Browse Items · Pediatric Palliative Care Library

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…

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…

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

Patient-controlled analgesia for mucositis pain in children: a three-period crossover study comparing morphine and hydromorphone

OBJECTIVES: (1) To test the safety and efficacy of a clinical protocol for administering opioid by using patient-controlled analgesia (PCA) for the management of mucositis pain in children after bone marrow transplantation, (2) to compare the…

Patient-controlled analgesia

In appropriately selected patients, PCA safely provides analgesia superior to that obtained with traditional IM prn opioid administration; however, to date, no compelling evidence shows that PCA is associated with a reduction in morbidity or a more…

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

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…

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…

Pain management: a fundamental human right

This article surveys worldwide medical, ethical, and legal trends and initiatives related to the concept of pain management as a human right. This concept recently gained momentum with the 2004 European Federation of International Association for the…

Tags: 2007, Analgesics, Anesthesia & Analgesia, Backlog, Brennan F, Carr DB, Chronic Disease, Cousins M, Drug and Narcotic Control/legislation & jurisprudence, Human Rights/legislation & jurisprudence, Humans, Journal Article, Opioid/therapeutic use, Pain/epidemiology/therapy, World Health Organization

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

Pain and symptom control in terminally ill children

The management of pain in terminally ill pediatric patients has incalculable benefits to patients, their families, and physicians and nurses. A therapeutic management plan is dependent on a thorough understanding of the causes of pain in these…

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…

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…

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…

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 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…

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…

Opioids for chronic noncancer pain: a new Canadian practice guideline

2010

Tags: 2010, Advisory Committees/organization & administration, Analgesics, Backlog, Canada, Canadian Medical Association Journal, Chronic Disease, Furlan AD, Humans, Journal Article, National Opioid Use Guideline Group, Opioid/administration & dosage/adverse effects/therapeutic use, Pain/drug Therapy, Practice Guidelines As Topic, Reardon R, Weppler C

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

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

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…

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 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 dependence and addiction during opioid treatment of chronic pain

Throughout the long history of opioid drug use by humans, it has been known that opioids are powerful analgesics, but they can cause addiction. It has also been observed, and is now substantiated by multiple reports and studies, that during opioid…

Tags: 2007, Analgesics, Backlog, Ballantyne JC, Brain/drug effects/physiopathology, Chronic Disease, Humans, Journal Article, LaForge KS, Models, Neurological, Opioid-Related Disorders/etiology/physiopathology/prevention & control, Opioid/adverse effects/therapeutic use, Pain, Pain/drug therapy/physiopathology/psychology, Physician's Practice Patterns/trends

Opioid analgesics: comparative features and prescribing guidelines

The term 'opioid' is a generic term for naturally occurring, semisynthetic and synthetic drugs which combine with opioid receptors to produce physiological effects and which are stereospecifically antagonised by naloxone. For clinical purposes,…

Tags: 1996, Analgesics, Backlog, Cherny NI, Comparative Study, Drug, Drugs, Humans, Journal Article, Opioid/administration & dosage/adverse effects/therapeutic use, Pain/drug Therapy, Prescriptions

Occurrence of withdrawal in critically ill sedated children

OBJECTIVES: To record the number of children with withdrawal symptoms after the administration of sedatives for mechanical ventilation, and to discuss the possible connection with the administration of midazolam. DESIGN: Retrospective data collection…

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…

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…

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…

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

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…

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…

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

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…

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…

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

Massive opioid resistance in an infant with a localized metastasis to the midbrain periaqueductal gray

We report the case of a 4-month-old infant with terminal malignancy who had systemic metastases and a localized metastasis to the dorsal midbrain periaqueductal gray (PAG). Extraordinary doses of opioids (dose equivalent of 2680 mg morphine…

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

Browse Items (131 total)