Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jan 2009
ReviewPain and palliative care pharmacotherapy literature summaries and analyses.
Timely and important studies are reviewed and commentaries provided by leading palliative care clinicians. Symptoms, interventions, and treatment-related adverse events addressed in this issue are management of Alzheimer's agitation with donepezil; needle-free lidocaine powder for minor painful procedures; psychostimulants in depression; anticoagulation for cancer-related venous thromboembolism; effect of waiting for acute pain treatment on risk of chronic pain; and an update on severe cutaneous reactions associated with medications.
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Buprenorphine is a partial mu agonist opioid that is FDA-approved to manage opioid addiction in settings outside of traditional methadone clinics. The clinical uses, pharmacokinetics, pharmacodynamics, toxicology, and management of overdoses of buprenorphine are reviewed.
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J Pain Palliat Care Pharmacother · Jan 2009
ReviewVariable use of opioid pharmacotherapy for chronic noncancer pain in Europe: causes and consequences.
According to the 2005 Pain in Europe Survey, the use of opioids to treat patients with chronic noncancer pain varies considerably among different countries in Europe. Undertreatment of chronic pain is common. ⋯ The validity of these restrictions is discussed in relation to the need to protect patients and society from harm due to adverse events, and the potential for misuse and abuse with prescribed opioids. This is balanced against the therapeutic goal of providing the best available pain-relieving treatment and to avoid the consequences of unnecessary suffering in patients with chronic noncancer pain.
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J Pain Palliat Care Pharmacother · Jan 2009
ReviewPalliative care pharmacotherapy literature summaries and analyses.
Timely and important studies are reviewed and commentaries provided by leading palliative care clinicians. Symptoms, interventions, and treatment-related adverse events addressed in this issue are computerized symptom management; anticholinergic agents in lung disease; neuropathic pain and morphine effectiveness; morphine dosing; inflammatory cytokines and pain; oral ghrelin-mimetics and sarcopenia; and opioid-induced bowel dysfunction.
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J Pain Palliat Care Pharmacother · Jan 2008
ReviewOpioid side effects and their treatment in patients with chronic cancer and noncancer pain.
Opioids are the foundation of standard analgesic regimens for moderate to severe pain due to life-threatening illnesses such as cancer, and are increasingly employed in chronic noncancer pain of the same severity. Opioids are frequently used for long periods in these populations, sometimes for years. However, side effects are common and may reduce quality of life, or become life threatening, and frequently cause patients to discontinue opioid therapy. ⋯ General management strategies include switching opioids ("opioid rotation"), discontinuation of concurrent medications that exacerbate side effects, and symptomatic treatment. In addition, recently recognized adverse events that occur after long-term opioid therapy are discussed. High-quality evidence is lacking for the treatment of most side effects, and the true incidence, underlying mechanisms, and clinical implications of long-term responses to opioid therapy are not yet fully understood.