Browse Items · Pediatric Palliative Care Library

Difficult pain

2006

Tags: 2006, Acupuncture/methods, Analgesia/methods, Analgesics, Backlog, Bmj, Colvin L, Fallon M, Forbes K, Forecasting, Humans, Journal Article, Methadone/therapeutic use, Nervous System Diseases/complications, Neuralgia, Opioid/therapeutic use, Pain/etiology/prevention & control, Palliative Care/methods, PedPal Lit, Psychotherapy/methods

The challenge of preemptive analgesia

2005

Tags: 2005, Adult, Aida S, Analgesia, Analgesics, Anesthesia, Backlog, Journal Article, Pain, Pain: Clinical Updates, Preoperative Care

Analgesic effect of the synthetic cannabinoid CT-3 on chronic neuropathic pain: a randomized controlled trial

CONTEXT: 1',1'dimethylheptyl-Delta8-tetrahydrocannabinol-11-oic acid (CT-3), a potent analog of THC-11-oic acid, produces marked antiallodynic and analgesic effects in animals without evoking the typical effects described in models of cannabinoids.…

Bisphosphonates for the relief of pain secondary to bone metastases

BACKGROUND: Bisphosphonates form part of standard therapy for hypercalcemia and the prevention of skeletal events in some cancers. However, the role of bisphosphonates in pain relief for bony metastases remains uncertain. OBJECTIVES: To determine the…

Tags: 2002, Analgesics, Antineoplastic Agents/therapeutic use, Backlog, Bone Neoplasms/complications/drug therapy/secondary, Clodronate, Clodronic Acid/therapeutic use, Cochrane Database of Systematic Reviews, Diphosphonates/therapeutic use, Etidronic Acid/therapeutic use, Humans, Journal Article, Non-Narcotic/therapeutic use, Pain/drug Therapy, Randomized Controlled Trials, Wiffen PJ, Wong R

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…

Opioids in renal failure and dialysis patients

This article reviews the literature pertaining to the metabolism of several of the commonly used opioids, and the known activity of their metabolites. The effect of renal failure on the pharmacokinetics of these drugs and metabolites is then…

Tags: 2004, Analgesics, Backlog, Chronic/complications/therapy, Dean M, Humans, Journal Article, Journal of Pain and Symptom Management, Kidney Failure, Opioid/therapeutic use, Pain/drug Therapy, Peritoneal Dialysis

Opioids in chronic non-cancer pain: systematic review of efficacy and safety

Opioids are used increasingly for chronic non-cancer pain. Controversy exists about their effectiveness and safety with long-term use. We analysed available randomised, placebo-controlled trials of WHO step 3 opioids for efficacy and safety in…

Patient-controlled analgesia with intravenous L-methadone in a child with cancer pain refractory to high-dose morphine

High dose opioids in pediatric palliative care.

Safety of subcutaneous clodronate and efficacy in hypercalcemia of malignancy: a novel route of administration

Bisphosphonates have become standard treatment in management of malignancy-induced hypercalcemia and malignant bone pain. One obstacle to the routine use of bisphosphonates in palliative patients is that oral bisphosphonates have low bioavailability…

Intravenous fentanyl for cancer pain: a "fast titration" protocol for the emergency room

Patients with cancer sometimes are admitted to the emergency room due to severe pain. Despite the fact that morphine's hydrophilicity can delay its peak effects after intravenous administration up to 30 minutes, it is still the most commonly used…

The use of methadone for cancer pain

Methadone is not a new analgesic drug [69]. Several studies have demonstrated that methadone is a valid alternative to morphine, hydromorphone, and fentanyl for the treatment of cancer-related pain, and extensive reviews on the subject have been…

Recommendations for using opioids in chronic non-cancer pain

1. The management of chronic pain should be directed by the underlying cause of the pain. Whatever the cause, the primary goal of patient care should be symptom control. 2. Opioid treatment should be considered for both continuous neuropathic and…

Attacking pain at its source: new perspectives on opioids

The treatment of severe pain with opioids has thus far been limited by their unwanted central side effects. Recent research promises new approaches, including opioid analgesics acting outside the central nervous system, targeting of opioid…

Morphine is not the only analgesic in palliative care: Literature review

BACKGROUND: No comprehensive review has been published to date, which provides information for nurses on pharmaceutical alternatives to morphine in palliative care. As nurses are often the health professional most involved with terminally ill…

Tags: 2004, Analgesics, Analgesics/therapeutic use, Backlog, Fentanyl/therapeutic use, Humans, Journal Article, Journal Of Advanced Nursing, Ketamine/therapeutic use, Methadone/therapeutic use, Morphine/therapeutic Use, Neoplasms/complications, Opioid/therapeutic use, Pain/drug Therapy, Palliative Care/methods, Wootton M

Analgesics for the treatment of pain in children

Clinical use of methadone

Methadone hydrochloride is a mu-opioid agonist that has been used for the treatment of pain and for the management and maintenance of opioid withdrawal for over 50 years. Several characteristics make methadone a useful drug. However, these same…

Methadone use in cancer patients with pain: a review

In recent years a better understanding of the pharmacologic and pharmacokinetic properties of methadone, including equianalgesic ratios has led to its increased use as a second line opioid for the treatment of pain in patients with cancer. Methadone…

Tags: 2002, Analgesics, Backlog, Bruera E, Drug Interactions, Humans, Journal Article, Journal of Palliative Medicine, Methadone/pharmacokinetics/therapeutic use, Neoplasms/complications, Opioid/pharmacokinetics/therapeutic use, Pain/drug therapy/etiology, Sweeney C

Increased numbers of opioid expressing inflammatory cells do not affect intra-articular morphine analgesia

BACKGROUND: Both locally expressed beta-endorphin (END) and low doses of morphine relieve pain within inflamed knee joints. Here we examined whether enhanced inflammation and END expression within the synovial tissue of patients undergoing…

Modulation of peripheral endogenous opioid analgesia by central afferent blockade

BACKGROUND: Peripheral tissue injury causes a migration of opioid peptide-containing immune cells to the inflamed site. The subsequent release and action of these peptides on opioid receptors localized on peripheral sensory nerve terminals causes…

Tissue monocytes/macrophages in inflammation: hyperalgesia versus opioid-mediated peripheral antinociception

BACKGROUND: Opioid-containing leukocytes migrate to peripheral sites of inflammation. On exposure to stress, opioid peptides are released, bind to opioid receptors on peripheral sensory neurons, and induce endogenous antinociception. In later stages…

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.…

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…

Treatment of pediatric chronic pain with tramadol hydrochloride: siblings with Ehlers-Danlos syndrome - Hypermobility type

OBJECTIVE: To evaluate the effectiveness of tramadol hydrochloride for the treatment of chronic pain refractory to previous treatment in two pediatric patients. METHODS: Tramadol hydrochloride was administered (50 mg/day to 150 mg/day) to two…

Tags: 2004, Analgesics, Backlog, Brown SC, Child, Chronic Disease, Ehlers-Danlos Syndrome/complications, Humans, Joint Instability/etiology, Journal Article, Male, Opioid/administration & dosage, Pain Research & Management, Pain/drug therapy/etiology, Preschool, Stinson J, Tramadol/administration & dosage

The efficacy and side effects of continuous infusion intravenous morphine (CIVM) for pain and symptoms due to advanced cancer

Morphine is the strong opioid of choice in the management of moderate-to-severe chronic cancer pain. The preferred route of administration is oral, in individually titrated doses, regularly scheduled around the clock We conducted a retrospective…

Immune mechanisms in pain control

2002

Tags: 2002, Analgesics, Anesthesia & Analgesia, Animals, Backlog, Cellular/physiology, Endorphins/metabolism, Humans, Immune System/physiology, Immunity, Journal Article, Machelska H, Non-U.S. Gov't, Opioid/pharmacology, Opioid/physiology, Pain/drug therapy/immunology/pathology, Receptors, Research Support, Stein C

Use of opioids in the treatment of severe pain in terminally ill patients--dying should not be painful

Pain is a common symptom at the end of life. The vast majority of pain can be readily managed if simple principles of practice are followed. Chronic pain requires continuous analgesia, and severe pain requires use of strong analgesics, most commonly…

Pain, sedation and morphine metabolism in cancer patients during long-term treatment with sustained-release morphine

BACKGROUND: Morphine-6-glucuronide (M-6-G) and morphine-3-glucuronide (M-3-G) are the two most important metabolites of morphine. Both are pharmacologically active, however, with different effects. M-6-G has been demonstrated capable of inducing…

Pharmacogenetics of codeine metabolism in an urban population of children and its implications for analgesic reliability

BACKGROUND: Codeine analgesia is wholly or mostly due to its metabolism to morphine by the cytochrome P450 enzyme CYP2D6, which shows significant genetic variation in activity. The aims of this study were to investigate genotype, phenotype and…

Oral opioid therapy for chronic peripheral and central neuropathic pain

BACKGROUND: Although opioids are commonly used to treat chronic neuropathic pain, there are limited data to guide their use. Few controlled trials have been performed, and many types of neuropathic pain remain unstudied. METHODS: Adults with…

Fast fact and concepts #107: Controlled sedation for refractory symptoms: Part II

This fact fact will review sedation techniques.

Tags: 2004, Analgesia/methods, Analgesics, Anesthesia/methods, Backlog, Journal Article, Salacz ME, Weissman DE

Palliative care tips: Commonly administered sub-cutaneous medications in palliative care

2002

Tags: "Hypnotics and Sedatives", 2002, Analgesics, Antiemetics, Backlog, Bielech M, Journal Article, Morphine, Narcotics, Opioid, Palliative Care, Pharmaceutical Preparations, Terminal Care, Turnbull K, Watanabe S

Management of burn pain in children

In spite of the many possible methods of pain control in the burned child satisfactory pain management may still be a problem, at times formidable. The most fruitful approach would seem to be frequent assessment of pain in the individual patient with…

Tags: 1989, Analgesics, Analgesics/administration & dosage/therapeutic use, Backlog, Bandages/adverse effects, Burns/complications/physiopathology, Child, Humans, Journal Article, Opioid/administration & dosage/pharmacokinetics/pharmacology/therapeutic use, Osgood PF, Pain/physiopathology/therapy, Patient Compliance, Pediatric Clinics of North America, Szyfelbein SK

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…

The opiate hypothesis in autism and self-injury

The opiate hypothesis maintains that patients engage in self-injurious behavior (SIB) either because they are partially analgesic (pathologically altered pain threshold) or because SIB supplies a "fix" for an addicted endogenous opiate system. The…

Tags: 1990, Analgesics, Autism, Autistic disorder, Backlog, Journal Article, Journal Of Child And Adolescent Psychopharmacology, Naloxone, Naltrexone, Opioid, Pain, Pain Measurement, Pain Threshold, Sandman CA, Self Mutiliation, Self-Injurious behavior

Pharmacokinetics of methadone in children and adolescents in the perioperative period

Introduction Previous studies by Gourlay and coworkers1-3 have demonstrated that in adults undergoing surgery, methadone has slow elimination and a very long duration of effective analgesia. For children, intramuscular injections are a major source…

Methadone as treatment for iatrogenic narcotic dependency in pediatric intensive care unit patients

View through a window may influence recovery from surgery

Records on recovery after cholecystectomy of patients in a suburban Pennsylvania hospital between 1972 and 1981 were examined to determine whether assignment to a room with a window view of a natural setting might have restorative influences.…

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…

Comparative clinical efficacy and safety of a novel controlled-release oxycodone formulation and controlled-release hydromorphone in the treatment of cancer pain

BACKGROUND: The use of oxycodone to treat chronic cancer pain has been hampered by its short elimination half-life, which necessitates administration every 4 hours. This study compared the clinical efficacy and safety of a novel oxycodone formulation…

Tags: 1997, Analgesics, Babul N, Backlog, Cancer, Comparative Study, Cross-Over Studies, Delayed-Action Preparations, Double-Blind Method, Drug Evaluation, Female, Hagen NA, Humans, Hydromorphone/administration & Male, Journal Article, Middle Aged, Neoplasms/complications, Opioid/administration & dosage, Oxycodone/administration & Pain/drug therapy

Browse Items (131 total)