Browse Items · Pediatric Palliative Care Library

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

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

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…

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…

Weaving for the future: using rulers and roses

2001

Tags: 2001, Administration, Backlog, Biomedical, Canadian Oncology Nursing Journal, Davies B, Evidence-based Medicine, Forecasting, Humans, Journal Article, Leadership, Models, Nurse's Role, Nursing, Nursing Process, Nursing Research/organization &, Oncologic Nursing/education/organization &, Organizational Objectives, Technology Assessment

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…

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…

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…

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…

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

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…

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]

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…

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…

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…

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…

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…

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

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

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

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

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

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…

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…

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

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

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

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

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…

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.…

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…

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…

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…

The decision to use topical anesthetic for intravenous insertion in the pediatric emergency department

OBJECTIVES: Topical anesthetic creams to reduce the pain of intravenous (IV) placement may be more effectively used in the emergency setting if they are applied by nurses in the triage area of the emergency department or soon after the patient is…

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…

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

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…

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…

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