Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jan 2002
Defining hospice and palliative care: some further thoughts.
Widespread acceptance of hospice in the United States has contributed to increased public and professional interest in improved care, not only for dying persons, but for persons undergoing treatment for conditions that may not pose an immediate threat to their life. 'Palliative care' has been brought into use to denote care that covers a broader category of patients who do not necessarily have a medical condition that is not, at present, life threatening. The use of two related and overlapping terms by health care professionals is confusing and, in the absence of clear definitions, has contributed to needless controversy. ⋯ Palliative care, once used as a euphemism for hospice, now has several meanings. This paper is designed to explore the historical evolution of both terms and to reduce the confusion and controversy surrounding their current application.
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J Pain Palliat Care Pharmacother · Jan 2002
An annotated guide to pain and palliative care on the World Wide Web.
Two dozen leading sites on the World Wide Web that pertain to pain management and palliative care are listed and described. Strengths and limitations are discussed.
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J Pain Palliat Care Pharmacother · Jan 2002
Pain and palliative care in Issue Number 3, 2001 of The Cochrane Library.
A brief description of how an individual can access The Cochrane Library and navigate within it is provided. The National Library of Medicine medical subject heading (MeSH) terminology is described. Selected new reviews from a recent edition of The Cochrane Library are listed in an annotated bibliography together with a description of the current volume of material now available on the library.
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Palliative care is the care of patients whose disease is incurable and whose life expectancy is limited to weeks or months. This commentary describes the development of modern palliative care, some of the elements and underlying philosophical constructs of such care, and calls for expansion and improvement in end of life care throughout the world.
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Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. ⋯ These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.