Browse Items · Pediatric Palliative Care Library

Opioids

Opioids are the most effective and widely used drugs in the treatment of severe pain. They act through G protein-coupled receptors. Four families of endogenous ligands (opioid peptides) are known. The standard exogenous opioid analgesic is morphine.…

Tags: 2007, Amino Acid Sequence, Analgesics, Animals, Backlog, Biomarkers of Pain, Chronic Disease, Drug Tolerance, Handbook Of Experimental Pharmacology, Humans, Journal Article, Ligands, Molecular Sequence Data, Opioid/adverse effects/pharmacology/therapeutic use, Opioid/drug effects, Receptors, Stein C, Zollner C

Osteoporosis pseudoglioma syndrome: treatment of spinal osteoporosis with intravenous bisphosphonates

OBJECTIVES: To determine whether intravenous bisphosphonate treatment is helpful for children with osteoporosis pseudoglioma syndrome who have severe osteoporosis. METHODS: Three children (ages 9 to 11 years) with osteoporosis pseudoglioma syndrome…

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

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

Beyond Amitriptyline: A Pediatric and Adolescent Oriented Narrative Review of the Analgesic Properties of Psychotropic Medications for the Treatment of Complex Pain and Headache Disorders

Children and adolescents with recurrent or chronic pain and headache are a complex and heterogenous population. Patients are best served by multi-specialty, multidisciplinary teams to assess and create tailored, individualized pain treatment and…

Tags: 2020, adolescent headache, adolescent pain, Analgesics, anxiety, Child Psychiatry, Children (Basel), complex pain, Depression, February 2021 List, McDaniel M, pain psychiatry, pediatric headache, pediatric pain, psychotropics, Sierra M, Snri, Windsor RB, Zappitelli M

Use of methadone in the morphine-tolerant burned paediatric patient

We describe the successful use of methadone in the restoration of sedation and provision of analgesia in two morphine-tolerant, paediatric patients who had suffered significant thermal injuries and were undergoing mechanical ventilation. Both…

Opioids and the neuroimmune axis

2005

Tags: 2005, Analgesics, Animals, Backlog, British Journal Of Anaesthesia, Humans, Immune System/drug effects/physiology, Inflammation/immunology, Journal Article, Lambert DG, mu/metabolism, Neuroimmunomodulation/immunology, Opioid, Opioid Peptides/physiology, Opioid/pharmacology, Rats, Receptors, Williams JP

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…

Codeine phosphate in paediatric medicine

2001

Tags: 2001, Analgesics, Backlog, British Journal Of Anaesthesia, Child, Codeine/pharmacokinetics/pharmacology/therapeutic use, Hatch DJ, Howard RF, Human, Journal Article, Non-U.S. Gov't, Opioid/pharmacokinetics/pharmacology/therapeutic use, Pain, Postoperative/drug therapy, Support, Williams DG

A systematic review of opioid conversion ratios used with methadone for the treatment of pain

OBJECTIVE: Review and analyze the evidence base comprising methadone conversion methods and associated dosing ratios for the treatment of pain. DESIGN: Systematic review. METHODS: Clinical trials and retrospective analyses, case series, and case…

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…

Glia: novel counter-regulators of opioid analgesia

Development of analgesic tolerance and withdrawal-induced pain enhancement present serious difficulties for the use of opioids for pain control. Although neuronal mechanisms to account for these phenomena have been sought for many decades, their…

Tags: 2005, Analgesics, Animals, Backlog, Brain/drug effects/metabolism, Drug Tolerance, Humans, Hutchinson MR, Johnston IN, Journal Article, Maier SF, Neuroglia/drug effects/metabolism, Neurotransmitter Agents/metabolism, Nociceptors/drug effects/metabolism, Opioid/administration & dosage, Pain/metabolism/prevention & control, Spinal Cord/drug effects/metabolism, Trends In Neurosciences, Watkins LR

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…

Paediatric fever management: continuing education for clinical nurses

PURPOSE: This study examined the influence of level of practice, additional paediatric education and length of paediatric and current experience on nurses' knowledge of and beliefs about fever and fever management. METHOD: Fifty-one nurses from…

Subcutaneous clodronate

1996

Tags: 1996, Aged, Analgesics, Backlog, Bruera E, Clodronic Acid/administration & dosage, Humans, Hypercalcemia/drug therapy, Infusions, Journal Article, Lancet, Lawlor P, Male, Middle Aged, Non-Narcotic/administration & dosage, Parenteral, Walker P, Watanabe S

End-of-life practices in the Netherlands under the Euthanasia Act

BACKGROUND: In 2002, an act regulating the ending of life by a physician at the request of a patient with unbearable suffering came into effect in the Netherlands. In 2005, we performed a follow-up study of euthanasia, physician-assisted suicide, and…

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…

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.…

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.…

A comparison of two regimens of patient-controlled analgesia for children with sickle cell disease

Recently, patient controlled analgesia (PCA) has gained prominence in the treatment of pain for children suffering from vaso-occlusive crisis associated with sickle cell disease. Because there are several different regimens that can be used for PCA,…

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

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…

New and lingering controversies in pediatric end-of-life care

OBJECTIVES: Professional societies, ethics institutes, and the courts have recommended principles to guide the care of children with life-threatening conditions; however, little is known about the degree to which pediatric care providers are aware of…

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…

Disappearance of morphine-induced hyperalgesia after discontinuing or substituting morphine with other opioid agonists

Hyperalgesia and allodynia in 4 cancer patients treated with morphine disappeared after discontinuing or substituting morphine with other opioid agonists. The first case describes a young female who developed hyperalgesia and myoclonus during…

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…

High dose opioids in pediatric palliative care.

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…

Pediatric palliative pain and symptom management

Tags: 2012, Analgesics, Backlog, Child, Disease Management, Humans, Journal Article, Opioid, Pain, Pain Management, Palliative Care, Pediatric Annals, Shaw TM

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…

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…

Challenges in using opioids to treat pain in persons with substance use disorders

Pain and substance abuse co-occur frequently, and each can make the other more difficult to treat. A knowledge of pain and its interrelationships with addiction enhances the addiction specialist's efficacy with many patients, both in the substance…

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

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

Are one or two dangerous? Opioid exposure in toddlers

Ingestions of opioid analgesics by children may lead to significant toxicity as a result of depression of the respiratory and central nervous systems. A review of the medical literature was performed to determine whether low doses of opioids are…

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

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…

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…

Assessment of nurses' judgement for analgesic requirements of postoperative children

Over the last 5-10 years, there has been significant growth in the knowledge and strategies of pain management in children. Investigations are required to discern whether concomitant improvements in clinical practice have occurred. The purpose of…

Tags: 1996, Acetaminophen/administration & dosage/therapeutic use, Analgesics, Backlog, Child, Female, Humans, Journal Article, Journal Of Clinical Pharmacy And Therapeutics, Male, Non-Narcotic/administration & dosage/therapeutic use, Nursing Assessment, Pain, Postoperative/drug therapy/psychology, Preschool, Romsing J, Suppositories, Tonsillectomy

Browse Items (131 total)