UTSW Internal Medicine Website

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Pain Lab
# Article Title Author Hits
1 Benzodiazepines Parkland Health and Hospital System 100
2 Chronic Pain Medication Pyramid Tina M. Kaufman, PhD, PA-C 114
3 Chronic Pain Policy and Procedure Tina Kaufman, PhD, PA-C 107
4 CNS Stimulants Parkland Health and Hospital System 103
5 Controlled Substance Reminders 2011 PCIM 109
6 DEA - Practitioners Manual DEA 2006 98
7 Gabapentin (Neurontin): Dosing Instructions for Neuropathic Pain PCIM 96
8 Guidelines for Chronic Non-cancer Pain Tina Kaufman, PhD, PA-C 97
9 LBP Algorithm PCIM 112
10 Management of Chronic Pain Tina Kaufman, PhD, PA-C 95
11 Narcotic Prescribing Reminders Tina Kaufman, PhD, PA-C 118
12 Neuropathic Pain Order Set PCIM 130
13 Opioid Equivalency Chart PHHS, Revised 06/19/08 105
14 Opioid Treatment Guidelines The Journal of Pain, 2009 155
15 Opioid Warnings - Use Caution PCIM 112
16 Overview Treatment of Back Pain Tina Kaufman, PhD, PA-C 160
17 Pain Contract Parkland Health and Hospital System 114
18 Pain Management: Handbook Texas Pain Society, 2006 121
19 Physical Examination of the Spine Pablo Zeballos, MD 141
20 Physical Therapy Attendance Sheet Tina Kaufman, PhD, PA-C 94
21 Prescribing Methadone For Chronic Pain Tina Kaufman, PhD, PA-C 87
22 Psych Attendance Sheet Tina Kaufman, PhD, PA-C 103
23 Taking Care Of Your Pain At Home Parkand Patient Education 108
24 Tips On Chronic Pain Medications Tina Kaufman, PhD, PA-C 111

Calculators

A-a Gradient
Patient age
Barometric pressure
PaO2
PaCO2
FiO2
A-a Gradient
Normal A-a Gradient
Calculated Osmolality
Serum sodium
Serum glucose
Serum BUN
Calculated Osm
Child's Class
Bilirubin
Albumin
INR
Ascites
Encephalopathy
Child-Pugh score
Scoring:
 A: 5-6
B: 7-9
C: 10-15
Cockroft-Gault eGFR
Patient age
Patient sex
Weight
 
Serum creatinine
eGFR
Corrected Calcium
Calcium
Albumin
Corrected calcium
FENa / FEUrea

Serum sodium or BUN
Serum creatinine
Urine sodium or urea
Urine creatinine
Fractional excretion (%)

Free Water Deficit

Serum sodium
Ideal sodium
Weight
 

Free water deficit (L)

Heparin Dosing

For ischemic CVA the heparin dosing is as follows: no bolus, and 600-1000 units/hr drip (not weight-based). For other indications, use the calculator below.
Heparin indication

(For ACS, strongly consider LMWH instead of unfractionated heparin. Also, if using a IIb/IIIa inhibitor with unfractionated heparin, dose the unfractionated heparin as though the patient has a STEMI.)
 
Patient sex
Weight
Height
Heparin dosing weight (kg)
Bolus dose
*
Initial drip rate
*


*Maximum doses:
VTE 9000 bolus, 2000/hr gtt
NSTEMI 5000 bolus, 1000/hr gtt
STEMI 5000 bolus, 1000/hr gtt
Ideal Body Weight / BMI

Patient's sex
Weight
 
Height
Weight (kg)
BMI
Ideal body weight (kg)

MDRD eGFR

Patient sex
Patient age
African-American?
Serum creatinine
eGFR / 1.73 m2

MELD Score
Bilirubin
INR
Creatinine*
*If the patient has been dialyzed at least twice within the last week, enter "4.0" for the serum creatinine.
MELD Score
Three-month mortality risk based on MELD Score:
Score
Mortality
‹10
4%
10-19
27%
20-29
76%
30-39
83%
40+
~100%
Narcotic Converter

First drug
First drug dose (mg)
Second drug
Second drug dose (mg)

Note #1: Opioid analgesics have widely variable half lives, and when you switch from one form to another, you should adjust the scheduling accordingly.

Note #2: Methadone should be dosed by someone with experience using the drug. Consult palliative care or pain management.

QTc

QT (msec)
HR (bpm)
QTc (msec)

Steroid Converter

First steroid
Dose to convert (mg)
Second steroid
Second steroid dose (mg)

TIMI Risk
Age over 65
3 or more CAD risk factors
Prior coronary stenosis (50% or more)
ST segment deviation on initial ECG
2 or more anginal events in previous 24 hours
ASA use in last 7 days
Cardiac enzyme elevation
TIMI Score
TIMI Risk for cardiac event (mortality, new MI, or need for emergent revascularization) in the next 14 days:
 
Score
0-1
4.7%
 
2
8.3%
 
3
13.2%
 
4
19.9%
 
5
26.2%
 
6-7
40.9%
TTKG
Serum potassium
Urine potassium
Serum osmolality
Urine osmolality
TTKG
Framingham Calculator