Browse Items · Pediatric Palliative Care Library

"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

A randomized, controlled trial of acetaminophen, ibuprofen, and codeine for acute pain relief in children with musculoskeletal trauma

OBJECTIVE: Our goal was to determine which of 3 analgesics, acetaminophen, ibuprofen, or codeine, given as a single dose, provides the most efficacious analgesia for children presenting to the emergency department with pain from acute musculoskeletal…

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

Analgesic effects of topical methadone: a report of four cases

Topical morphine has been used on open wounds for pain management, but has a variable duration of action not suitable for palliative dressing changes. The objective of this study is to find an opioid and delivery method that would provide…

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…

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…

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…

Changes in availability of paediatric medicines in Australia between 1998 and 2002

2005

Tags: 2005, Administration, and those both licensed for paediatric use and subsidized increased from 356 (23.1%) to 441 (23.2%). The number of medicines with formulations suitable for paediatric use increased from 861 (55.7%) to 967 (50.8%), Backlog, British Journal of Clinical Pharmacology, but not for children under the age of two years., Chui J, ei ght (9%) for 2-11 years and 12 (13%) for 12-18 years. An additional 14 orally available chemical entities previously only licensed for adults, Journal Article, licensed medicines available in Australia in the calendar years 1998 and 2002 were examined. RESULTS: The total number of medicines licensed in Australia increased from 1544 to 1903, Newborn Licensure, Oral Adolescent Age Factors Australia Chemistry, PedPal Lit, Pharmaceutical Child Child, Preschool Dosage Forms Drug Approval/statistics & numerical data Humans Infant Infant, Reith D, statistics & numerical data, the number of licensed paediatric items increased from 579 (37.5%) to 725 (38.1%), Tordoff J, trends Pediatrics, trends Pharmaceutical Preparations, were licensed for children by 2002. CONCLUSIONS: There have been some improvements in medicines licensing for older children

Clinical experience with oral methadone administration in the treatment of pain in 196 advanced cancer patients

PURPOSE: The aims of this study were to describe the analgesia, side effects, and dosage and the causes of suspension of treatment in a large sample of advanced cancer patients with pain after treatment with oral methadone from 7 to 90 days. PATIENTS…

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…

Cost-effectiveness analysis of ziprasidone versus haloperidol in sequential intramuscular/oral treatment of exacerbation of schizophrenia: economic subanalysis of the ZIMO trial.

OBJECTIVE: This study aimed to assess the cost effectiveness of ziprasidone versus haloperidol in sequential intramuscular (IM)/oral treatment of patients with exacerbation of schizophrenia in Spain. METHODS: A cost-effectiveness analysis from the…

Direct conversion from oral morphine to transdermal fentanyl: a multicenter study in patients with cancer pain

Direct conversion from oral morphine to transdermal fentanyl with a ratio of oral morphine/transdermal fentanyl (100:1 mg) daily was examined in patients with cancer pain. Patients with a 'stable and low level of cancer pain' receiving a constant…

Tags: 1996, Administration, Adult, Aged, Analgesics, Backlog, Cutaneous, Donner B, Female, Fentanyl, Humans, Journal Article, Male, Middle Aged, Morphine, Neoplasms, Opioid, Pain, Pain Measurement, Regression Analysis, Strumpf M, Tryba M, Zenz M

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…

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, 2022 Special Edition 1 - Parent Perspectives, Administration, Communication Skills, Feudtner C, Hinds PS, Hospice, interpersonal skills, October T, Palliative Medicine, Parent, Pediatrics, Practice Management, Weaver MS

Implementation and evaluation of a quality improvement process to improve pain management in a hospice setting

The purpose of this article is to describe the implementation and evaluation of a quality improvement process to improve pain management in a hospice setting. A retrospective chart audit of 702 patient visits pre- and 536 patient visits…

Tags: 1998, Administration, Alden C, American Journal of Hospice & Palliative Medicine, Backlog, Duggleby W, Hospice Care/standards, Human, Journal Article, Non-U.S. Gov't, Nursing Audit, Outcome and Process Assessment (Health Care)/organization &, Pain/nursing, Program Development, Program Evaluation, Retrospective Studies, Support, Total Quality Management/organization & administration

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…

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…

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.…

Ketamine injection used orally

Ketamine has been used parenterally for pain unresponsive to opioids, including neuropathic pain, and has also been used as an alternative analgesic agent after surgery. Although oral administration of ketamine has been used for some time as a single…

Tags: 1996, Administration, Adult, Backlog, Broadley KE, Drug Resistance, Excitatory Amino Acid Antagonists/administration & dosage, Hospice Care, Humans, Journal Article, Ketamine/administration & dosage, Kurowska A, Male, Oral, Pain/drug Therapy, Palliative Medicine, Tookman A

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…

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…

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…

Metronomics during palliative care in paediatric oncology? For sure! But handle me with care

Tags: 2016, Acta Paediatrica, Administration, Andre N, Child, Humans, Metronomic, Neoplasms/dt [drug Therapy], Oncology 2017 List, Palliative Care/mt [methods], Pasquier E

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

Opioid rotation in patients with cancer pain. A retrospective comparison of dose ratios between methadone, hydromorphone, and morphine

BACKGROUND. When a change of opioid is considered, equianalgesic dose tables are used. These tables generally propose a dose ratio of 5:1 between morphine and hydromorphone. In the case of a change from subcutaneous hydromorphone to methadone, dose…

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…

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…

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…

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…

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…

Oral pharmacotherapy of childhood movement disorders

Movement disorders, a common problem in children with neurologic impairment, are receiving increasing clinical attention. The differences in movement disorders between adults and children are striking; presentation is frequently insidious and may be…

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

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…

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…

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…

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…

State of the science: procedural pain management in the neonate

Neonates in the neonatal intensive care unit experience painful procedures. Over the last 10 years, investigators have examined several pharmacologic and nonpharmacolgic treatment strategies to decrease or eliminate the pain associated with…

Tags: 2006, Administration, Artificial/adverse effects Sucking Behavior Sucrose/administration & dosage, Backlog, Central Venous/adverse effects Evidence-Based Medicine Glucose/administration & dosage Humans Infant Care Infant, D'Apolito KC, Human Neonatal Nursing/organization & administration Nurse's Role Nursing Assessment Nursing Research Pain/diagnosis/etiology/prevention & control Pain Measurement Phlebotomy/adverse effects Respiration, Intratracheal/adverse effects Milk, Journal Article, Journal of Perinatal & Neonatal Nursing, Neonatal/methods Intubation, Newborn Intensive Care, OralAnalgesia/methods/nursing Analgesics/therapeutic use Catheterization, PedPal Lit

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…

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

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…

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