Browse Items · Pediatric Palliative Care Library

Sublingual absorption of selected opioid analgesics

Ongoing interest in the improvement of pain management with opioid analgesics had led to the investigation of sublingual opioid absorption. The present report determined the percent absorption of selected opioid analgesics from the oral cavity of…

"Good-Parent Beliefs": Research, Concept, and Clinical Practice

Parents of ill children have willingly identified their personal beliefs about what they should do or focus on to fulfill their own internal definition of being a good parent for their child. This observation has led to the development of the…

Tags: 2020, Administration, Communication Skills, Feudtner C, Hinds P S, Hospice, interpersonal skills, July 2020 List, October T, Palliative Medicine, Pediatrics, Practice Management, Weaver M S

Sublingual lorazepam at home for acute treatment of seizures

eizures are often initially treated at home. The standard treatment is rectal diazepam. Sublingual (SL) lorazepam is easy to administer but has not been well evaluated for efficacy in epilepsy. It has been reported to be effective for serial seizures…

Tags: 2003, Administration, Allen A, Archives of Disease in Childhood, Backlog, Benzodiazepinones, Bjelajac A, Chlorobenzenes, Convulsions, Epilepsy, home care services, Home Nursing, Journal Article, Lorazepam, Oral, Seizures, Sublingual, Wassmer E, Weiss S

Oral morphine and respiratory function amongst hospice inpatients with advanced cancer

BACKGROUND: Respiratory depression is the opioid adverse effect feared most by physicians. This may hinder adequate dosing in cancer pain. The study was conducted to examine the respiratory function of patients with advanced cancer receiving…

Pharmacokinetic optimisation of opioid treatment in acute pain therapy

Traditionally, opioids have been administered as fixed doses at fixed dose intervals. This approach has been largely ineffective. Patient-controlled analgesia (PCA) and upgraded traditional approaches incorporating flexibility in dose size and dose…

Intravenous ketamine infusion as an adjuvant to morphine in a 2-year-old with severe cancer pain from metastatic neuroblastoma

A 2.8-year-old female patient (11.6 kg) was admitted to the hospital for uncontrolled pain and swelling in the left leg relating to a metastatic neuroblastoma. Initially, her pain was managed with oral morphine 2 mg (approx. 0.2 mg/kg) every 4 hours.…

Effect of sublingual application of cannabinoids on intraocular pressure: a pilot study

PURPOSE: The purpose of this study was to assess the effect on intraocular pressure (IOP) and the safety and tolerability of oromucosal administration of a low dose of delta-9-tetrahydrocannabinol (Delta-9-THC) and cannabidiol (CBD). PATIENTS AND…

Utilizing an oral sucrose solution to minimize neonatal pain

ISSUES AND PURPOSE: To present an evidence-based practice protocol for oral sucrose administration to minimize neonatal procedural pain. CONCLUSION: Examination of published research may provide additional modalities to expand an established…

Beta-endorphin concentration after administration of sucrose in preterm infants

BACKGROUND: Sucrose is an effective analgesic for procedural pain in preterm infants. It has been hypothesized that its analgesic effects are mediated by the release of endogenous opioid neurotransmitters such as beta-endorphin. OBJECTIVE: To…

Bisphosphonates: from grandparents to grandchildren

Bisphosphonates are synthetic analogues of pyrophosphate that inhibit bone resorption by their action on osteoclasts. Bisphosphonates have been extensively used in the elderly with primary and secondary osteoporosis, Paget's disease, and…

Pain medication during terminal care of children with cancer

The purpose of this study was to evaluate the need for pain medication and the adequacy or inadequacy of the analgesia achieved, in children with cancer who died while in terminal care. Of the 100 pediatric patients with cancer treated at the…

Oral methadone for the treatment of severe pain in hospitalized children: a report of five cases

OBJECTIVE: Pain relief is still inadequate in many hospitalized patients, especially children in whom suboptimal use of analgesic drugs is still common. In the past 2 years, oral methadone has been used extensively in our institution for treating…

Methadone is safe for treating hospitalized patients with severe pain

PURPOSE: Methadone is still regarded as a second line opioid for patients suffering from severe pain, and is rarely used in hospitalized patients. The infrequent use of methadone is probably due to its long plasma half-life that could lead to…

Bisphosphonate treatment of bone disease

In 1997 a review article on bisphosphonates in this journal identified 24 published articles relating to children at that time. Since then there has been a considerable increase in their use in clinical paediatric practice and research with there…

Methadone titration in opioid-resistant cancer pain

AIM: To assess the use of methadone in patients with cancer pain who fail to respond to increasing doses of other opioids or experience intolerable side-effects from them. METHOD: Inpatients of a specialist palliative care unit were titrated onto…

Topical and peripherally acting analgesics

Acute nociceptive, inflammatory, and neuropathic pain all depend to some degree on the peripheral activation of primary sensory afferent neurons. The localized peripheral administration of drugs, such as by topical application, can potentially…

Tags: 2003, Administration, Afferent/drug effects/metabolism/physiology, Analgesics/administration & dosage/pharmacology/therapeutic use, Animals, Backlog, Humans, Journal Article, Neurons, Nociceptors/metabolism/physiology, Non-U.S. Gov't, Pain/drug therapy/metabolism/physiopathology, Peripheral Nervous System/drug effects, Pharmacological Reviews, Research Support, Sawynok J, Signal Transduction/drug effects/physiology, Topical

Oral methadone for chronic noncancer pain: a systematic literature review of reasons for administration, prescription patterns, effectiveness, and side effects

OBJECTIVE: To assess the indications, prescription patterns, effectiveness, and side effects of oral methadone for the treatment of chronic noncancer pain. METHODS: We conducted searches of several electronic databases, textbooks and reference lists…

Trends in the use of opioids at the end of life and the expected effects on hastening death

The aim of our study was to describe trends in opioid use and perceptions of having hastened the end of life of a patient. In 2005, a questionnaire was sent to 6860 physicians in The Netherlands who had attended a death. The response rate was 78%. In…

An update on the clinical use of methadone for cancer pain

Methadone is a synthetic opioid agonist considered a second choice drug in the management of cancer pain. Methadone has a number of unique characteristics including excellent oral and rectal absorption, no known active metabolites, high potency, low…

Tags: 1997, Administration, Analgesics, Backlog, Bruera E, Evaluation Studies, Humans, Journal Article, Methadone/administration & dosage/adverse effects/therapeutic use, Neoplasms/drug therapy, Non-U.S. Gov't, Opioid/administration & dosage/adverse effects/therapeutic use, Oral, Pain, Palliative Care/trends, Rectal, Research Support, Ripamonti C, Zecca E

Switching from morphine to oral methadone in treating cancer pain: what is the equianalgesic dose ratio?

PURPOSE: To define the dose ratio between morphine and methadone in relation to the previous morphine dose and the number of days needed to achieve the same level of analgesia in a group of patients with advanced cancer with pain who switched from…

Metronomic therapy can increase quality of life during paediatric palliative cancer care, but careful patient selection is essential

AIM: Children with refractory or high-risk malignancies frequently suffer from poor quality of life during palliative care. This study explored the effect of metronomic drug administration on survival and quality of life in paediatric patients with…

Intranasal fentanyl for respiratory distress in children and adolescents

Respiratory distress is one of the most common and frightening symptoms of children with life-limiting conditions. Because treatment of the underlying cause is frequently impossible or insufficient, in many children, symptomatic treatment is…

Initial experiences with medicinal extracts of cannabis for chronic pain: results from 34 'N of 1' studies

Three Cannabis Based Medicinal Extracts (CBMEs) for sublingual use became available in 2000. A total of 34 'N of 1' studies were undertaken using this novel therapy for patients with chronic, mainly neuropathic, pain and associated symptoms to…

Setting-up a Supportive and Palliative Care Service for Children with Life-threatening Illnesses in Maharashtra -- Children's Palliative Care Project in India

Objectives: To describe the key initiatives that were successful in planning and implementing hospital- and community-based Paediatric Palliative Care (PPC) services designed for a resource-limited setting in Maharashtra, India, in collaboration with…

The use of oral methadone to control moderate and severe pain in children and young adults with malignancy

Twenty-two courses of oral methadone were given to control moderate or severe pain in 19 children with cancer. Of these, 21 courses gave adequate pain control for periods of 5 to 267 days (median 24 days). In 16 courses, methadone was continued until…

Tags: 1986, Administration, Adolescent, Backlog, Child, Journal Article, Methadone, Miser AW, Miser JS, Neoplasms, Oral, Pain, The Clinical Journal Of Pain

Patient-controlled analgesia with oral methadone in cancer pain: preliminary report

BACKGROUND: Methadone is a very useful drug in cancer pain because of its low cost, lack of active metabolites, high oral availability, and the rapid onset of its analgesic effect. It seems to be well tolerated in patients with difficult pain…

Switching from morphine to methadone to improve analgesia and tolerability in cancer patients: a prospective study

PURPOSE: To evaluate the clinical benefits of switching from morphine to oral methadone in patients who experience poor analgesia or adverse effects from morphine. PATIENTS AND METHODS: Fifty-two consecutive cancer patients receiving oral morphine…

Systemic lidocaine for neuropathic pain relief

The effectiveness of systemic lidocaine in relieving acute and chronic pain has been recognized for over 35 years. In particular, systemic lidocaine has been utilized both as a diagnostic and therapeutic tool for intractable neuropathic pain during…

Tags: 2000, Administration, Analgesics/administration & dosage/diagnostic use/therapeutic use, Animals, Backlog, Chen LL, Humans, Journal Article, Lidocaine/administration & dosage/diagnostic use/therapeutic use, Mao J, Mexiletine/therapeutic use, Neuralgia/drug therapy/metabolism, Oral, P.H.S., Pain, Research Support, Sodium Channel Blockers, U.S. Gov't

Opioid switch to oral methadone in cancer pain

The occurrence of undesirable side effects due to opioids (delirium, confusion, myoclonus, nausea, emesis) is one of the major complications in the management of pain, especially in chronic cancer pain states. Methadone, as an alternative to…

Clinical pharmacokinetics of morphine

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…

Transdermal fentanyl: clinical pharmacology

The transdermal therapeutic system (TTS) fentanyl has been designed for rate-controlled drug delivery. It provides a convenient regimen for the use of a drug previously limited by a short duration of action and a noninvasive parenteral route for a…

Tags: 1992, Administration, Backlog, Cutaneous, Fentanyl/administration & dosage/pharmacokinetics/pharmacology, Humans, Journal Article, Journal of Pain and Symptom Management, Lehmann KA, Zech D

Use of melatonin in the treatment of paediatric sleep disorders

A group of Vancouver health professionals, including the authors, have studied the use of oral melatonin in the treatment of chronic sleep disorders in children with disabilities since the Fall of 1991. This review article is based on the first 100…

Tags: 1996, Administration, Adolescence, Adult, Backlog, Child, Chronic Disease, Disabled Persons, Human, Infant, Jan JE, Journal Article, Journal Of Pineal Research, Melatonin/ae [Adverse Effects], Melatonin/tu [Therapeutic Use], O'Donnell ME, Oral, Preschool, Sleep Disorders/dt [Drug Therapy]

Transdermal fentanyl for pain relief in a paediatric palliative care population

This multicentre, observational study examined the efficacy of the therapeutic transdermal fentanyl system (TTS-fentanyl) in children requiring opioids for pain in life-threatening disease. Forty-one children receiving oral morphine (median dose 60…

Opioid use in palliative care of children and young people with cancer

OBJECTIVE: Identify opioids prescribed, preferred routes, and doses among children with incurable cancer. STUDY DESIGN: Prospective survey with monthly questionnaires regarding patients 0 to 19 years old from oncology centers. Data were collected by…

Morphine and alternative opioids in cancer pain: the EAPC recommendations

An expert working group of the European Association for Palliative Care has revised and updated its guidelines on the use of morphine in the management of cancer pain. The revised recommendations presented here give guidance on the use of morphine…

N of 1 randomised controlled trials of oral ketamine in patients with chronic pain

Anecdotal reports suggest that the general anaesthetic drug ketamine, taken orally in low doses, can give rise to some extra analgesia in patients with refractory neuropathic pain. This study was designed to determine the proportion of patients with…

Tags: 1999, Administration, Analgesics/administration & dosage/therapeutic use, Backlog, Female, Gaines SP, Haines DR, Humans, Journal Article, Ketamine/administration & dosage/therapeutic use, Male, Oral, Pain, Pain/drug therapy/etiology/physiopathology, Placebos

Tags: 2003, Administration, Age of Onset, Ataxia/drug therapy, Backlog, Basal Ganglia/physiopathology, Child, Edgar TS, Humans, Hyperkinesis/drug therapy, Hypokinesia/drug therapy, Journal Article, Journal of Child Neurology, Movement Disorders/drug therapy/physiopathology, Muscle Hypotonia/drug therapy/physiopathology, Muscle Spasticity/drug therapy, Neuromuscular Agents/administration & dosage, Oral, Posture

Browse Items (52 total)