Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jan 2004
Evidence-based pain management and palliative care in The Cochrane Library.
The Cochrane Library of systematic reviews is published quarterly. Issue 2 for 2003 of the library was published in May 2003. That issue contains 2395 reviews of which 1669 are in full text. ⋯ Issue 3 contains 85 new reviews, five are relevant to practitioners in pain and palliative care. References are published in the same format as the citation for Cochrane reviews. The Cochrane trials database now stands at over 375,000 records with an additional 4100 one-page summaries of non-Cochrane reviews in the NHS database of reviews of effectiveness (DARE).
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J Pain Palliat Care Pharmacother · Jan 2004
Comparative StudyPrescribing and self-administration of morphine in Hispanic and non Hispanic Caucasian patients treated with patient-controlled analgesia.
The purpose of this study was to determine whether differences in either prescribing or self-administration of morphine exist between Hispanic and White (Caucasian) post-operative patients treated with patient-controlled analgesia (PCA). A review of the medical records of 30 Hispanic and 30 White patients who received postoperative PCA was conducted. ⋯ No differences in the amount of morphine prescribed (11.23 +/- 3.22 mg/hr in Hispanic patients, 11.05 +/- 4.28 mg/hr in White patients; p = 0.8503) or self-administered (2.58 +/- 2.02 mg/hr in Hispanic patients, 3.32 +/- 3.00 mg/hr in White patients; p = 0.2711) were discovered. This study identified no statistically significant difference in either opioid prescribing or self-administration between Hispanic and White post-operative patients.
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J Pain Palliat Care Pharmacother · Jan 2004
OxyContin abuse and diversion and efforts to address the problem: highlights of a government report.
Representative Frank R. Wolf, Chairman of the U. S. ⋯ On December 23, 2003, the GAO submitted a 57 page report to the Representatives describing the outcomes of the investigation. The full report includes appendices that describe the scope and methodology of the investigation, summaries of FDA changes to the original approved OxyContin label, databases used to monitor abuse and diversion of OxyContin and oxycodone, and comments from the FDA and DEA. This special report is an abstract of the GAO report and includes the conclusions and recommendations for action form the full report.
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J Pain Palliat Care Pharmacother · Jan 2004
Case ReportsSerotonin mechanisms in pain and functional syndromes: management implications in comorbid fibromyalgia, headache, and irritable bowl syndrome - case study and discussion.
A young woman presented with multiple central hypersensitivity disorders, including fibromyalgia, headache, pelvic pain and several smooth muscle spasm disorders, including irritable bowel syndrome, irritable bladder and Raynaud's phenomenon. She also had significant fatigue and sleep problems. ⋯ This experience illustrates the value of serotonin receptor type 2 (5HT2) inhibition with atypical neuroleptics, of neural cation channel and glutamate inhibition with anticonvulsants, and the potential usefulness of antidepressants after establishing 5HT2 control to enhance downward inhibitory tracts. Medications with combined usefulness for both bipolar mood and pain disorders were highly effective for her multiple hypersensitivity problems.
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Myths and misinformation about pain and its management often lead to poor therapy for patients in pain. Nine common myths about pain and its management are described and refuted.