Date: 23.04.20 & 24.06.20
Duration: 2 hours
Online via Microsoft Teams
Reflective Summary:
The session was an overview of the medicines commonly used and that are regularly seen clinically in presenting patients. I pre-read the (“World health organization model list of essential medicines,” 2019) before the session which took much longer than I expected. We were also provided with a list of these medications and we watched a webinair.
There are different groups of medicines that patients commonly use:
Epilepsy – muscle relaxants
Pain killers – there are 10 varieties – over the counter medication versus prescription e.g. paracetomol
Some medications may be used for dual dosage such as an adjunct for another treatment.
Someone on anti-depressants may be pre-disposed to anxiety and other stressors. Biopsychosocial factors may be involved and are connected to chronic pain.
Opiate medications – patients should be prescribed this group of medications for longer than 3 months because their tolerance to the medicine dosage is reduced. Patients can become dependent and need higher doses. Only 1% of LBP is linked to serious pathology so generally medication doesn’t really help.
Half-lifes – used for type of pain and pattern of pain.
Slow releasing medication for someone whose pain stops them from sleeping at night.
We also discussed a case study regarding Lower Back Pain (LBP). When discussing the case we considered easing and aggravating factors, whether there was lateral or bilateral radiating pain, symptoms of Cauda Equinae, previous medical history and the ADLs that the client struggled with. We also looked at the biopsychosocial factors which can be associated with LBP.
We did a quick revision of the biopsychosocial model which explains why people have pain when there isn’t necessarily the pathology to explain it. The biopsychosocial model was developed by (Engel, 2012). Chronic pain is when a patient has experienced pain for longer than 3 months. Patients are unlikely to have tissue damage after 3 months. Fear stems from previous experiences and social experiences. It is a defensive mechanism. We have a role to play in terms of the way we talk about the movement that the patient finds painful. By encouraging the patient and helping them to believe that they can do the movement that they are frightened to do because of the fear of pain. Nociception is switched on, sending messages to the brain but the stimulus hasn’t changed.
The session was very helpful but I probably didn’t need to have spent so much time reading the WHO list of essential medicines in depth before the session. It really was just an overview of the common medicines that are prescribed for patients, who may present to us in clinic with a sporting injury.
Areas for further improvement plus action plan:
References:
Engel, G. L. (2012). The need for a new medical model: A challenge for biomedicine. Psychodynamic Psychiatry, 40(3), 377–396. https://doi.org/10.1521/pdps.2012.40.3.377
World health organization model list of essential medicines. (2019). World Health Organization. Geneva: World Health Organization.
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