Dr. Jessica Otte, MD, CCFP gave this presentation on October 17th, 2020 at the "Bringing Best Evidence to Clinicians" virtual conference. Dr. Otte is a family physician in Nanaimo, BC. She has always been passionate about helping patients find the right health care according to the evidence and their needs and values, and she practices this daily with a focus on care of the elderly and palliative … [Read more...]
[125] Can prescribers avoid contributing to opioid use disorder?
Case vignette: A 21 y/o has surgery for a condition expected to improve. He fills a discharge prescription for 5 days of an opioid at a standard dose. At 1-week follow-up with his family doctor for suture removal, he describes ongoing pain. Is a renewal of opioid appropriate, potentially dangerous, or both? Aggressive promotion of opioids for chronic non-cancer pain (CNCP) began in the … [Read more...]
Acetaminophen vs. NSAIDs during COVID-19 pandemic
TREATING FEVER AND PAIN in the time of COVID-19 Many people are asking doctors for information about whether it is safe to use NSAID drugs now. Examples of this drug class include ibuprofen (generic, Advil, Motrin), naproxen (generic, Aleve), diclofenac (generic, Voltaren, Arthrotec), celecoxib (Celebrex), meloxicam (Mobicox) and many others. Feeling an increase in your body temperature can … [Read more...]
[115] Cannabinoids for Chronic Pain
Canada's parliament legalized the recreational use of herbal cannabis (marijuana) in October 2018. The well-publicized limitations of clinical research and well-recognized side effects such as cannabis intoxication have not deterred people from seeking out and using herbal cannabis for chronic pain in increasing numbers. This is occurring with or without a physician’s authorization.1 In fact, half … [Read more...]
[105] Is cyclobenzaprine useful for pain?
Cyclobenzaprine is a tricyclic molecule discovered in 1956 that is structurally related to amitriptyline and imipramine. Evaluated first as a possible tranquilizer, it was noted to have atropine-like properties in animals.1 In Canada, Merck Frosst Research Laboratories envisaged cyclobenzaprine as a centrally active skeletal muscle relaxant.2 However, it was soon apparent that despite being … [Read more...]
