Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jan 2005
ReviewAprepitant (EMEND): the role of substance P in nausea and vomiting.
Aprepitant (EMEND) is the first commercially available drug from a new class of agents, the Substance P/neurokinin NK-1 receptor antagonists. Aprepitant is indicated for prevention of acute and delayed chemotherapy-induced nausea and vomiting (CINV) associated with highly emetogenic chemotherapy in adults. Its ability to antagonize the effects of Substance P has lead to greater understanding of the pathophysiology of nausea and vomiting. Its broad range of activity against a wide variety of central and peripheral emetogenic stimuli make it potentially useful in non-chemotherapy related nausea and vomiting.
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The use of steroids administered into the epidural space to manage low back pain is described in a manner that a clinician might use to explain this intervention to a patient or care-giver.
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J Pain Palliat Care Pharmacother · Jan 2005
Pain as a human right: the 2004 Global Day Against Pain.
On October 11, 2004, the International Association for the Study of Pain (IASP), the World Health Organization (WHO), and the European Federation of IASP Chapters (EFIC) held a Global Day against Pain campaign to promote pain relief as a human right. International leaders in pain management and public health participated in the full day program that took place in Geneva Switzerland and was simultaneously broadcast around the world through the Word Wide Web. The declaration and statements that were released and announced, and selected contents of the program are summarized in this report.
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Methadone is a synthetic opioid that is effective for the relief of moderate-to-severe pain and for the treatment of opioid dependence. The pharmacokinetics of methadone differ from those of morphine in that methadone has a higher bioavailability, a much longer half-life, and is hepatically metabolized by cytochrome P450 enzymes. The pharmacokinetics of methadone are variable and an understanding of the factors that impact the onset, magnitude, and duration of analgesia is required to optimize therapy. ⋯ AMEDLINE search was performed to identify literature published between 1966 and May 2005 relevant to the pharmacokinetics of methadone. These publications were reviewed and the literature summarized regarding unique and clinically important elements of methadone disposition including its absorption profile, distribution, and metabolism/excretion. General dosing guidelines, dosage conversions from other opioids and pharmacokinetic issues in special populations are discussed.