Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jan 2004
Extemporaneously compounded sterile medications: relevance of new United States pharmacopeial standards to pain clinicians.
The United States Pharmacopeia (USP) is the United States' congressionally authorized book of standards for pharmaceutical manufacturing in the United States. The most current edition of the USP includes a new chapter entitled Pharmaceutical Compounding-Sterile Preparations that sets standards for all health care professionals who prepare, store or dispense sterile preparations. Extemporaneously compounded sterile formulations are sometimes needed for symptom control in pain and palliative practice. The implications and relevance of this new USP chapter to pain and palliative care clinicians-and the importance of all clinicians understanding the implications of how their patient's compounded sterile products are prepared-are discussed.
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J Pain Palliat Care Pharmacother · Jan 2004
Case ReportsProfound morphine tolerance following high-dose methadone therapy.
Cross-tolerance among opioid analgesics may be a barrier to effective pain management. Although the exact mechanism is unknown, methadone continues to remain a viable option when other opioids have failed. ⋯ A case of profound morphine tolerance following high-dose methadone therapy is described. The potential role of methadone-induced cross-tolerance is discussed.
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J Pain Palliat Care Pharmacother · Jan 2004
The treatment outcomes of pain survey (TOPS): a clinical monitoring and outcomes instrument for chronic pain practice and research.
The field of health outcomes research has increased the utilization of health-related quality-of-life (HRQoL) instruments to document economic, clinical, and humanistic outcomes (ECHO). The Medical Outcomes Study Short Form 36-item Questionnaire (MOSSF-36, SF-36) has been utilized extensively in many disease states for this purpose, although it is not validated for use in chronic pain patients. ⋯ The TOPS is well validated in these patients. In addition to its utility as an outcomes research tool, the TOPS is sensitive enough to document clinical changes in individual patients, making it a useful assessment tool for clinicians.
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J Pain Palliat Care Pharmacother · Jan 2004
Would depression management relieve pain and improve function.
Chronic pain represents an important clinical, social, and economic problem that often is confounded by affective disorders. While clinicians do not know if chronic pain induces depression or depression initiates pain, co-morbidity is common and the burden of illness increases when patients suffer from both illnesses. ⋯ Patients who have chronic pain also may benefits from antidepressant medications for improved function and quality of life. To obtain optimal clinical outcomes, it is imperative to address both conditions when planning therapy for and studies of chronic pain.
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J Pain Palliat Care Pharmacother · Jan 2004
The American Pain Foundation TARGET Chronic Pain Initiative: better patient/clinician communication to improve pain management.
The American Pain Foundation has developed a program to improve clinician-chronic pain patient communication. The program includes a card describing a six part evaluation process for clinicians and patient notebook in which important daily information is recorded. The program is described including information on how to obtain the resources.