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Pain Report #12 Optimizing Chronic Pain Management in Elderly Persons: Integrating Pharmacokinetics & Pharmacodynamics

Release Date: March 01, 2010
Expiration Date: February 28, 2013

Nurse Practitioners, Pharmacists, Physicians, Registered Nurses, Physician Assistants

Learning Objectives

Upon completion of this activity, the participant should be able to:

  • Discuss the prevalence and consequences of under treatment of chronic pain
  • Review the principles related to the evaluation of pain in the geriatric population, including the barriers to proper pain assessment in the elderly
  • Recognize the fundamental physiological changes associated with aging
  • Identify the pharmacokinetic and pharmacodynamic principles related to rational polypharmacy with respect to pain management in the elderly
  • Describe the types of pharmacotherapies used to manage pain in the elderly, including their mechanisms of action, specialized uses, side effects, dosage information and other pertinent characteristics

Statement of Need

Pharmacologic intervention remains a principal treatment for pain management, even though adverse drug reactions in the elderly are a significant risk. Pharmacokinetic and metabolic changes associated with increased age can make the elderly vulnerable to side effects and overdosing associated with analgesic agents. Selecting an agent likely to cause the fewest side effects is paramount and should be determined by targeting the underlying pathophysiology.

Method of Participation

This activity has no fee and should take approximately one hour to complete. Participants should first read the objectives and other introductory CE information, then proceed to the educational offering. To receive credit for this activity, participants must complete the post-test with a passing score of 80%, then complete the evaluation. This credit is valid through February 28, 2013. No credit will be given after this date.

In the event you have questions about this activity or are unable to print the certificate, please email and a certificate will be emailed within 2 weeks.

System requirements

  • Computer or smart phone with internet access
  • Web browser (IE 7.0+ or Webkit/Mozilla Compatible) with Javascript enabled


Dannemiller is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.


Dannemiller designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Registered Nurses

Dannemiller is a provider approved by the California Board of Registered Nursing, Provider Number 4229 for 1.00 contact hours. 
RNs outside of California must verify with their licensing agency for approval of this course.

Nurse Practitioners

Dannemiller is approved as a provider of nurse practitioner continuing education by the American Academy of Nurse Practitioners: AANP Provider Number 090419. This program was planned in accordance with AANP CE Standards and Policies and AANP Commercial Support Standards. It provides 1.00 contact hours of continuing education (which includes 0.60 hours of pharmacology).

Physician Assistants

AAPA accepts certificates of participation for educational activities certified for Category 1 credit from AOACCME, Prescribed credit from AAFP, and AMA PRA Category 1 Credit™ from organizations accredited by the ACCME. Physician assistants may receive a maximum of 1.00 AMA PRA Category 1 Credit(s)™ for completing this program.


Dannemiller is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This activity is a knowledge based activity. Dannemiller has assigned 1.00 contact hours (0.10 CEU) of continuing pharmacy education credit to this activity. ACPE program number 522-000-10-105-H01-P.



Bernard M. Abrams, MD
Clinical Professor of Neurology
University of Missouri School of Medicine at Kansas City

John Kriak, PharmD
President and Chief Consultant


In accordance with the Accreditation Council for Continuing Medical Education (ACCME), Dannemiller requires that any person who is in a position to control the content of a CME activity must disclose all relevant financial relationships they have with a commercial interest. 

The following faculty have stated they have no relevant financial disclosures:

  • Bernard Abrams, MD,
  • John Kriak, PharmD

 Dannemiller staff, Barbra Thompson, Publications Project Manager, has nothing to disclose.

To resolve identified conflicts of interest, the educational content was reviewed by Paul J. Christo, MD, who has disclosed that he is a consultant/advisory board for Chattem, Ameritox, Actavis, QuadrantHealthCom, Inc., and Perrigo and an investigator for Medtronic. The resulting certified activity was found to provide educational content that is current, evidence based and commercially balanced.

Off-label statement

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by FDA. The opinions expressed in the educational activity are those of the faculty. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. Further, participants should appraise the information presented critically and are encouraged to consult appropriate resources for any product or device mentioned in this program.


The content and views presented in this educational activity are those of the authors and do not necessarily reflect those of Dannemiller. This material is prepared based upon a review of multiple sources of information, but it is not exhaustive of the subject matter. Therefore, healthcare professionals and other individuals should review and consider other publications and materials on the subject matter before relying solely upon the information contained within this educational activity.