The most important medications used to relieve pain and prevent side effects are called analgesics. When milder analgesics such as aspirin or codeine are no longer effective, there should be no hesitation in using stronger analgesics (called narcotics) such as morphine. The dose of the narcotic is exactly matched to the level of pain the person is experiencing and adjusted whenever the pain changes. In some situations, patients remain alert despite large doses of medication. The patient does not become "accustomed" to the drug or require increasingly higher doses to control the pain; nor does he or she become addicted.
Medications may be given by mouth (liquid or pill), by suppository , by injection into a vein, by continuous infusion with a "pain pump" or in a "patch" on the skin.
For chronic pain, medication must be given regularly. It is inappropriate to wait until the patient is in pain again before the next dose is given. Sometimes, taking regular doses means the patient will need to be awakened from sleep, especially at night. But it is important to maintain the schedule to prevent the pain from reappearing or "breaking through." Use of the pain pump is becoming more common. The pump is designed to give a continuous dose of medication 24 hours a day through a small portable, computerized device so that patients can remain independent and out of hospital.
Each of the other symptoms (constipation, cough, difficulty breathing, diarrhea, confusion, etc.) requires the same close attention that pain requires if patients are to be comfortable. It is important that patients and families discuss any symptom with the nurse or doctor and state any preferences they may have for managing it. If patients are involved in planning how to treat or relieve symptoms, they are more likely to feel in control
