docPHONE MANUAL

Site: BIOSOFT EDUCATIONAL RESOURCES - Authored by Dr Ananda Perera
Course: BIOSOFT HELP FILES
Book: docPHONE MANUAL
Printed by: Guest user
Date: Thursday, 19 September 2024, 5:28 PM

Description

This is the manual for docPHONE system designed and developed by Dr Ananda Perera.

1. docPHONE FAQs

COMMON QUESTIONS / පොදු ප්‍රශ්න / பொதுவான கேள்விகள்

docPhone is a SMS solution for remote medical consultations and service provision. docPhone යනු දුරස්ථ වෛද්‍ය උපදේශන සහ සේවා සැපයීම සඳහා වන SMS විසඳුමකි. docPHONE ஆனது குடும்ப மருத்துவ நிபுணரான டாக்டர் ஆனந்த பெரேராவால் வடிவமைக்கப்பட்டு உருவாக்கப்பட்ட ஒரு chatbot ஆலோசனை அமைப்பாகும்.

QUESTIONS ANSWERED IN THE IMPLEMENTATION AND INITIAL STAGES OF THE docPHONE LAUNCH / ඩොක්ෆෝන් දියත් කිරීමේ ක්‍රියාත්මක කිරීමේ සහ ආරම්භක අදියරවල පිළිතුරු සපයන ලද ප්‍රශ්න / DocPhone வெளியீட்டின் செயலாக்கம் மற்றும் ஆரம்ப கட்டங்களில் பதிலளிக்கப்பட்ட கேள்விகள்
  1. Accuracy of the system. පද්ධතියේ නිරවද්‍යතාවය. அமைப்பின் துல்லியம்.
  1. Location of the systems and placement of the systems. පද්ධති පිහිටීම සහ පද්ධති ස්ථානගත කිරීම. சிஸ்டம் இடம் மற்றும் சிஸ்டம் இடம்.
  1. Accessibility of the systems. පද්ධතිවල ප්‍රවේශය. அமைப்புகளுக்கான அணுகல்.
  1. Security, privacy and confidentiality issues: patient names, id, address, phone etc. ආරක්ෂාව, පෞද්ගලිකත්වය සහ රහස්‍යභාවය පිළිබඳ ගැටළු: රෝගියාගේ නම්, හැඳුනුම්පත, ලිපිනය, දුරකථන ආදිය. பாதுகாப்பு, தனியுரிமை மற்றும் ரகசியத்தன்மை சிக்கல்கள்: நோயாளியின் பெயர்கள், ஐடி, முகவரி, தொலைபேசி போன்றவை.
  1. What is the scope of the program docPhone? covers the medicals selfcare morbidity spectrum See below under Type of Problems for which docPhone can give advice. වැඩසටහන docPhone හි විෂය පථය කුමක්ද? වෛද්‍ය ස්වයං ආරක්ෂණ රෝගාබාධ වර්ණාවලිය ආවරණය කරයි docPhone උපදෙස් දිය හැකි ගැටළු වර්ගය යටතේ පහත බලන්න. நிரல் docPhone இன் நோக்கம் என்ன? மருத்துவ சுய பாதுகாப்பு என்பது, docPhone ஆலோசனை வழங்கக்கூடிய சிக்கல்களின் வகையின் கீழ் கீழே உள்ள நோய்களின் ஸ்பெக்ட்ரத்தை உள்ளடக்கியது.
  1. Who should use it? Any person who experiences any ill health except in the course of a diagnosed chronic disease. In fact the following is a description of the typical user of the docPhone: එය භාවිතා කළ යුත්තේ කවුද? හඳුනාගත් නිදන්ගත රෝගයක් හැර වෙනත් අසනීපයක් අත්විඳින ඕනෑම පුද්ගලයෙකු. ඇත්ත වශයෙන්ම පහත දැක්වෙන්නේ docPhone හි සාමාන්‍ය පරිශීලකයාගේ විස්තරයකි: அதை யார் பயன்படுத்த வேண்டும்? கண்டறியப்பட்ட நாள்பட்ட நோயைத் தவிர வேறு நோயை அனுபவிக்கும் எந்தவொரு நபரும். உண்மையில் பின்வருவது docPhone பற்றிய பொதுவான பயனரின் விளக்கமாகும்:
  1. Who is the typical user of the docPhone. docPhone හි සාමාන්‍ය පරිශීලකයා කවුද? docPhone வழக்கமான பாவனையாளர் யார்?
    • Adult (age above 18 yrs). වැඩිහිටි (වයස අවුරුදු 18 ට වැඩි). பெரியவர்கள் (18 வயதுக்கு மேல்).
    • Fully functional – who is engaged in day to day life activities may be less but not zero. සම්පුර්ණයෙන්ම ක්‍රියාකාරී – එදිනෙදා ජීවිතයේ ක්‍රියාකාරකම්වල යෙදෙන අය අඩු විය හැකි නමුත් ශුන්‍ය නොවිය හැක. முழுமையாக செயல்படும் – தினசரி வாழ்க்கையின் செயல்பாடுகளில் குறைக்கப்படலாம் ஆனால் பூஜ்ஜியமாக இருக்காது.
    • Non pregnant and not lactating. ගර්භනී නොවන සහ කිරිදීම නොයෙදෙන. கர்ப்பிணி அல்லாத மற்றும் பாலூட்டாத.
    • Who experiences medical symptoms. රෝග ලක්ෂණ අත්විඳින අය. அறிகுறிகளை அனுபவிப்பவர்கள்.

2. LEGAL TERMS

LEGAL QUESTIONS / නීතිමය ප්‍රශ්න / சட்ட கேள்விகள்
  • Are relative. මේවා සාපේක්ෂයි. இவை தொடர்புடையவை.
  • Will change as we gain more experience. අපි වැඩි අත්දැකීම් ලබා ගන්නා විට වෙනස් වනු ඇත. அதிக அனுபவத்தைப் பெறும்போது மாறும்.
  • We are trying to strike a balance between the full responsibility (docPhone point of view) and full anonymity (users’ point of view). අපි සම්පූර්ණ වගකීම (docPhone දෘෂ්ටිකෝණය) සහ සම්පූර්ණ නිර්නාමිකභාවය (පරිශීලකයන්ගේ දෘෂ්ටිකෝණය) අතර සමතුලිතතාවයක් ඇති කිරීමට උත්සාහ කරන්නෙමු. முழுப் பொறுப்பு (docPhone முன்னோக்கு) மற்றும் முழுமையான அநாமதேய (பயனர்களின் பார்வை) ஆகியவற்றுக்கு இடையே சமநிலையை ஏற்படுத்த முயற்சிக்கிறோம்.
  • The system cannot take any responsibility for an anonymous entity. පද්ධතියට නිර්නාමික ආයතනයක් සඳහා කිසිදු වගකීමක් ගත නොහැක. ஒரு அநாமதேய நிறுவனத்திற்கு கணினி எந்தப் பொறுப்பையும் ஏற்க முடியாது.
  • The system cannot take any responsibility for a person whom the system cannot identify. පද්ධතියට හඳුනාගත නොහැකි පුද්ගලයෙකු සම්බන්ධයෙන් පද්ධතියට කිසිදු වගකීමක් ගත නොහැක. கணினியால் அடையாளம் காண முடியாத ஒரு நபருக்கு அமைப்பு எந்தப் பொறுப்பையும் ஏற்க முடியாது.
  • The system cannot take any responsibility for a person whose data are incomplete. දත්ත අසම්පූර්ණ පුද්ගලයෙකු සඳහා පද්ධතියට කිසිදු වගකීමක් ගත නොහැක. தரவு முழுமையடையாத ஒரு நபருக்கு கணினி எந்தப் பொறுப்பையும் ஏற்க முடியாது.
  • The system cannot take any responsibility for a person whose language mastery is unknown. භාෂා ප්‍රවීනත්වය නොදන්නා පුද්ගලයෙකු සම්බන්ධයෙන් පද්ධතියට කිසිදු වගකීමක් ගත නොහැක. மொழிப் புலமை தெரியாத ஒருவருக்கு அமைப்பு எந்தப் பொறுப்பையும் ஏற்க முடியாது.
  • The system cannot take any responsibility for a person who impose as a caregiver. භාරකරුවෙකු ලෙස පනවන පුද්ගලයෙකු සම්බන්ධයෙන් පද්ධතියට කිසිදු වගකීමක් ගත නොහැක. பாதுகாவலராக நியமிக்கப்படும் நபர் தொடர்பாக அமைப்பு எந்தப் பொறுப்பையும் ஏற்க முடியாது.
  • The system cannot take any responsibility for a person who misuses the system. සිස්ටම් එක වැරදි විදියට පාවිච්චි කරන කෙනෙක් ගැන කිසිම වගකීමක් සිස්ටම් එකට ගත නොහැක. கணினியை தவறாகப் பயன்படுத்தும் ஒருவருக்கு கணினி எந்தப் பொறுப்பையும் ஏற்க முடியாது.

3. docPHONE APPS

SERVICES PROVIDED BY docPhone / ඩොක්ෆෝන් මගින් සපයනු ලබන සේවා / டாக்ஃபோன் மூலம் வழங்கப்படும் சேவைகள்
  1. Cough 13.5 කැස්ස 13.5 இருமல் 13.5
  2. Sore throat 9.7 උගුරේ අමාරුව 9.7 தொண்டை புண் 9.7
  3. Colds and flu 9.7 සෙම්ප්‍රතිශ්‍යාව සහ උණ 9.7 சளி மற்றும் காய்ச்சல் 9.7
  4. Ear pain and stuffiness 9.0 කන් වේදනාව සහ හිරවීම 9.0 காது வலி மற்றும் அடைப்பு 9.0
  5. Abdominal pain 6.4 උදර වේදනාව 6.4 வயிற்று வலி 6.4Nausea and vomiting 6.0 ඔක්කාරය හා වමනය 6.0  குமட்டல் மற்றும் வாந்தி 6.0
  6. Fever 4.2 උණ 4.2 காய்ச்சல் 4.2
  7. Skin problems 3.9 සමේ ගැටළු 3.9 தோல் பிரச்சினைகள் 3.9
  8. Eyes burning and/or itching 3.8 ඇස් දැවිල්ල  සහ/හෝ කැසීම 3.8 கண்கள் எரியும் மற்றும்/அல்லது அரிப்பு 3.8
  9. Headaches 3.7 හිසරදය 3.7 தலைவலி 3.7
  10. Chest pain 3.5 පපුවේ වේදනාව 3.5 மார்பு வலி 3.5
  11. Low-back pain 3.0 කොන්දේ  කැක්කුම  3.0 முதுகு வலி 3.0
  12. Diarrhea 2.8 පාචනය 2.8 வயிற்றுப்போக்கு 2.8
  13. Difficult urination (women) 2.3 මුත්‍රා කිරීමේ අපහසුතාවය(කාන්තාවන්) 2.3 கடினமான சிறுநீர் கழித்தல் (பெண்கள்) 2.3
  14. Shortness of breath 2.2 හුස්ම හිරවීම 2.2 மூச்சுத் திணறல் 2.2
  15. Dizziness and fainting 2.0 කරකැවිල්ල සහ ක්ලාන්තය 2.0 தலைச்சுற்றல் மற்றும் மயக்கம் 2.0
  16. Runny nose 1.9 නාසයෙන් දියර ගැලීම 1.9மூக்கு ஒழுகுதல் 1.9
  17. Cuts 1.8 කැපුම් 1.8 வெட்டுக்கள் 1.8
  18. Wheezing 1.7 හුස්ම හිරවීම 1.7 மூச்சுத்திணறல் 1.7
  19. Foot pain 1.5 පාදයේ වේදනාව 1.5 கால் வலி 1.5
  20. Arm injuries 1.5 අත් තුවාල 1.5 கை காயங்கள் 1.5
  21. Head injuries 1.5 හිස තුවාල 1.5 தலையில் காயங்கள் 1.5
  22. Hives 1.5 කරප්පන්/පලු දැමීම படை நோய் 1.5 தச்சர்/இடித்தல்
  23. Leg pain 1.4 පාදයේ වේදනාව 1.4 கால் வலி 1.4

4. docPHONE CLINICAL HELP

DOCPHONE CLINICAL HELP / DOCPHONE සායනික උපකාරය / DOCPHONE மருத்துவ உதவி

docPHONE is a chatbot consultation system designed and developed by Dr Ananda Perera Specialist in Family Medicine/General Practice. The technology support is from Mobios Pvt Ltd. docPHONE යනු පවුල් වෛද්‍ය සේවය  පිළිබඳ විශේෂඥ වෛද්‍ය ආනන්ද පෙරේරා විසින් නිර්මාණය කර සංවර්ධනය කරන ලද චැට්බෝට් උපදේශන පද්ධතියකි. තාක්‍ෂණික සහය Mobios Pvt Ltd වෙතිනි. docPHONE ஆனது குடும்ப மருத்துவ நிபுணரான டாக்டர் ஆனந்த பெரேராவால் வடிவமைக்கப்பட்டு உருவாக்கப்பட்ட ஒரு chatbot ஆலோசனை அமைப்பாகும். தொழில்நுட்ப ஆதரவு Mobios Pvt Ltd இனால் வழங்கப்பட்டது.

To use the system, access the website: පද්ධතිය භාවිතා කිරීමට වෙබ් අඩවියට පිවිසෙන්න: இவ்வமைப்பைப் பயன்படுத்த இணையதளத்தைப் பார்வையிடவும்:

247eConsult.com

Select the symptom you want to assess and follow the conversation in the screen. ඔබට තක්සේරු කිරීමට අවශ්‍ය රෝග ලක්ෂණය තෝරන්න සහ තිරයේ සංවාදය අනුගමනය කරන්න. நீங்கள் மதிப்பிட விரும்பும் நோய் அறிகுறியைத் தேர்ந்தெடுத்து, திரை உரையாடலைப் பின்பற்றவும்.

The system is to be used by any person above 18 yrs. මෙම පද්ධතිය වයස අවුරුදු 18 ට වැඩි ඕනෑම පුද්ගලයෙකු විසින් භාවිතා කළ හැකිය. இந்த அமைப்பை 18 வயதுக்கு மேற்பட்ட அனைவரும் பயன்படுத்தலாம்.

The system works for the common problems identified in the community by research. So you may use it for any of the reasons mentioned in the entry to the system. පර්යේෂණ මගින් ප්‍රජාව  තුළ හඳුනාගත් පොදු ගැටළු සඳහා පද්ධතිය ක්‍රියා  කරයි. එබැවින් පද්ධතියට ඇතුල් වීමේ දී සඳහන් කර ඇති ඕනෑම හේතුවක් සඳහා ඔබට එය භාවිතා කළ හැකිය. ஆய்வுகளின் மூலம் சமூகத்தில் கண்டறியப்பட்ட பொதுவான பிரச்சனைகளுக்கு இந்த அமைப்பு செயல்படுகிறது. எனவே கணினி உள்நுழைவில் குறிப்பிடப்பட்டுள்ள எந்த காரணத்திற்காகவும் இதைப் பயன்படுத்தலாம்.

This is a work in progress – we plan to add more and more problems encountered in the community. මෙය ක්‍රියාත්මක වෙමින් පවතින කාර්යයකි – ප්‍රජාව තුළ ඇති ගැටළු තව තවත් එකතු කිරීමට අපි සැලසුම් කරමු. இது செயல்பாட்டில் உள்ள வேலைத்திட்டம் – சமூகத்தில் மேன்மேலும் உள்ள  சிக்கல்களைச் சேகரிக்க நாங்கள் திட்டமிட்டுள்ளோம்.

Actions advised falls into many categories – first the over the counter medications. These medications must be taken under the supervision of a pharmacist. Then any referrals and the type of specialist are detailed and the urgency of the next consultation is given. Often Dr Ananda Perera’s contact number is given. This is given for many reasons : He can be consulted as any other medical specialist. Then if you are having problems in running the program you may contact him for clinical support. Sometimes the program advises consultation with him for further evaluation. උපදෙස් දී ඇති ක්‍රියා බොහෝ කාණ්ඩවලට අයත් වේ – ප්‍රථමයෙන් කවුන්ටර ඖෂධ. මෙම ඖෂධ ඖෂධවේදියෙකුගේ අධීක්ෂණය යටතේ ගත යුතුය.එවිට ඕනෑම යොමු කිරීම් සහ විශේෂඥ වර්ගය සවිස්තරාත්මක වන අතර ඊළඟ උපදේශනයේ හදිසිතාව ලබා දෙනු ලැබේ.බොහෝවිට වෛද්‍ය ආනන්ද පෙරේරාගේ සම්බන්ධතා අංකය ලබාදේ.මෙය බොහෝ හේතු නිසා ලබා දී ඇත : ඔහු වෙනත් ඕනෑම වෛද්‍ය විශේෂඥයෙකු මෙන් උපදෙස් ලබා ගත හැක.ඔබට වැඩසටහන ක්‍රියාත්මක කිරීමේදී ගැටළු තිබේ නම්, ඔබට සායනික සහාය සඳහා ඔහු හා සම්බන්ධ විය හැකිය.සමහර විට වැඩසටහන වැඩිදුර ඇගයීම සඳහා ඔහු සමඟ සාකච්ඡා කිරීමට උපදෙස් දෙයි. அறிவுறுத்தப்படும் செயல்கள் பல வகைகளில் அடங்கும் – முதலில் கவுண்டர்ககளில் மருந்து. இந்த மருந்துகள் மருந்தாளுநரின் மேற்பார்வையின் கீழ் எடுக்கப்பட வேண்டும்.பின்னர் ஏதேனும் பரிந்துரைகள் மற்றும் விசேட வகை நிபுணர்கள் அடுத்த ஆலோசனையின் காலமும் விவரமாக வழங்கப்படும்.பொதுவாக டாக்டர் ஆனந்த பெரேராவின் தொடர்பு எண் வழங்கப்படும். இது பல காரணங்களுக்காக கொடுக்கப்பட்டுள்ளது: மற்ற மருத்துவ நிபுணரைப் போலவே அவரின் ஆலோசனையைப் பெறலாம். இத்திட்டத்தை செயல்படுத்துவதில் உங்களுக்கு ஏதேனும் சிக்கல்கள் இருந்தால், மருத்துவ உதவிக்காக நீங்கள் அவரைத் தொடர்பு கொள்ளலாம். சில சமயங்களில் இத்திட்டத்தை மேலும் மதிப்பீடு செய்ய அவருடன் கலந்தாலோசிப்பது நல்லது.

Once you make a payment you can make unlimited consultations for the same problem. ඔබ ගෙවීමක් කළ පසු ඔබට එම ගැටලුව සඳහා අසීමිත උපදේශන ලබා ගත හැක. நீங்கள் பணம் செலுத்தியவுடன் அந்த பிரச்சனைக்கு வரம்பற்ற ஆலோசனைகளைப் பெறலாம்.

All the problems are evaluated using a common pathway –  first any serious diseases are assessed followed by common diseases in the community. This is causing a practical problem of longer teleconsultation. However we are considering a faster algorithm for the clinical evaluations. However please be informed longer consultations are more comprehensive and more reliable. සියලුම ගැටළු පොදු මාර්ගයක් භාවිතා කර ඇගයීමට ලක් කෙරේ – පළමුව ඕනෑම බරපතල රෝග තක්සේරු කරනු ලබන්නේ ප්‍රජාව තුළ පොදු රෝග වලින් පසුවය.මෙය දිගු දුරස්ථ උපදේශන ප්‍රායෝගික ගැටලුවක් ඇති කරයි. කෙසේ වෙතත් අපි සායනික ඇගයීම් සඳහා වේගවත් ඇල්ගොරිතමයක් සලකා බලමු.කෙසේ වෙතත්, දිගු උපදේශන වඩාත් විස්තීර්ණ සහ වඩා විශ්වාසදායක බව කරුණාකර දැනුවත් කරන්න. அனைத்து பிரச்சனைகளும் பொதுவான பாதையைப் பயன்படுத்தி மதிப்பிடப்படுகின்றன – எந்தவொரு தீவிர நோய்களும் முதலில் சமூகத்தில் பொதுவான நோய்களால் மதிப்பிடப்படுகின்றன. இது நீண்ட தூர தொலை. ஆலோசனையை நடைமுறைக்கு சிக்கலாக மாற்றுகிறது. இருப்பினும், மருத்துவ மதிப்பீட்டிற்கான வேகமான அல்காரிதத்தை நாங்கள் கருதுகிறோம். இருப்பினும், தொலைஆலோசனைகள் மிகவும் விரிவானதாகவும் நம்பகமானதாகவும் இருக்கும் என்பதை நினைவில் கொள்ளவும்.

5. docPHONE Triage System

docPHONE can basically be accepted as a triage system too.  In fact every APP in the docPHONE series with a management advice which consists of : the diagnosis, whom to consult in case it is required, any referral advice in case it is indicated and also most often references for the management and the particular app.  docPHONE triage system adopts the following ad hoc definitions until standardized definitions are adopted :

Life Threatening Emergency - Emergency medical service consultation NOW is required. Immediate life saving support is required and most probably Ambulance transport now is required. Or even transport by any vehicle to the nearest most well equipped hospital is required in the absence of a dedicated ambulance transport with trained personnel.

Emergency - Immediate medical consultation within 12 hrs

Urgency - Within 24 hrs medical consultation

ASAP - within 48 hrs

Routine medical consultation - within a week

Medical Selfcare - In this case the recommended actions can be taken by the person at home

6. MEDICAL SELFCARE - INTRODUCTION

ABOUT

247econsult is a website designed, developed and maintained by a group of Sri Lankan doctors for Sri Lankan patients.

 

 SERVICES

All our services have three common overarching principles : MEDICAL SELFCARE, EMPOWERMENT AND ENGAGEMENT.

Medical Self Care :

WHO says the medical selfcare is :

Self-care is the ability of individuals, families and communities to promote health, prevent disease, maintain health, and to cope with illness and disability with or without the support of a health-care provider (WHO 2019, Hatch et al 1983)

 

Key facts extracted from WHO website as relevant for what we are doing (WHO 2021) :

 

WHO concept : Tools are required to support medical selfcare.

247eConsult Tools : Apps for many medical selfcare requirements : dieting, exercises, vaccines, symptom checkers, pregnancy and newborn care,

 

WHO concept : Tools are required to support coping with illness and disability

247eConsult Tools : Apps for Illness Automation System - see details below

 

WHO concept :  4.3 billion people have no access to essential health care services

247eConsult Tools : Provision of free apps in all the three languages spoken in Sri Lanka

 

WHO concept :  Looming global shortage of health workers

247eConsult Tools : Use of ICT and training and use of locally available resources for healthcare delivery

 

WHO concept :  1 : 8700 hr ratio of physician care to medical self care

247eConsult Tools : Availability of services 24/7 is a given in ICT

 

WHO concept :  Medical selfcare is sought for convenience, confidentiality, cost, discrimination 

247eConsult Tools : All our tools achieve these requirements

 

WHO concept :  Medical selfcare promote persons' active participation in their own healthcare and push then towards greater self-determination, self-efficacy, autonomy and engagement in health. 247eConsult Tools : All our tools are designed to achieve these ends

 

WHO concept :  Sustained adoption of quality, evidence-based self-care interventions reduce deaths and diseases, improve the health and well being

247eConsult Tools : All our tools are designed to achieve these ends

 

 Hatch S, Kickbusch I, editors; World Health Organization Regional Office for Europe. Self-help and health in Europe: new approaches in health care. Albany (NY): World Health Organization Publications Center USA; 1983.

 WHO 2019. WHO consolidated guideline on self-care interventions for health: sexual and reproductive health and rights. Geneva: World Health Organization; 2019. Licence: CC BY-NC-SA 3.0 IGO.

WHO 2021 - https://www.who.int/news-room/fact-sheets/detail/self-care-health-interventionsy Accessed 12/05/2021 7L18 PM

7. docPHONE Technology

docPHONE is the brand under which the MOBIOS creates, designs, develops and deploys  the medical AI powered chatbots. Chatbot at its simplest is just a small software program.  The purpose of a chatbot is to replicate a human conversation. The human conversation will be conducted either as written language or spoken language. The former is a text chatbot and the other  a voice chatbot. Based on the type of programming used in the development process a chatbot can also be either simple chatbot or a Artificial Intelligent (AI) chatbot which sometimes is also called an Intelligent Personal Assistant (IPAs). MOBIOS creates all types of chatbots based on these programming methods.

8. PAIN KILLERS

1. ANALGESIC LADDER

THE MODERN ANALGESIC LADDER
STEP 1 : Non-opioid analgesics, NSAIDS,
STEP 2 : Weak opioids
STEP 3 : Strong Opioids
STEP 4 : Nerve blocks - epidurals, PCA pump, neurolytic block therapy, Spinal stimulators
Ref :
Vargas-Schaffer G. Is the WHO analgesic ladder still valid? Twenty-four years of experience. Can Fam Physician. 2010;56(6):514-e205.

Non opioid anagesics are/NSAIDS :
Non-selective NSAIDs

Diclofenac
Diflunisal
Etodolac
Fenoprofen
Flurbiprofen
Ibuprofen
Indomethacin
Ketoprofen
Ketorolac
Mefenamic acid
Meloxicam
Nabumetone
Naproxen
Oxaprozin
Piroxicam
Sulindac
Tolmetin
COX-2 Selective NSAIDs
Celecoxib

WEAK OPIOIDS
Codeine
Tramadol


STRONG OPIOIDS
morphine
oxycodone
hydromorphone
buprenorphine
fentanyl
methadone - Methadone, in step 3, is important because it is currently very useful in the treatment of cancer pain, chronic noncancer pain, and refractory neuropathic pain that does not respond to conventional treatment.15,24,25 Methadone is also very useful in the rotation of opioids15,21–27 in cancer pain.
Adjuvants

NERVE BLOCKS
epidurals, PCA pump, neurolytic block therapy, Spinal stimulators


Adjuvants
steroids
anxiolytics,
antidepressants,
hypnotics,
anticonvulsants,
antiepileptic-like gabapentinoids (gabapentin and pregabalin),
membrane stabilizers,
sodium channel blockers, and
N-methyl-d-aspartate receptor antagonists for the treatment of neuropathic pain,
Cannabinoids

9. OTC DRUGS - HOW TO

HOW TO TAKE OVER THE COUNTER DRUGS (OTC) SAFELY

OCT drugs mean over the counter drugs. They can be purchased by you from a pharmacy over the counter
without any doctor's prescription. Follow the instruction below carefully :

Read the product information leaflet provided with the drug. It will tell you about the ingredients of the drug,
dose, how to take it, how frequently to take it

Also see whether it is to be taken before or after meals

Be aware of any common side effects of the drug

Make sure your age range and the gender is appropriate for the drug

Make sure that if you have any chronic disease like diabetes or blood pressure whether it is safe to take in the first place

Also make sure that whatever the drugs you are taking now will not interfere with any new drug you are taking

Never take more than the recommended dose. Be alert to the exact dose which is advocated

Consult your pharmacist for better use and your safety

Never take two different drugs with the same ingredient

Be very careful that your not ALLERGIC to the drug NOR to any ingredient of the drug

Never use OTC drugs repeatedly or for longer periods

If you develop allergy to a OTC drug you will get the following symptoms : coughing, swelling of the lips,
tongue or face, itchy skin, or hives. If you are concerned about a drug allergy or an allergic reaction to an
ingredient in any type of OTC pain reliever, speak to your doctor or pharmacist before using it.

Allergic symptoms where immediate medical attention is required :
throat and tongue swelling, hoarse voice, a high-pitched sound on breathing in, shortness of breath, wheezing.
fast pulse rate, feeling dizzy, being pale and sweaty, losing consciousness.

Always keep drugs out of reach of children.