Inadequate pain management may be associated with which one(s) of the following?

Appropriate, adequate pain management and assessment are often considered standard of care with pain representing a "fifth vital sign."

In the case of cancer pain management, protocols developed for the individual patient As opposed to using standardized protocols generally result in better pain management.

For mild to moderate pain (step 1), appropriate pharmacological intervention likely involves a non-opioid drug with or without an adjuvant agent.

For mild to moderate pain or pain uncontrolled after step 1 guidelines have been followed, appropriate medications may involve a short-acting opioid around-the-clock with or without and adjuvant agent, step 2. For example morphine, hydromorphone, oxycodone might be added to acetaminophen or nonsteroidal anti-inflammatory agent, providing for enhanced opioid dose flexibility.

For moderate to severe pain or pain not effectively managed using step 2 interventions, sustained-release or long-acting opioid medications administered around-the-clock or continuous infusion using short-acting opioids as needed with or without non-opioid and with or without adjuvant agents. For example, oxycodone, morphine, oxymorphone [sustained-release] or transdermal fentanyl (Sublimaze) may be appropriate.

Relatively recently (2006) the FDA noted deaths in life-threatening adverse consequence of methadone administration-including cardiac arrhythmias and respiratory depression in patients on methadone.

Choose correct statement(s) about therapeutic responses to opiates

Chronic opioid administration of one opiate agonist confers a reduced effectiveness with respect other opioid agonists.

A 10 mg dosage (orally) of morphine, normally viewed as a high-dose for patients not taking such medication, could be contrasted with the case in which a 100 mg IV morphine dose would only produce limited sedation in a patient with significant tolerance to morphine.