A patient who is taking a fixed-dose combination drug with an opioid and acetaminophen for cancer pain reports increased muscular pain. The patient asks the nurse if the pain medication dose can be increased. What will the nurse tell this patient?
a. An adjuvant analgesic medication will probably be used to help with this pain.
b. An additional dose of acetaminophen can be used to enhance pain relief.
c. Increasing the dose is possible, because there is no ceiling to opioid pain relief.
d. The provider will prescribe separate dosing of the opioid and acetaminophen.
D
Fixed-dose combination products are not useful as pain increases, because the side effects of the nonopioid drug become intolerable as the dosage increases. As pain becomes more severe, the components of the combined regimen should be given separately. Adjuvant analgesics are used for neuropathic pain and not nociceptive pain (which this patient has described). Acetaminophen doses should not be increased. Increasing the dose of a fixed-dose combination drug is not rec-ommended.
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