reduction of oral non-steroidal anti-inflammatory drugs and opioids for knee
osteoarthritis: systematic analytic review. Osteoarthritis and cartilage, 24(6), 962-
972.
White, P. F. (2017). What are the advantages of non-opioid analgesic techniques in the
management of acute and chronic pain?.