Articles: opioid.
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Expert Rev Neurother · Mar 2015
ReviewProgress in the treatment of small fiber peripheral neuropathy.
Small fiber neuropathy is a syndrome of diverse disease etiology because of multiple pathophysiologic mechanisms with major presentations of neuropathic pain and autonomic symptoms. Over the past decade, there has been substantial progress in the treatments for neuropathic pain, dysautonomia and disease-modifying strategy. In particular, anticonvulsants and antidepressants alleviate neuropathic pain based on randomized clinical trials.
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Individuals seeking treatment for chronic pain in multidisciplinary pain management services are typically already on high doses of pain medications. This cross-sectional cohort study of patients with long-term chronic pain examined profiles of polypharmacy and pain medication-related harm exposure. ⋯ While treatment with multiple medications for synergistic or adjunctive effects may assist in medical management of chronic pain, this approach generates increased potential harm exposure. We show that the majority of detriment comes from medications other than opioids and highlight the importance of profiling all pain medications contributing to polypharmacy in clinical pain studies.
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Pain is one of the most common and distressing symptoms in patients with cancer, with a high prevalence of 90%. Appropriate pain assessment is very important in managing cancer pain. ⋯ The use of a self-reporting pain assessment tool as a communication instrument provides an effective foundation for evaluating pain intensity in cancer pain management. A more individualized approach to patient education about pain management may improve patient outcome.
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J Pain Palliat Care Pharmacother · Mar 2015
The attractiveness of opposites: agonists and antagonists.
Opioid-induced bowel dysfunction, of which constipation is the most common aspect, is a major limiting factor in the use of opioids for pain management. The availability of an oral, long-acting formulation of oxycodone and naloxone represents a highly significant development in pain management. The combination of an opioid analgesic with an opioid antagonist offers reliable pain control with a significant reduction in the burden of opioid-induced constipation.
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Cough is a distressing symptom in advanced cancer. Opioids are used to relieve respiratory symptoms including dyspnea and cough. In addition to a central mechanism, opioids are thought to work peripherally via opioid receptors of the lung. Therefore, direct inhalation of morphine has been investigated in chronic lung disease or cancer. We report our experience of a nebulized form of morphine to control intractable cough in patients with advanced cancer. ⋯ Nebulized morphine was effective in controlling intractable cough due to cancer and it was convenient and safe.