Browse Items · Pediatric Palliative Care Library

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…

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…

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…

Neuropathic cancer pain: prevalence, severity, analgesics and impact from the European Palliative Care Research Collaborative-Computerised Symptom Assessment study

BACKGROUND: Neuropathic pain causes greater pain intensity and worse quality of life than nociceptive pain. There are no published data that confirm this in the cancer population. AIM: We hypothesised that patients with neuropathic cancer pain had…

Nociceptin levels in the cerebrospinal fluid of chronic pain patients with or without intrathecal administration of morphine

The neuropeptide nociceptin/orphanin FQ (N/OFQ) is the endogenous ligand for the opioid-like receptor ORL-1 and is thought to be involved in pain transmission and modulation. Human studies have not yet defined its role in pain patients. The aims of…

High-dose oral morphine in cancer pain management: a report of twelve cases

We present 12 case reports from patients treated with more than 600 mg of morphine per day. We found no "opioid-nonresponsive pain" under treatment with a combination of morphine and nonopioids, supplemented with coanalgesics where appropriate. Side…

Tramadol: does it have a role in cancer pain management?

Tramadol (Ultram, Ortho-McNeil Pharmaceutical, Inc., Raritan, NJ) is considered a Step 2 analgesic under the World Health Organization's guidelines for the treatment of patients with cancer pain. It is a centrally acting analgesic that has affinity…

Tags: 2005, Analgesics, Backlog, Humans, Journal Article, Journal of opioid management, Methadone, Neoplasms/complications, Opioid/adverse effects/chemistry/pharmacokinetics/therapeutic use, Pain/drug therapy/etiology, Prommer EE, Tramadol/adverse effects/chemistry/pharmacokinetics/therapeutic use

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

Clinical pharmacokinetics and pharmacodynamics of opioid analgesics in infants and children

Pain in childhood has not always been managed as actively as that in adults because of the limited amount of research available to provide guidelines for the management of paediatric pain. However, for many years now the pharmacokinetics and…

Tags: 1995, Analgesics, Backlog, Child, Clinical Pharmacokinetics, Hamunen K, Humans, Infant, Journal Article, Maunuksela EL, Olkkola KT, Opioid/administration & dosage/pharmacokinetics/pharmacology, Preschool

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…

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…

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…

Methadone response in advanced cancer patients with pain followed at home

Concerns about the safety of therapy with methadone, which may arise because of its pharmacokinetic characteristics and inappropriate dosing, may deter clinicians from using this drug, especially in elderly patients. Experience is accumulating that…

Use of intravenous acetaminophen (paracetamol) in a pediatric patient at the end of life: case report

BACKGROUND: For the better part of 100 years, acetaminophen (or paracetamol as it is known outside of the United States) has been a common first-line analgesic in pediatrics and is typically well tolerated with minimal side effects. Its use as an…

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…

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

Pain control by immune-derived opioids

1. The nervous and immune systems communicate with each other by use of cytokines and neuropeptides. 2. Interactions between immune cell-derived opioid peptides and opioid receptors located in peripheral inflamed tissue lead to endogenous analgesia.…

Tags: 2000, Analgesics, Backlog, Biomarkers of Pain, Clinical And Experimental Pharmacology & Physiology, Humans, Journal Article, Machelska H, Neuropeptides/therapeutic use, Opioid/drug effects/immunology, Opioid/therapeutic use, Pain/drug therapy/immunology, Peripheral Nervous System/drug effects, Receptors, Stein C

A review of the use of methadone for the treatment of chronic noncancer pain

Methadone, although having been available for approximately half a century, is now receiving increasing attention in the management of chronic pain. This is due to recent research showing that methadone exhibits at least three different mechanisms of…

Tags: 2005, Analgesics, Backlog, Canada, Chronic Disease, Drug, Humans, Journal Article, Legislation, Lynch ME, Methadone, Methadone/adverse effects/chemistry/pharmacokinetics/pharmacology/therapeutic use, Non-U.S. Gov't, Opioid/adverse effects/chemistry/pharmacokinetics/pharmacology/therapeutic use, Pain Research & Management : The Journal Of The Canadian Pain Society = Journal De La Societe Canadienne Pour Le Traitement De La Douleur, Pain/drug Therapy, Research Support

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…

Postoperative epidural analgesia with bupivacaine and fentanyl: hourly pain assessment in 348 paediatric cases

BACKGROUND: The objective of this prospective study was the evaluation of the analgesia provided by an epidural infusion of bupivacaine and fentanyl after different types of surgery in children. METHODS: Data were collected from 348 epidural…

Chronic pain management and the surgeon: barriers and opportunities

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…

A Descriptive Report Of End-of-life Care Practices Occurring In Two Neonatal Intensive Care Units

BACKGROUND:
In Canada and other developed countries, the majority of neonatal deaths occur in tertiary neonatal intensive care units. Most deaths occur following the withdrawal of life-sustaining treatments.
AIM:
To explore neonatal death events and…

Biological rhythms in pain and in the effects of opioid analgesics

Pain is difficult and sometimes frustrating to treat, even though new devices and new approaches have been developed in recent years. Pain varies tremendously from one patient to the next, and there are also some studies suggesting that the intensity…

Tags: 1995, Analgesics, Animals, Backlog, Circadian Rhythm/drug effects/physiology, Humans, Journal Article, Labrecque G, Opioid/administration & dosage/therapeutic use, Pain/drug therapy/physiopathology, Pharmacology & Therapeutics, Vanier MC

Intravenous morphine for emergency treatment of cancer pain

Despite the wide use of the World Health Organization (WHO) analgesic ladder for the relief of cancer pain, it is not uncommon to find patients presenting with severe pain to palliative care centres. This is more so in the developing world, where…

Patients with malignant hematological disorders treated on a palliative care unit: prognostic impact of clinical factors

A reliable estimation of prognosis in patients receiving palliative care is desirable in order to facilitate clinical decision finding. For patients with advanced hematological malignancies, only few data are available to estimate prognosis of the…

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.…

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…

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…

Transdermal fentanyl. A review of its pharmacological properties and therapeutic efficacy in pain control

Fentanyl is a synthetic opioid with short-acting analgesic activity after intravenous or subcutaneous administration. The low molecular weight, high potency and lipid solubility of fentanyl make it suitable for delivery via the transdermal…

Tags: 1997, Analgesics, Backlog, Benfield P, Drugs, Fentanyl/administration & dosage/adverse effects/pharmacokinetics, Humans, Jeal W, Journal Article, Opioid/administration & dosage, Pain/drug Therapy

Population pharmacokinetics of oral morphine and its glucuronides in children receiving morphine as immediate-release liquid or sustained-release tablets for cancer pain

OBJECTIVES: (1) To determine the pharmacokinetics of morphine, morphine-6-glucuronide (M6G), and morphine-3-glucuronide (M3G) in children with cancer receiving morphine as immediate-release morphine liquid or sustained-release tablets. (2) To…

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…

Can end of life care for the pediatric patient suffering with escalating and intractable symptoms be improved?

Over twelve thousand children are diagnosed each year with cancer, and approximately 2200 children die each year from the disease. A percentage of these patients experiences escalating and intractable distress with symptoms that include pain,…

Tags: 2006, Analgesics, Backlog, Branowicki PA, Dinning C, Houlahan KE, Journal Article, Journal Of Pediatric Oncology Nursing, Mack JW, McCabe M, Opioid/therapeutic use Boston ChildClinical Protocols Humans Neoplasms/nursing Pain/drug therapyPalliative Care/methods/organization & administration Pilot Projects Practice Guidelines, PedPal Lit

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…

Influence of pain treatment by epidural fentanyl and bupivacaine on homing of opioid-containing leukocytes to surgical wounds

Endogenous opioids released from leukocytes extravasating into injured tissue can interact with peripheral opioid receptors to inhibit nociception. Animal studies have shown that the homing of opioid-producing leukocytes to the injured site is…

Tags: 2007, Adjuvants, Aged, Analgesia, Analgesics, Anesthesia, Anesthesia/immunology/pharmacology, Anesthetics, Backlog, beta-Endorphin/drug effects/immunology/metabolism, Biomarkers of Pain, Brain, Behavior, And Immunity, Bupivacaine/immunology/therapeutic use, Cell Movement/drug effects/immunology, Enkephalin, Epidural, Female, Fentanyl/immunology/therapeutic use, Heurich M, Humans, Journal Article, Kopf A, Lenzner M, Leukocytes/drug effects/immunology/metabolism, Local/immunology/therapeutic use, Longitudinal Studies, Male, Methionine/drug effects/immunology/metabolism, Middle Aged, Morciniec P, Mousa SA, Nociceptors/drug effects/immunology, Opioid/immunology/therapeutic use, Pain, Patient-Controlled, Pirinitramide/therapeutic use, Postganglionic/drug effects/immunology, Postoperative/immunology/prevention & control, Stein C, Subcutaneous Tissue/immunology, Sympathetic Fibers, Welte M, Wound Healing/drug effects/immunology

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…

Strong opioids in pediatric palliative medicine

2005

Tags: 2005, Analgesics, Backlog, Devins M, early research in children does suggest some significant differences in opioid pharmacokinetics, Hain RD, illustrated by the WHO guidelines, is essential for the adequate management of pain complicating the palliative phase in children with life-limiting conditions., Journal Article, Miser A, much of what has been published regarding the management of pain in palliative medicine in adults can be extrapolated. On saying that, Opioid/administration & dosage/adverse effects/therapeutic use Child Child, Paediatr Drugs, particularly with respect to morphine clearance, PedPal Lit, Preschool Half-Life Humans InfantMorphine/adverse effects/pharmacokinetics/therapeutic use Pain/classification/drug therapy Palliative Care/methods Tissue Distribution, the use of opioids in pediatric palliative care presents some unique challenges. Confident and rational use of o pioids by pediatricians, unsuitable for use in children, Wallace WH, which seems to be faster in adults. Thus

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)