1
40
45
-
Text
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URL Address
<a href="http://doi.org/10.1056/NEJMsa0906126" target="_blank" rel="noreferrer">http://doi.org/10.1056/NEJMsa0906126</a>
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Title
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Outcome reporting in industry-sponsored trials of gabapentin for off-label use
Publisher
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The New England Journal Of Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2009
Subject
The topic of the resource
Humans; Treatment Outcome; Clinical Protocols; Pain/drug therapy; Migraine Disorders/drug therapy; Randomized Controlled Trials as Topic/standards; Publication Bias; Bipolar Disorder/drug therapy; Hal's Folder; Amines/therapeutic use; Cyclohexanecarboxylic Acids/therapeutic use; gamma-Aminobutyric Acid/therapeutic use; Off-Label Use/statistics & numerical data; Outcome Assessment (Health Care)/methods/standards
Creator
An entity primarily responsible for making the resource
Vedula SS; Bero L; Scherer RW; Dickersin K
Description
An account of the resource
BACKGROUND: There is good evidence of selective outcome reporting in published reports of randomized trials. METHODS: We examined reporting practices for trials of gabapentin funded by Pfizer and Warner-Lambert's subsidiary, Parke-Davis (hereafter referred to as Pfizer and Parke-Davis) for off-label indications (prophylaxis against migraine and treatment of bipolar disorders, neuropathic pain, and nociceptive pain), comparing internal company documents with published reports. RESULTS: We identified 20 clinical trials for which internal documents were available from Pfizer and Parke-Davis; of these trials, 12 were reported in publications. For 8 of the 12 reported trials, the primary outcome defined in the published report differed from that described in the protocol. Sources of disagreement included the introduction of a new primary outcome (in the case of 6 trials), failure to distinguish between primary and secondary outcomes (2 trials), relegation of primary outcomes to secondary outcomes (2 trials), and failure to report one or more protocol-defined primary outcomes (5 trials). Trials that presented findings that were not significant (P > or = 0.05) for the protocol-defined primary outcome in the internal documents either were not reported in full or were reported with a changed primary outcome. The primary outcome was changed in the case of 5 of 8 published trials for which statistically significant differences favoring gabapentin were reported. Of the 21 primary outcomes described in the protocols of the published trials, 6 were not reported at all and 4 were reported as secondary outcomes. Of 28 primary outcomes described in the published reports, 12 were newly introduced. CONCLUSIONS: We identified selective outcome reporting for trials of off-label use of gabapentin. This practice threatens the validity of evidence for the effectiveness of off-label interventions.
2009
Identifier
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<a href="http://doi.org/10.1056/NEJMsa0906126" target="_blank" rel="noreferrer">10.1056/NEJMsa0906126</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2009
Amines/therapeutic use
Backlog
Bero L
Bipolar Disorder/drug therapy
Clinical Protocols
Cyclohexanecarboxylic Acids/therapeutic use
Dickersin K
gamma-Aminobutyric Acid/therapeutic use
Hal's Folder
Humans
Journal Article
Migraine Disorders/drug therapy
Off-Label Use/statistics & numerical data
Outcome Assessment (Health Care)/methods/standards
Pain/drug Therapy
Publication Bias
Randomized Controlled Trials as Topic/standards
Scherer RW
The New England Journal Of Medicine
Treatment Outcome
Vedula SS
-
Text
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Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1089/jpm.2006.0139" target="_blank" rel="noreferrer">http://doi.org/10.1089/jpm.2006.0139</a>
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Title
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Palliative sedation therapy in the last weeks of life: a literature review and recommendations for standards
Publisher
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Journal Of Palliative Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2007
Subject
The topic of the resource
Humans; Risk Assessment; Fluid Therapy; Informed Consent; International Cooperation; Parenteral Nutrition; Practice Guidelines; Neoplasms; Palliative Care/standards; Pain/drug therapy; Attitude to Death/ethnology; Terminal Care/standards; Hypnotics and Sedatives/administration & dosage/classification/therapeutic use
Creator
An entity primarily responsible for making the resource
de Graeff A; Dean M
Description
An account of the resource
PURPOSE: Palliative sedation therapy (PST) is a controversial issue. There is a need for internationally accepted definitions and standards. METHODS: A systematic review of the literature was performed by an international panel of 29 palliative care experts. Draft papers were written on various topics concerning PST. This paper is a summary of the individual papers, written after two meetings and extensive e-mail discussions. RESULTS: PST is defined as the use of specific sedative medications to relieve intolerable suffering from refractory symptoms by a reduction in patient consciousness, using appropriate drugs carefully titrated to the cessation of symptoms. The initial dose of sedatives should usually be small enough to maintain the patients' ability to communicate periodically. The team looking after the patient should have enough expertise and experience to judge the symptom as refractory. Advice from palliative care specialists is strongly recommended before initiating PST. In the case of continuous and deep PST, the disease should be irreversible and advanced, with death expected within hours to days. Midazolam should be considered first-line choice. The decision whether or not to withhold or withdraw hydration should be discussed separately. Hydration should be offered only if it is considered likely that the benefit will outweigh the harm. PST is distinct from euthanasia because (1) it has the intent to provide symptom relief, (2) it is a proportionate intervention, and (3) the death of the patient is not a criterion for success. PST and its outcome should be carefully monitored and documented. CONCLUSION: When other treatments fail to relieve suffering in the imminently dying patient, PST is a valid palliative care option.
2007
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1089/jpm.2006.0139" target="_blank" rel="noreferrer">10.1089/jpm.2006.0139</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2007
Attitude To Death/ethnology
Backlog
de Graeff A
Dean M
Fluid Therapy
Humans
Hypnotics and Sedatives/administration & dosage/classification/therapeutic use
Informed Consent
International Cooperation
Journal Article
Journal of Palliative Medicine
Neoplasms
Pain/drug Therapy
Palliative Care/standards
Parenteral Nutrition
Practice Guidelines
Risk Assessment
Terminal Care/standards
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1111/j.1526-4637.2008.00461.x" target="_blank" rel="noreferrer">http://doi.org/10.1111/j.1526-4637.2008.00461.x</a>
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Title
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A systematic review of opioid conversion ratios used with methadone for the treatment of pain
Publisher
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Pain Medicine (malden, Mass.)
Date
A point or period of time associated with an event in the lifecycle of the resource
2008
Subject
The topic of the resource
Female; Humans; Adult; Analgesics; Middle Aged; Drug Therapy; Clinical Trials as Topic; Chronic disease; Palliative Care/methods; Pain/drug therapy; Methadone/therapeutic use; Opioid/therapeutic use; Statistics as Topic; Combination
Creator
An entity primarily responsible for making the resource
Weschules DJ; Bain KT
Description
An account of the resource
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 reports of human subjects published in the English language between January 1966 and June 2006 were included; review articles and reports with incomplete opioid data were excluded. Scatterplots displayed the relationship between previous morphine dose and final methadone dose and dose ratio. Correlation analyses were conducted using Pearson's and Spearman's correlation coefficient with a one-tailed test of significance. RESULTS: Twenty-two clinical studies and 19 case reports or series were reviewed (N = 730 patients). Methadone rotations were most common in cancer patients (N = 625, 88.9%) and those prescribed morphine (N = 259 patients, 41.7% of rotations where prerotation opioid was identified [N = 621]) or hydromorphone (N = 234 patients, 37.7% of rotations). In clinical studies, the most common reason for switching to methadone was a combination of inadequate analgesia and adverse effects (N = 254, 38.6%). Despite various approaches, 46-89% of rotations were successful. Overall, there was a relatively strong, positive correlation between the previous morphine dose and the final methadone dose and dose ratio, but ratios varied widely. CONCLUSIONS: There was no evidence to support the superiority of one method of rotation to methadone over another. Patients may be successfully rotated to methadone despite discrepancies between rotation ratios initially used and those associated with stabilization. Further research is needed to identify patient-level factors that may explain the wide variance in successful methadone rotations.
2008
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1111/j.1526-4637.2008.00461.x" target="_blank" rel="noreferrer">10.1111/j.1526-4637.2008.00461.x</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2008
Adult
Analgesics
Backlog
Bain KT
Chronic Disease
Clinical Trials as Topic
Combination
Drug Therapy
Female
Humans
Journal Article
Methadone/therapeutic use
Middle Aged
Opioid/therapeutic use
Pain Medicine (malden, Mass.)
Pain/drug Therapy
Palliative Care/methods
Statistics as Topic
Weschules DJ
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1503/cmaj.071178" target="_blank" rel="noreferrer">http://doi.org/10.1503/cmaj.071178</a>
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Title
A name given to the resource
Adverse effects of medical cannabinoids: a systematic review
Publisher
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Canadian Medical Association Journal
Date
A point or period of time associated with an event in the lifecycle of the resource
2008
Subject
The topic of the resource
Humans; Canada; Adverse Drug Reaction Reporting Systems; Drug Prescriptions; Cannabinoids/adverse effects; Cannabinoids/therapeutic use; Pain/drug therapy
Creator
An entity primarily responsible for making the resource
Wang T; Collet J; Shapiro S; Ware M
Description
An account of the resource
BACKGROUND: The therapeutic use of cannabis and cannabis-based medicines raises safety concerns for patients, clinicians, policy-makers, insurers, researchers and regulators. Although the efficacy of cannabinoids is being increasingly demonstrated in randomized controlled trials, most safety information comes from studies of recreational use. METHODS: We performed a systematic review of safety studies of medical cannabinoids published over the past 40 years to create an evidence base for cannabis-related adverse events and to facilitate future cannabis research initiatives. We critically evaluated the quality of published studies with a view to identifying ways to improve future studies. RESULTS: A total of 321 articles were eligible for evaluation. After excluding those that focused on recreational cannabis use, we included 31 studies (23 randomized controlled trials and 8 observational studies) of medical cannabis use in our analysis. In the 23 randomized controlled trials, the median duration of cannabinoid exposure was 2 weeks (range 8 hours to 12 months). A total of 4779 adverse events were reported among participants assigned to the intervention. Most (4615 [96.6%]) were not serious. Of the 164 serious adverse events, the most common was relapse of multiple sclerosis (21 events [12.8%]), vomiting (16 events [9.8%]) and urinary tract infection (15 events [9.1%]). The rate of nonserious adverse events was higher among participants assigned to medical cannabinoids than among controls (rate ratio [RR] 1.86, 95% confidence interval [CI] 1.57-2.21); the rates of serious adverse events did not differ significantly between these 2 groups (RR 1.04, 95% CI 0.78-1.39). Dizziness was the most commonly reported nonserious adverse event (714 events [15.5%]) among people exposed to cannabinoids. INTERPRETATION: Short-term use of existing medical cannabinoids appeared to increase the risk of nonserious adverse events. The risks associated with long-term use were poorly characterized in published clinical trials and observational studies. High-quality trials of long-term exposure are required to further characterize safety issues related to the use of medical cannabinoids.
2008
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1503/cmaj.071178" target="_blank" rel="noreferrer">10.1503/cmaj.071178</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2008
Adverse Drug Reaction Reporting Systems
Backlog
Canada
Canadian Medical Association Journal
Cannabinoids/adverse effects
Cannabinoids/therapeutic use
Collet J
Drug Prescriptions
Humans
Journal Article
Pain/drug Therapy
Shapiro S
Wang T
Ware M
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1503/cmaj.100187" target="_blank" rel="noreferrer">http://doi.org/10.1503/cmaj.100187</a>
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Title
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Opioids for chronic noncancer pain: a new Canadian practice guideline
Publisher
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Canadian Medical Association Journal
Date
A point or period of time associated with an event in the lifecycle of the resource
2010
Subject
The topic of the resource
Humans; Canada; Practice Guidelines as Topic; Analgesics; Chronic disease; Pain/drug therapy; Opioid/administration & dosage/adverse effects/therapeutic use; Advisory Committees/organization & administration
Creator
An entity primarily responsible for making the resource
Furlan AD; Reardon R; Weppler C; National Opioid Use Guideline Group
Identifier
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<a href="http://doi.org/10.1503/cmaj.100187" target="_blank" rel="noreferrer">10.1503/cmaj.100187</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
Description
An account of the resource
2010
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
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1503/cmaj.100548" target="_blank" rel="noreferrer">http://doi.org/10.1503/cmaj.100548</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
What we still don't know about treating chronic noncancer pain with opioids
Publisher
An entity responsible for making the resource available
Canadian Medical Association Journal
Date
A point or period of time associated with an event in the lifecycle of the resource
2010
Subject
The topic of the resource
Humans; Practice Guidelines as Topic; Analgesics; Chronic disease; Pain/drug therapy; Opioid/therapeutic use
Creator
An entity primarily responsible for making the resource
Chou R
Identifier
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<a href="http://doi.org/10.1503/cmaj.100548" target="_blank" rel="noreferrer">10.1503/cmaj.100548</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
Description
An account of the resource
2010
2010
Analgesics
Backlog
Canadian Medical Association Journal
Chou R
Chronic Disease
Humans
Journal Article
Opioid/therapeutic use
Pain/drug Therapy
Practice Guidelines As Topic
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1007/s00508-006-0611-4" target="_blank" rel="noreferrer">http://doi.org/10.1007/s00508-006-0611-4</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Benefits of an add-on treatment with the synthetic cannabinomimetic nabilone on patients with chronic pain--a randomized controlled trial
Publisher
An entity responsible for making the resource available
Wiener Klinische Wochenschrift
Date
A point or period of time associated with an event in the lifecycle of the resource
2006
Subject
The topic of the resource
Female; Humans; Male; Middle Aged; Treatment Outcome; Anti-Anxiety Agents; Double-Blind Method; Cross-Over Studies; quality of life; Chronic disease; Pain/drug therapy; Pain Measurement/drug effects; Adjuvant; Cannabinoids/administration & dosage; Chemotherapy; Placebo Effect; Tetrahydrocannabinol/administration & dosage/analogs & derivatives
Creator
An entity primarily responsible for making the resource
Pinsger M; Schimetta W; Volc D; Hiermann E; Riederer F; Polz W
Description
An account of the resource
OBJECTIVE: The aim of this study was to investigate the efficacy and efficiency of an add-on treatment with the synthetic cannabinomimetic nabilone on patients with chronic pain. Of major interest were the evaluation of the influence the treatment had on pain and on quality of life as well as the subjective assessment of positive effects and side effects by the study participants. METHODS: The placebo-controlled double-blinded pilot study was divided into a 14 week cross-over period (two 4 week medication phases plus wash-out phases) followed by a 16 week medication switch period with free choice of the study drugs (drug A and drug B) by the study participants. The principal inclusion criterion was chronic therapy-resistant pain in causal relationship with a pathologic status of the skeletal and locomotor system. The study participants chose the dosage of the study drug themselves (between 1 und 4 capsules/day, in the case of nabilone this corresponds to (1/4)-1 mg/day). Pain intensity was assessed by a visual analogue scale (VAS), quality of life by the Mezzich and Cohen QOL-score. RESULTS: Altogether, 30 patients were included and analyzed. From the results, it is obvious that throughout the cross-over periods the nabilone treatment was superior (medians [25%-; 75%-percentiles]: nabilone/placebo): decrease of the average spinal pain intensity within the last 4 weeks (DeltaVAS) 0.9 [0.0; 2.0] / 0.5 [0.0; 1.7], decrease of the current spinal pain intensity (DeltaVAS) 0.6 [0.0; 2.5] / 0.0 [-1.0, 1.0] (p = .006), decrease of the average headache intensity within the last 4 weeks (DeltaVAS) 1.0 [-1.0; 2.4] / 0.2 [-0.9; 1.0], increase of the number of days without headache within the last 4 weeks 2.0 [0.0; 6.5] / 0.0 [-5.0; 4.0], increase of the quality of life (DeltaQOL-Score) 5.0 [0.8; 10.8] / 2.0 [-2.3; 8.0]. In the medication switch period, the number of study participants who favoured nabilone (nabilone intake > or =85% of all medication days) was more than 4 times higher than those who favoured placebo. The number of days with nabilone intake was clearly higher than the number with placebo intake (medians: 89% vs. 11% of all medication days, p = .003). CONCLUSION: In summary, the study results allow the conclusion that a majority of patients with chronic pain classify nabilone intake in addition to the standard treatment as a measure with a positive individual benefit-riskratio. Thus, this kind of treatment may be an interesting and attractive enrichment of analgetic therapy concepts.
2006
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1007/s00508-006-0611-4" target="_blank" rel="noreferrer">10.1007/s00508-006-0611-4</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2006
Adjuvant
Anti-Anxiety Agents
Backlog
Cannabinoids/administration & dosage
Chemotherapy
Chronic Disease
Cross-Over Studies
Double-Blind Method
Female
Hiermann E
Humans
Journal Article
Male
Middle Aged
Pain Measurement/drug effects
Pain/drug Therapy
Pinsger M
Placebo Effect
Polz W
Quality Of Life
Riederer F
Schimetta W
Tetrahydrocannabinol/administration & dosage/analogs & derivatives
Treatment Outcome
Volc D
Wiener Klinische Wochenschrift
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1155/2005/286713" target="_blank" rel="noreferrer">http://doi.org/10.1155/2005/286713</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
A review of the use of methadone for the treatment of chronic noncancer pain
Publisher
An entity responsible for making the resource available
Pain Research & Management : The Journal Of The Canadian Pain Society = Journal De La Societe Canadienne Pour Le Traitement De La Douleur
Date
A point or period of time associated with an event in the lifecycle of the resource
2005
Subject
The topic of the resource
Humans; Canada; Analgesics; Methadone; Non-U.S. Gov't; Research Support; Chronic disease; Pain/drug therapy; Drug; Legislation; Methadone/adverse effects/chemistry/pharmacokinetics/pharmacology/therapeutic use; Opioid/adverse effects/chemistry/pharmacokinetics/pharmacology/therapeutic use
Creator
An entity primarily responsible for making the resource
Lynch ME
Description
An account of the resource
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 action including potent opioid agonism, N-methyl-D-aspartate antagonism and monoaminergic effects. This, along with methadone's excellent oral and rectal absorption, high bioavailability, long duration of action and low cost, make it a very attractive option for the treatment of chronic pain. The disadvantages of significant interindividual variation in pharmacokinetics, graduated dose equivalency ratios based on prerotation opioid dose when switching from another opioid, and the requirement for special exemption for prescribing methadone make it more complicated to use. The present review is intended to educate physicians interested in adding methadone to their armamentarium for assisting patients with moderate to severe pain.
2005
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1155/2005/286713" target="_blank" rel="noreferrer">10.1155/2005/286713</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
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
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1300/j457v01n04_04" target="_blank" rel="noreferrer">http://doi.org/10.1300/j457v01n04_04</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Pediatric palliative and end-of-life care: the role of social work in pediatric oncology
Publisher
An entity responsible for making the resource available
Journal of Social Work in End-of-Life & Palliative Care
Date
A point or period of time associated with an event in the lifecycle of the resource
2005
Subject
The topic of the resource
Humans; Pediatrics; Professional Role; Interdisciplinary Communication; Communication; Medical Oncology; Palliative Care/organization & administration; Family/psychology; Pain/drug therapy; Terminal Care/organization & administration; Patient Care Team/organization & administration; Social Work/organization & administration
Creator
An entity primarily responsible for making the resource
Jones BL
Description
An account of the resource
Pediatric oncology social workers are often engaged in the psychosocial care of dying children and their families. Despite their participation on the interdisciplinary team, the role for social work in pediatric palliative and end-of-life care has not been clearly defined. This survey of 131 pediatric oncology social workers identified current and best social work practices for care of children and their families at the end of life. Implications for practice, education, and research are discussed.
2005
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1300/j457v01n04_04" target="_blank" rel="noreferrer">10.1300/j457v01n04_04</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2005
Backlog
Communication
Family/psychology
Humans
Interdisciplinary Communication
Jones BL
Journal Article
Journal of Social Work in End-of-Life & Palliative Care
Medical Oncology
Pain/drug Therapy
Palliative Care/organization & Administration
Patient Care Team/organization & administration
Pediatrics
Professional Role
Social Work/organization & administration
Terminal Care/organization & Administration
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1542/peds.2004-0905" target="_blank" rel="noreferrer">http://doi.org/10.1542/peds.2004-0905</a>
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Title
A name given to the resource
New and lingering controversies in pediatric end-of-life care
Publisher
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Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
2005
Subject
The topic of the resource
Child; Humans; Analgesics; Data Collection; Attitude of Health Personnel; Medical Futility; Medical Staff; Withholding Treatment; Life Support Care; Medical; Practice Guidelines; ICU Decision Making; Pain/drug therapy; Opioid/therapeutic use; Specialties; Terminal Care/psychology; Nurses/psychology; Hospital/psychology
Creator
An entity primarily responsible for making the resource
Solomon MZ; Sellers DE; Heller KS; Dokken DL; Levetown M; Rushton C; Truog RD; Fleischman AR
Description
An account of the resource
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 or in agreement with these guidelines. The study's objectives were to determine the extent to which physicians and nurses in critical care, hematology/oncology, and other subspecialties are in agreement with one another and with widely published ethical recommendations regarding the withholding and withdrawing of life support, the provision of adequate analgesia, and the role of parents in end-of-life decision-making. METHODS: Three children's hospitals and 4 general hospitals with PICUs in eastern, southwestern, and southern parts of the United States were surveyed. This population-based sample was composed of attending physicians, house officers, and nurses who cared for children (age: 1 month to 18 years) with life-threatening conditions in PICUs or in medical, surgical, or hematology/oncology units, floors, or departments. Main outcome measures included concerns of conscience, knowledge and beliefs, awareness of published guidelines, and agreement or disagreement with guidelines. RESULTS: A total of 781 clinicians were sampled, including 209 attending physicians, 116 house officers, and 456 nurses. The overall response rate was 64%. Fifty-four percent of house officers and substantial proportions of attending physicians and nurses reported, "At times, I have acted against my conscience in providing treatment to children in my care." For example, 38% of critical care attending physicians and 25% of hematology/oncology attending physicians expressed these concerns, whereas 48% of critical care nurses and 38% of hematology/oncology nurses did so. Across specialties, approximately 20 times as many nurses, 15 times as many house officers, and 10 times as many attending physicians agreed with the statement, "Sometimes I feel we are saving children who should not be saved," as agreed with the statement, "Sometimes I feel we give up on children too soon." However, hematology/oncology attending physicians (31%) were less likely than critical care (56%) and other subspecialty (66%) attending physicians to report, "Sometimes I feel the treatments I offer children are overly burdensome." Many respondents held views that diverged widely from published recommendations. Despite a lack of awareness of key guidelines, across subspecialties the vast majority of attending physicians (range: 92-98%, depending on specialty) and nurses (range: 83-85%) rated themselves as somewhat to very knowledgeable regarding ethical issues. CONCLUSIONS: There is a need for more hospital-based ethics education and more interdisciplinary and cross-subspecialty discussion of inherently complex and stressful pediatric end-of-life cases. Education should focus on establishing appropriate goals of care, as well as on pain management, medically supplied nutrition and hydration, and the appropriate use of paralytic agents. More research is needed on clinicians' regard for the dead-donor rule.
2005
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1542/peds.2004-0905" target="_blank" rel="noreferrer">10.1542/peds.2004-0905</a>
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Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2005
Analgesics
Attitude Of Health Personnel
Backlog
Child
Data Collection
Dokken DL
Fleischman AR
Heller KS
Hospital/psychology
Humans
ICU Decision Making
Journal Article
Levetown M
Life Support Care
Medical
Medical Futility
Medical Staff
Nurses/psychology
Opioid/therapeutic use
Pain/drug Therapy
Pediatrics
Practice Guidelines
Rushton C
Sellers DE
Solomon MZ
Specialties
Terminal Care/psychology
Truog RD
Withholding Treatment
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1002/14651858.cd002068" target="_blank" rel="noreferrer">http://doi.org/10.1002/14651858.cd002068</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Bisphosphonates for the relief of pain secondary to bone metastases
Publisher
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Cochrane Database Of Systematic Reviews
Date
A point or period of time associated with an event in the lifecycle of the resource
2002
Subject
The topic of the resource
Humans; Analgesics; Pain/drug therapy; Non-Narcotic/therapeutic use; Antineoplastic Agents/therapeutic use; Bone Neoplasms/complications/drug therapy/secondary; Clodronate; Clodronic Acid/therapeutic use; Diphosphonates/therapeutic use; Etidronic Acid/therapeutic use; Randomized Controlled Trials
Creator
An entity primarily responsible for making the resource
Wong R; Wiffen PJ
Description
An account of the resource
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 effectiveness of bisphosphonates for the relief of pain from bone metastases. SEARCH STRATEGY: MEDLINE (1966-1999), EMBASE (1980-1999), CancerLit (1966-1999), the Cochrane library (Issue 1, 2000) and the Oxford Pain Database were searched using the strategy devised by the Cochrane Pain, Palliative and Supportive Care Group with additional terms 'diphosphonate', 'bisphosphonate', 'multiple myeloma' and 'bone neoplasms'. (Last search: January 2000). SELECTION CRITERIA: Randomized trials of bisphosphonates compared with open, blinded, or different doses/types of bisphosphonates in cancer patients were included where pain and/or analgesic consumption were outcome measures. Studies where pain was reported only by observers were excluded. DATA COLLECTION AND ANALYSIS: Article eligibility, quality assessment and data extraction were undertaken by both reviewers. The proportions of patients with pain relief at 4, 8 and 12 weeks were assessed. The proportion of patients with analgesic reduction, the mean pain score, mean analgesic consumption, adverse drug reactions, and quality of life data were compared as secondary outcomes. MAIN RESULTS: Thirty randomized controlled studies (21 blinded, four open and five active control) with a total of 3682 subjects were included. For each outcome, there were few studies with available data. For the proportion of patients with pain relief (eight studies) pooled data showed benefits for the treatment group, with an NNT at 4 weeks of 11[95% CI 6-36] and at 12 weeks of 7 [95% CI 5-12]. In terms of adverse drug reactions, the NNH was 16 [95% CI 12-27] for discontinuation of therapy. Nausea and vomiting were reported in 24 studies with a non-significant trend for greater risk in the treatment group. One study showed a small improvement in quality of life for the treatment group at 4 weeks. The small number of studies in each subgroup with relevant data limited our ability to explore the most effective bisphosphonates and their relative effectiveness for different primary neoplasms. REVIEWER'S CONCLUSIONS: There is evidence to support the effectiveness of bisphosphonates in providing some pain relief for bone metastases. There is insufficient evidence to recommend bisphosphonates for immediate effect; as first line therapy; to define the most effective bisphosphonates or their relative effectiveness for different primary neoplasms. Bisphosphonates should be considered where analgesics and/or radiotherapy are inadequate for the management of painful bone metastases.
2002
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1002/14651858.cd002068" target="_blank" rel="noreferrer">10.1002/14651858.cd002068</a>
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Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
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
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1016/j.jpainsymman.2004.02.021" target="_blank" rel="noreferrer">http://doi.org/10.1016/j.jpainsymman.2004.02.021</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Opioids in renal failure and dialysis patients
Publisher
An entity responsible for making the resource available
Journal Of Pain And Symptom Management
Date
A point or period of time associated with an event in the lifecycle of the resource
2004
Subject
The topic of the resource
Humans; Analgesics; Pain/drug therapy; Opioid/therapeutic use; Chronic/complications/therapy; Kidney Failure; Peritoneal Dialysis
Creator
An entity primarily responsible for making the resource
Dean M
Description
An account of the resource
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 reviewed. Finally, the effect of renal dialysis on opioid drugs and metabolites is reviewed. Based on the review, it is recommended that morphine and codeine are avoided in renal failure/dialysis patients; hydromorphone or oxycodone are used with caution and close monitoring; and that methadone and fentanyl/sufentanil appear to be safe to use. Note is made that the "safe" drugs in renal failure are also the least dialyzable.
2004
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/j.jpainsymman.2004.02.021" target="_blank" rel="noreferrer">10.1016/j.jpainsymman.2004.02.021</a>
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Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
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
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1016/j.pain.2004.09.019" target="_blank" rel="noreferrer">http://doi.org/10.1016/j.pain.2004.09.019</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Opioids in chronic non-cancer pain: systematic review of efficacy and safety
Publisher
An entity responsible for making the resource available
Pain
Date
A point or period of time associated with an event in the lifecycle of the resource
2004
Subject
The topic of the resource
Humans; Pain Measurement; Analgesics; Treatment Outcome; Methadone; Time Factors; Double-Blind Method; Non-U.S. Gov't; Research Support; Comparative Study; Chronic disease; Pain/drug therapy; Opioid/adverse effects/therapeutic use; Drug Evaluation; Drug Utilization Review; Randomized Controlled Trials/methods
Creator
An entity primarily responsible for making the resource
Kalso E; Edwards JE; Moore RA; McQuay HJ
Description
An account of the resource
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 chronic non-cancer pain. The Oxford Pain Relief Database (1950-1994) and Medline, EMBASE and the Cochrane Library were searched until September 2003. Inclusion criteria were randomised comparisons of WHO step 3 opioids with placebo in chronic non-cancer pain. Double-blind studies reporting on pain intensity outcomes using validated pain scales were included. Fifteen randomised placebo-controlled trials were included. Four investigations with 120 patients studied intravenous opioid testing. Eleven studies (1025 patients) compared oral opioids with placebo for four days to eight weeks. Six of the 15 included trials had an open label follow-up of 6-24 months. The mean decrease in pain intensity in most studies was at least 30% with opioids and was comparable in neuropathic and musculoskeletal pain. About 80% of patients experienced at least one adverse event, with constipation (41%), nausea (32%) and somnolence (29%) being most common. Only 44% of 388 patients on open label treatments were still on opioids after therapy for between 7 and 24 months. The short-term efficacy of opioids was good in both neuropathic and musculoskeletal pain conditions. However, only a minority of patients in these studies went on to long-term management with opioids. The small number of selected patients and the short follow-ups do not allow conclusions concerning problems such as tolerance and addiction.
2004
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/j.pain.2004.09.019" target="_blank" rel="noreferrer">10.1016/j.pain.2004.09.019</a>
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Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2004
Analgesics
Backlog
Chronic Disease
Comparative Study
Double-Blind Method
Drug Evaluation
Drug Utilization Review
Edwards JE
Humans
Journal Article
Kalso E
McQuay HJ
Methadone
Moore RA
Non-U.S. Gov't
Opioid/adverse effects/therapeutic use
Pain
Pain Measurement
Pain/drug Therapy
Randomized Controlled Trials/methods
Research Support
Time Factors
Treatment Outcome
-
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
PedPalASCNet Member Publications
Subject
The topic of the resource
A collection of relevant articles published by one or more of PedPalASCNet's members
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1016/s0885-3924(03)00071-x" target="_blank" rel="noreferrer">http://doi.org/10.1016/s0885-3924(03)00071-x</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
High dose opioids in pediatric palliative care.
Publisher
An entity responsible for making the resource available
Journal Of Pain And Symptom Management
Date
A point or period of time associated with an event in the lifecycle of the resource
2003
Subject
The topic of the resource
Child; Female; Humans; Male; Adult; Analgesics; Age Factors; adolescent; Preschool; infant; Dose-Response Relationship; Drug; Palliative Care; Opioid/administration & dosage/therapeutic use; Pain/drug therapy
Creator
An entity primarily responsible for making the resource
Siden H; Nalewajek
Identifier
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<a href="http://doi.org/10.1016/s0885-3924(03)00071-x" target="_blank" rel="noreferrer">10.1016/s0885-3924(03)00071-x</a>
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Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
Description
An account of the resource
2003-05
2003
Adolescent
Adult
Age Factors
Analgesics
Backlog
Child
Dose-Response Relationship
Drug
Female
Humans
Infant
Journal Article
Journal of Pain and Symptom Management
Male
Nalewajek
Opioid/administration & dosage/therapeutic use
Pain/drug Therapy
Palliative Care
Preschool
Siden H
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1016/S1090-3801(02)00143-X" target="_blank" rel="noreferrer">http://doi.org/10.1016/S1090-3801(02)00143-X</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Recommendations for using opioids in chronic non-cancer pain
Publisher
An entity responsible for making the resource available
European Journal Of Pain
Date
A point or period of time associated with an event in the lifecycle of the resource
2003
Subject
The topic of the resource
Humans; Analgesics; Drug Administration Schedule; Psychology; Chronic disease; Biomarkers of Pain; Pain/drug therapy; Quality of Life/psychology; Opioid/therapeutic use; Patient Education
Creator
An entity primarily responsible for making the resource
Kalso E; Allan L; Dellemijn PL; Faura CC; Ilias WK; Jensen TS; Perrot S; Plaghki LH; Zenz M
Description
An account of the resource
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 nociceptive pain if other reasonable therapies fail to provide adequate analgesia within a reasonable timeframe. 3. The aim of opioid treatment is to relieve pain and improve the patient's quality of life. Both of these should be assessed during a trial period. 4. The prescribing physician should be familiar with the patient's psychosocial status. 5. The use of sustained-release opioids administered at regular intervals is recommended. 6. Treatment should be monitored. 7. A contract setting out the patient's rights and responsibilities may help to emphasize the importance of patient involvement. 8. Opioid treatment should not be considered a lifelong treatment.
2003
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/S1090-3801(02)00143-X" target="_blank" rel="noreferrer">10.1016/S1090-3801(02)00143-X</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2003
Allan L
Analgesics
Backlog
Biomarkers of Pain
Chronic Disease
Dellemijn PL
Drug Administration Schedule
European Journal Of Pain
Faura CC
Humans
Ilias WK
Jensen TS
Journal Article
Kalso E
Opioid/therapeutic use
Pain/drug Therapy
Patient Education
Perrot S
Plaghki LH
Psychology
Quality Of Life/psychology
Zenz M
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1046/j.1365-2648.2003.02936.x" target="_blank" rel="noreferrer">http://doi.org/10.1046/j.1365-2648.2003.02936.x</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Morphine is not the only analgesic in palliative care: Literature review
Publisher
An entity responsible for making the resource available
Journal Of Advanced Nursing
Date
A point or period of time associated with an event in the lifecycle of the resource
2004
Subject
The topic of the resource
Humans; Analgesics; Palliative Care/methods; Pain/drug therapy; Neoplasms/complications; Methadone/therapeutic use; Opioid/therapeutic use; Fentanyl/therapeutic use; Morphine/therapeutic use; Ketamine/therapeutic use; Analgesics/therapeutic use
Creator
An entity primarily responsible for making the resource
Wootton M
Description
An account of the resource
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 patients, there is a clear need for a review of current practices which is accessible to nurses. AIM: The aim of this review is to examine the pharmaceutical alternatives to morphine use in palliative care that are currently available. METHODS: Searches were made of the CINAHL and MEDLINE databases for articles published between 1990 and 2000, using the keywords 'pain management', 'cancer pain' and 'morphine'. FINDINGS: Most evidence on the use of pharmaceutical alternatives to morphine is anecdotal, demonstrating a need for more research to be conducted in this field. Evidence presented in this review shows encouraging results following the administration of methadone, fentanyl or ketamine to patients with difficult pain problems. CONCLUSION: Nurses need to be aware of treatment options that may benefit patients with difficult pain problems. Although positive experiences have been documented when using alternatives to morphine, more research must be conducted to allow practitioners to add more pharmaceutical alternatives to their pain management armouries.
2004
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1046/j.1365-2648.2003.02936.x" target="_blank" rel="noreferrer">10.1046/j.1365-2648.2003.02936.x</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
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
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1080/j354v16n01_04" target="_blank" rel="noreferrer">http://doi.org/10.1080/j354v16n01_04</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Clinical use of methadone
Publisher
An entity responsible for making the resource available
Journal of Pain and Palliative Care Pharmacotherapy
Date
A point or period of time associated with an event in the lifecycle of the resource
2002
Subject
The topic of the resource
Humans; Analgesics; Drug Interactions; Therapeutic Equivalency; Half-Life; Drug Administration Schedule; Pain/drug therapy; Receptors; Biological Availability; Opioid/adverse effects/pharmacokinetics/therapeutic use; Dosage Forms; Kidney Diseases/metabolism; Liver Diseases/metabolism; Methadone/adverse effects/pharmacokinetics/therapeutic use; Opioid-Related Disorders/drug therapy; Opioid/agonists; Substance Withdrawal Syndrome/etiology
Creator
An entity primarily responsible for making the resource
Layson-Wolf C; Goode JV; Small RE
Description
An account of the resource
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 characteristics and wide interpatient variability can make methadone difficult to use safely. A MEDLINE search was conducted on publications between January 1996 and May 2001 to identify literature relevant to this subject. Those publications were reviewed, and from them, other literature was identified and reviewed. Published studies demonstrate methadone's efficacy in pain management and in opioid withdrawal. However, interpatient variability in pharmacokinetic variables of methadone produces difficulties in developing guidelines for methadone use. Clinicians should not be deterred from use of this drug which has been shown to benefit patients in both pain management and methadone maintenance, but an individualized patient approach must be taken to use methadone safely.
2002
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1080/j354v16n01_04" target="_blank" rel="noreferrer">10.1080/j354v16n01_04</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2002
Analgesics
Backlog
Biological Availability
Dosage Forms
Drug Administration Schedule
Drug Interactions
Goode JV
Half-Life
Humans
Journal Article
Journal of Pain and Palliative Care Pharmacotherapy
Kidney Diseases/metabolism
Layson-Wolf C
Liver Diseases/metabolism
Methadone/adverse effects/pharmacokinetics/therapeutic use
Opioid-Related Disorders/drug therapy
Opioid/adverse effects/pharmacokinetics/therapeutic use
Opioid/agonists
Pain/drug Therapy
Receptors
Small RE
Substance Withdrawal Syndrome/etiology
Therapeutic Equivalency
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1111/j.1365-2044.2004.03674.x" target="_blank" rel="noreferrer">http://doi.org/10.1111/j.1365-2044.2004.03674.x</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Initial experiences with medicinal extracts of cannabis for chronic pain: results from 34 'N of 1' studies
Publisher
An entity responsible for making the resource available
Anaesthesia
Date
A point or period of time associated with an event in the lifecycle of the resource
2004
Subject
The topic of the resource
Female; Humans; Male; Adult; Analgesics; Aged; Middle Aged; Treatment Outcome; Patient Selection; Double-Blind Method; Cross-Over Studies; Chronic disease; Administration; Pain/drug therapy; Drug Combinations; Sleep/drug effects; Pain Measurement/methods; Sublingual; Cannabidiol/adverse effects/therapeutic use; Depressive Disorder/drug therapy; Multiple Sclerosis/drug therapy; Non-Narcotic/adverse effects/therapeutic use; Tetrahydrocannabinol/adverse effects/therapeutic use
Creator
An entity primarily responsible for making the resource
Notcutt W; Price M; Miller R; Newport S; Phillips C; Simmons S; Sansom C
Description
An account of the resource
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 explore efficacy, tolerability, safety and dosages. Three CBMEs (Delta9 Tetrahydrocannabinol (THC), Cannabidiol (CBD) and a 1:1 mixture of them both) were given over a 12-week period. After an initial open-label period, the CBMEs were used in a randomised, double-blind, placebo controlled, crossover trial. Extracts which contained THC proved most effective in symptom control. Regimens for the use of the sublingual spray emerged and a wide range of dosing requirements was observed. Side-effects were common, reflecting a learning curve for both patient and study team. These were generally acceptable and little different to those seen when other psycho-active agents are used for chronic pain. These initial experiences with CBME open the way to more detailed and extensive studies.
2004
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1111/j.1365-2044.2004.03674.x" target="_blank" rel="noreferrer">10.1111/j.1365-2044.2004.03674.x</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2004
Administration
Adult
Aged
Anaesthesia
Analgesics
Backlog
Cannabidiol/adverse effects/therapeutic use
Chronic Disease
Cross-Over Studies
Depressive Disorder/drug therapy
Double-Blind Method
Drug Combinations
Female
Humans
Journal Article
Male
Middle Aged
Miller R
Multiple Sclerosis/drug therapy
Newport S
Non-Narcotic/adverse effects/therapeutic use
Notcutt W
Pain Measurement/methods
Pain/drug Therapy
Patient Selection
Phillips C
Price M
Sansom C
Simmons S
Sleep/drug effects
Sublingual
Tetrahydrocannabinol/adverse effects/therapeutic use
Treatment Outcome
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1176/appi.psy.44.6.515" target="_blank" rel="noreferrer">http://doi.org/10.1176/appi.psy.44.6.515</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Pharmacokinetic drug interactions of morphine, codeine, and their derivatives: theory and clinical reality, Part II
Publisher
An entity responsible for making the resource available
Psychosomatics
Date
A point or period of time associated with an event in the lifecycle of the resource
2003
Subject
The topic of the resource
Humans; Pain/drug therapy; Codeine/chemistry/metabolism/pharmacology; Drug Synergism; Morphine/chemistry/metabolism/pharmacology
Creator
An entity primarily responsible for making the resource
Armstrong SC; Cozza KL
Description
An account of the resource
Pharmacokinetic drug-drug interactions with codeine, dihydrocodeine, hydrocodone, oxycodone, and buprenorphine are reviewed in this column. These compounds have a very similar chemical structure to morphine. Unlike morphine, which is metabolized chiefly through conjugation reactions with uridine diphosphate glucuronosyl transferase (UGT) enzymes, these five drugs are metabolized both through oxidative reactions by the cytochrome P450 (CYP450) enzyme and conjugation by UGT enzymes. There is controversy as to whether codeine, dihydrocodeine, and hydrocodone are actually prodrugs requiring activation by the CYP450 2D6 enzyme or UGT enzymes. Oxycodone and buprenorphine, however, are clearly not prodrugs and are metabolized by the CYP450 2D6 and 3A4 enzymes, respectively. Knowledge of this metabolism assists in the understanding for the potential of drug-drug interactions with these drugs. This understanding is important so that clinicians can choose the proper dosages for analgesia and anticipate potential drug-drug interactions.
2003
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1176/appi.psy.44.6.515" target="_blank" rel="noreferrer">10.1176/appi.psy.44.6.515</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2003
Armstrong SC
Backlog
Codeine/chemistry/metabolism/pharmacology
Cozza KL
Drug Synergism
Humans
Journal Article
Morphine/chemistry/metabolism/pharmacology
Pain/drug Therapy
Psychosomatics
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1186/1472-6939-3-3" target="_blank" rel="noreferrer">http://doi.org/10.1186/1472-6939-3-3</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Consensus guidelines on analgesia and sedation in dying intensive care unit patients
Publisher
An entity responsible for making the resource available
Bmc Medical Ethics
Date
A point or period of time associated with an event in the lifecycle of the resource
2002
Subject
The topic of the resource
Humans; Intensive Care Units; Terminally Ill; Consensus; Euthanasia; Suicide; Stress; Empirical Approach; Death and Euthanasia; Practice Guidelines; Pain/drug therapy; Active; Hypnotics and Sedatives/therapeutic use; Assisted; Terminal Care/standards; Psychological/drug therapy; Analgesics/therapeutic use; Palliative Care/methods/standards
Creator
An entity primarily responsible for making the resource
Hawryluck LA; Harvey WR; Lemieux-Charles L; Singer PA
Description
An account of the resource
BACKGROUND: Intensivists must provide enough analgesia and sedation to ensure dying patients receive good palliative care. However, if it is perceived that too much is given, they risk prosecution for committing euthanasia. The goal of this study is to develop consensus guidelines on analgesia and sedation in dying intensive care unit patients that help distinguish palliative care from euthanasia. METHODS: Using the Delphi technique, panelists rated levels of agreement with statements describing how analgesics and sedatives should be given to dying ICU patients and how palliative care should be distinguished from euthanasia. Participants were drawn from 3 panels: 1) Canadian Academic Adult Intensive Care Fellowship program directors and Intensive Care division chiefs (N = 9); 2) Deputy chief provincial coroners (N = 5); 3) Validation panel of Intensivists attending the Canadian Critical Care Trials Group meeting (N = 12). RESULTS: After three Delphi rounds, consensus was achieved on 16 statements encompassing the role of palliative care in the intensive care unit, the management of pain and suffering, current areas of controversy, and ways of improving palliative care in the ICU. CONCLUSION: Consensus guidelines were developed to guide the administration of analgesics and sedatives to dying ICU patients and to help distinguish palliative care from euthanasia.
2002
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1186/1472-6939-3-3" target="_blank" rel="noreferrer">10.1186/1472-6939-3-3</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2002
Active
Analgesics/therapeutic use
Assisted
Backlog
Bmc Medical Ethics
Consensus
Death and Euthanasia
Empirical Approach
Euthanasia
Harvey WR
Hawryluck LA
Humans
Hypnotics and Sedatives/therapeutic use
Intensive Care Units
Journal Article
Lemieux-Charles L
Pain/drug Therapy
Palliative Care/methods/standards
Practice Guidelines
Psychological/drug therapy
Singer PA
Stress
Suicide
Terminal Care/standards
Terminally Ill
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1001/jama.259.2.243" target="_blank" rel="noreferrer">http://doi.org/10.1001/jama.259.2.243</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Use of patient-controlled analgesia for management of acute pain
Publisher
An entity responsible for making the resource available
Jama
Date
A point or period of time associated with an event in the lifecycle of the resource
1988
Subject
The topic of the resource
Humans; Acute Disease; Pain/drug therapy; Analgesics/administration & dosage/adverse effects; Infusion Pumps; Infusions; Injections; Intravenous; Self Administration/adverse effects/instrumentation
Creator
An entity primarily responsible for making the resource
White PF
Description
An account of the resource
Patient-controlled analgesia (PCA) provides improved titration of analgesic drugs, thereby minimizing individual pharmacokinetic and pharmacodynamic differences. Patient-controlled analgesia decreases patient anxiety resulting from delays in receiving pain-relieving medication and from the slow onset of analgesic action when these drugs are administered either intramuscularly or in the extradural space. With PCA therapy, patients are reportedly able to maintain a near optimal state of analgesia with minimal sedation and few side effects. The potential for overdose can be minimized if small bolus doses are used with a mandatory lockout interval between successive doses. Finally, studies of the cost-effectiveness of PCA therapy are important if this therapeutic approach is to achieve more widespread acceptance.
1988
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1001/jama.259.2.243" target="_blank" rel="noreferrer">10.1001/jama.259.2.243</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
1988
Acute Disease
Analgesics/administration & dosage/adverse effects
Backlog
Humans
Infusion Pumps
Infusions
Injections
Intravenous
JAMA
Journal Article
Pain/drug Therapy
Self Administration/adverse effects/instrumentation
White PF
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=6154844" target="_blank" rel="noreferrer">http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=6154844</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Helping a child to live whilst dying
Publisher
An entity responsible for making the resource available
Lancet
Date
A point or period of time associated with an event in the lifecycle of the resource
1980
Subject
The topic of the resource
Child; Female; Grief; Attitude of Health Personnel; Attitude to Death; Child Psychology; Parents/psychology; Palliative Care/psychology; Human; Case Report; Pain/drug therapy; Neoplasm Metastasis; Terminal Care/psychology; Hospitalized/psychology; Brachial Plexus; Hospital Units/standards; Sarcoma/drug therapy/radiotherapy
Creator
An entity primarily responsible for making the resource
Chapman JA; Goodall J
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
Description
An account of the resource
1980
1980
Attitude Of Health Personnel
Attitude To Death
Backlog
Brachial Plexus
Case Report
Chapman JA
Child
Child Psychology
Female
Goodall J
Grief
Hospital Units/standards
Hospitalized/psychology
Human
Journal Article
Lancet
Neoplasm Metastasis
Pain/drug Therapy
Palliative Care/psychology
Parents/psychology
Sarcoma/drug therapy/radiotherapy
Terminal Care/psychology
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1007/bf03020377" target="_blank" rel="noreferrer">http://doi.org/10.1007/bf03020377</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Methadone is safe for treating hospitalized patients with severe pain
Publisher
An entity responsible for making the resource available
Canadian Journal Of Anaesthesia
Date
A point or period of time associated with an event in the lifecycle of the resource
2001
Subject
The topic of the resource
Child; Female; Hospitalization; Humans; Male; Adult; Analgesics; Aged; Middle Aged; Analgesia; adolescent; Preschool; infant; Administration; Oral; retrospective studies; Pain/drug therapy; Pain Measurement/drug effects; Epidural; Methadone/administration & dosage/adverse effects/therapeutic use; Monitoring; Opioid/administration & dosage/adverse effects/therapeutic use; Physiologic
Creator
An entity primarily responsible for making the resource
Shir Y; Rosen G; Zeldin A; Davidson EM
Description
An account of the resource
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 accumulation and toxicity. In the present study we report that clinically effective analgesic doses of methadone, given either epidurally or orally, can be used safely for prolonged treatment in hospitalized patients. Clinical features: Over a five-year period we administered methadone at Hadassah Hospital in Jerusalem to 3,954 in-patients with severe pain, 12% of whom were younger than 17 yr. Satisfactory pain relief was recorded in more than 85% of the patients. None of the patients treated with oral methadone developed serious side effects. Three patients, treated with epidural methadone (0.09%), developed a clinically significant respiratory depression. In all three cases, epidural pump failure or pump misprogramming resulted in methadone overdose. None of the children or adults treated with methadone developed addiction during hospitalization. CONCLUSION: Based on its analgesic properties and marked safety profile, we suggest that methadone could be added to the analgesic armamentarium of in-hospital health-care providers. Moreover, methadone could serve as the opioid of first choice in some in-patient populations.
2001
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1007/bf03020377" target="_blank" rel="noreferrer">10.1007/bf03020377</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2001
Administration
Adolescent
Adult
Aged
Analgesia
Analgesics
Backlog
Canadian Journal Of Anaesthesia
Child
Davidson EM
Epidural
Female
Hospitalization
Humans
Infant
Journal Article
Male
Methadone/administration & dosage/adverse effects/therapeutic use
Middle Aged
Monitoring
Opioid/administration & dosage/adverse effects/therapeutic use
Oral
Pain Measurement/drug effects
Pain/drug Therapy
Physiologic
Preschool
Retrospective Studies
Rosen G
Shir Y
Zeldin A
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1016/s0022-3476(95)70370-5" target="_blank" rel="noreferrer">http://doi.org/10.1016/s0022-3476(95)70370-5</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Control of severe pain in children with terminal malignancy
Publisher
An entity responsible for making the resource available
Journal Of Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
1995
Subject
The topic of the resource
Child; Female; Male; Preschool; Non-U.S. Gov't; infant; retrospective studies; Pain/drug therapy; Infusions; Human; Parenteral; Support; Adolescence; Terminal Care; Neoplasms/physiopathology; Palliative Care/methods; Analgesia/methods; Morphine/administration & dosage/therapeutic use
Creator
An entity primarily responsible for making the resource
Collins J J; Grier HE; Kinney HC; Berde CB
Description
An account of the resource
OBJECTIVE: To identify the characteristics of the subset of children with malignancy in whom massive opioid infusions are needed during the terminal phase. DESIGN: Retrospective review of the records of the 199 patients who died of malignancy after treatment at Children's Hospital, Boston, from March 1989 to July 1993, identifying characteristics of patients who required massive opioid infusions (operationally defined as infusion of > 3 mg/kg per hour of morphine dose equivalent) during the terminal phase. RESULTS: Twelve patients (6%) required massive opioid infusions, and eight of these patients required extraordinary measures (epidural or subarachnoid infusion and/or sedation) to achieve adequate analgesia. The duration of epidural or subarachnoid infusions in three patients ranged from 3 to 9 days, and minimal complications occurred. The duration of sedation ranged from 1 to 15 days. Maximal intravenous opioid dosing ranged from 3.8 to 518 mg/kg per hour of morphine equivalent. The maximal infusion rate (exceeding all previous published reports) occurred in an infant with an isolated metastasis in the periaqueductal gray matter, a brain-stem site linked to mediating analgesia and defense reactions. The need for massive opioid dosing in 11 of 12 patients was associated with tumor spread to the spinal nerve roots, nerve plexus, large peripheral nerve, or spinal cord compression. CONCLUSIONS: Standard dosing of opioids adequately treats most cancer pain in children; however, a significant group requires more extensive management. These problems occur more commonly among patients with solid tumors metastatic to spine and major nerves.
1995
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/s0022-3476(95)70370-5" target="_blank" rel="noreferrer">10.1016/s0022-3476(95)70370-5</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
1995
Adolescence
Analgesia/methods
Backlog
Berde CB
Child
Collins J J
Female
Grier HE
Human
Infant
Infusions
Journal Article
Journal of Pediatrics
Kinney HC
Male
Morphine/administration & dosage/therapeutic use
Neoplasms/physiopathology
Non-U.S. Gov't
Pain/drug Therapy
Palliative Care/methods
Parenteral
Preschool
Retrospective Studies
Support
Terminal Care
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1016/s0885-3924(00)00162-7" target="_blank" rel="noreferrer">http://doi.org/10.1016/s0885-3924(00)00162-7</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Variability of analgesic practices for hospitalized children on different pediatric specialty units
Publisher
An entity responsible for making the resource available
Journal Of Pain And Symptom Management
Date
A point or period of time associated with an event in the lifecycle of the resource
2000
Subject
The topic of the resource
Child; Female; Humans; Male; Pediatrics; Preschool; Non-U.S. Gov't; P.H.S.; Research Support; U.S. Gov't; Pain/drug therapy; Analgesics/administration & dosage/therapeutic use; Hospital Units
Creator
An entity primarily responsible for making the resource
Jacob E; Puntillo KA
Description
An account of the resource
This study examined the differences in the prescription and administration of analgesics in eight pediatric specialty units. Medical records of patients (n = 153) who were reported by nurses to be having pain were reviewed. Results showed that there were variations in the type of analgesics prescribed and administered in the different units. Mean doses of opioids were slightly subtherapeutic. The mean doses of the nonsteroidal anti-inflammatory drugs and adjuvants were all within the therapeutic range. There were large intervals between doses of medications. Because few patients had pain scores recorded before and after analgesic administration, evidence of relief was inconclusive, and the actual effectiveness of analgesics could not be consistently evaluated. Undertreatment of pain may result from administration of subtherapeutic analgesic doses, long intervals between administrations of doses, lack of proper documentation to guide practice, or a combination of these reasons.
2000
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/s0885-3924(00)00162-7" target="_blank" rel="noreferrer">10.1016/s0885-3924(00)00162-7</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2000
Analgesics/administration & dosage/therapeutic use
Backlog
Child
Female
Hospital Units
Humans
Jacob E
Journal Article
Journal of Pain and Symptom Management
Male
Non-U.S. Gov't
P.H.S.
Pain/drug Therapy
Pediatrics
Preschool
Puntillo KA
Research Support
U.S. Gov't
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1046/j.1460-9592.2001.00697.x" target="_blank" rel="noreferrer">http://doi.org/10.1046/j.1460-9592.2001.00697.x</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Unlicensed and off label analgesic use in paediatric pain management
Publisher
An entity responsible for making the resource available
Paediatric Anaesthesia
Date
A point or period of time associated with an event in the lifecycle of the resource
2001
Subject
The topic of the resource
Child; Humans; Great Britain; Drug Utilization; Prospective Studies; Hospitals; Pediatric; Pain/drug therapy; Analgesics/therapeutic use; Drug Approval
Creator
An entity primarily responsible for making the resource
Conroy S; Peden V
Description
An account of the resource
BACKGROUND: The management of pain in children has advanced enormously in recent years. Pharmacological treatment of pain is complicated however, by the widespread use of unlicensed and off label medicines in the paediatric population, leading to everyday practical problems. This study aimed to document the incidence and nature of unlicensed and off label analgesic agents in children. METHODS: Data regarding analgesic use were collected prospectively over a 4-week period from two wards. The data were analysed to determine whether the drug use was licensed, unlicensed or off label. RESULTS: Seven hundred and fifteen prescription episodes were analysed. Some 480 of these (67%) were licensed; 235 were licensed medicines used in an off label manner (33%). No medicines were unlicensed. Paracetamol was the most common analgesic used. CONCLUSION: Issues regarding the use of off label drugs in children at risk of pain are discussed. Suggestions are made regarding the way forward for the future.
2001
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1046/j.1460-9592.2001.00697.x" target="_blank" rel="noreferrer">10.1046/j.1460-9592.2001.00697.x</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2001
Analgesics/therapeutic use
Backlog
Child
Conroy S
Drug Approval
Drug Utilization
Great Britain
Hospitals
Humans
Journal Article
Paediatric Anaesthesia
Pain/drug Therapy
Peden V
Pediatric
Prospective Studies
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1056/nejm199212033272311" target="_blank" rel="noreferrer">http://doi.org/10.1056/nejm199212033272311</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Barbiturates in the care of the terminally ill
Publisher
An entity responsible for making the resource available
The New England Journal Of Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
1992
Subject
The topic of the resource
Child; Female; Humans; Adult; "Hypnotics and Sedatives"; Ethics; Medical; Palliative Care/standards; Pain/drug therapy; Analgesia/methods; Sarcoma; Terminal Care/methods/standards; Astrocytoma/nursing; Barbiturates/administration & dosage; Ewing's/nursing; Mechanical; Multiple Organ Failure/nursing; Sarcoma/physiopathology/secondary; Spinal Cord Neoplasms/physiopathology/secondary; Spinal Neoplasms/nursing; Ventilators
Creator
An entity primarily responsible for making the resource
Truog RD; Berde CB; Mitchell C; Grier HE
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1056/nejm199212033272311" target="_blank" rel="noreferrer">10.1056/nejm199212033272311</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
Description
An account of the resource
1992
"Hypnotics and Sedatives"
1992
Adult
Analgesia/methods
Astrocytoma/nursing
Backlog
Barbiturates/administration & dosage
Berde CB
Child
Ethics
Ewing's/nursing
Female
Grier HE
Humans
Journal Article
Mechanical
Medical
Mitchell C
Multiple Organ Failure/nursing
Pain/drug Therapy
Palliative Care/standards
Sarcoma
Sarcoma/physiopathology/secondary
Spinal Cord Neoplasms/physiopathology/secondary
Spinal Neoplasms/nursing
Terminal Care/methods/standards
The New England Journal Of Medicine
Truog RD
Ventilators
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1056/nejm199506223322506" target="_blank" rel="noreferrer">http://doi.org/10.1056/nejm199506223322506</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
The control of pain in peripheral tissue by opioids
Publisher
An entity responsible for making the resource available
The New England Journal Of Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
1995
Subject
The topic of the resource
Humans; Animals; Biomarkers of Pain; Pain/drug therapy; Receptors; Opioid/drug effects; Narcotics/therapeutic use; Neurons; Afferent/drug effects; Peripheral Nervous System Diseases/drug therapy/physiopathology
Creator
An entity primarily responsible for making the resource
Stein C
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1056/nejm199506223322506" target="_blank" rel="noreferrer">10.1056/nejm199506223322506</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
Description
An account of the resource
1995
1995
Afferent/drug effects
Animals
Backlog
Biomarkers of Pain
Humans
Journal Article
Narcotics/therapeutic use
Neurons
Opioid/drug effects
Pain/drug Therapy
Peripheral Nervous System Diseases/drug therapy/physiopathology
Receptors
Stein C
The New England Journal Of Medicine
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1056/nejm199810013391402" target="_blank" rel="noreferrer">http://doi.org/10.1056/nejm199810013391402</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Cyclic administration of pamidronate in children with severe osteogenesis imperfecta
Publisher
An entity responsible for making the resource available
The New England Journal Of Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
1998
Subject
The topic of the resource
Child; Female; Humans; Male; Drug Administration Schedule; adolescent; Preschool; Non-U.S. Gov't; Research Support; Pain/drug therapy; Clodronate; Bone Density/drug effects; Periodicity; Diphosphonates/administration & dosage; Alkaline Phosphatase/blood; Bone Development/drug effects; Bone Resorption/drug therapy; Bone/prevention & control; Calcium/urine; Fractures; Lumbar Vertebrae/physiopathology/radiography; Osteogenesis Imperfecta/drug therapy/metabolism/physiopathology
Creator
An entity primarily responsible for making the resource
Glorieux FH; Bishop NJ; Plotkin H; Chabot G; Lanoue G; Travers R
Description
An account of the resource
BACKGROUND: Severe osteogenesis imperfecta is a disorder characterized by osteopenia, frequent fractures, progressive deformity, loss of mobility, and chronic bone pain. There is no effective therapy for the disorder. We assessed the effects of treatment with a bisphosphonate on bone resorption. METHODS: In an uncontrolled observational study involving 30 children who were 3 to 16 years old and had severe osteogenesis imperfecta, we administered pamidronate intravenously (mean [+/-SD] dose, 6.8+/-1.1 mg per kilogram of body weight per year) at 4-to-6-month intervals for 1.3 to 5.0 years. Clinical status, biochemical characteristics reflecting bone turnover, the bone mineral density of the lumbar spine, and radiologic changes were assessed regularly during treatment. RESULTS: Administration of pamidronate resulted in sustained reductions in serum alkaline phosphatase concentrations and in the urinary excretion of calcium and type I collagen N-telopeptide. There was a mean annualized increase of 41.9+/-29.0 percent in bone mineral density, and the deviation of bone mineral density from normal, as indicated by the z score, improved from -5.3+/-1.2 to -3.4+/-1.5. The cortical width of the metacarpals increased by 27+/-20.2 percent per year. The increases in the size of the vertebral bodies suggested that new bone had formed. The mean incidence of radiologically confirmed fractures decreased by 1.7 per year (P<0.001). Treatment with pamidronate did not alter the rate of fracture healing, the growth rate, or the appearance of the growth plates. Mobility and ambulation improved in 16 children and remained unchanged in the other 14. All the children reported substantial relief of chronic pain and fatigue. CONCLUSIONS: In children with severe osteogenesis imperfecta, cyclic administration of intravenous pamidronate improved clinical outcomes, reduced bone resorption, and increased bone density.
1998
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1056/nejm199810013391402" target="_blank" rel="noreferrer">10.1056/nejm199810013391402</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
1998
Adolescent
Alkaline Phosphatase/blood
Backlog
Bishop NJ
Bone Density/drug effects
Bone Development/drug effects
Bone Resorption/drug therapy
Bone/prevention & control
Calcium/urine
Chabot G
Child
Clodronate
Diphosphonates/administration & dosage
Drug Administration Schedule
Female
Fractures
Glorieux FH
Humans
Journal Article
Lanoue G
Lumbar Vertebrae/physiopathology/radiography
Male
Non-U.S. Gov't
Osteogenesis Imperfecta/drug therapy/metabolism/physiopathology
Pain/drug Therapy
Periodicity
Plotkin H
Preschool
Research Support
The New England Journal Of Medicine
Travers R
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1089/jpm.1998.1.315" target="_blank" rel="noreferrer">http://doi.org/10.1089/jpm.1998.1.315</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
The double effect of pain medication: separating myth from reality
Publisher
An entity responsible for making the resource available
Journal Of Palliative Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
1998
Subject
The topic of the resource
Humans; Analgesics; Intention; Double Effect Principle; Suicide; Death and Euthanasia; Euthanasia; Palliative Care/ethics; Pain/drug therapy; Opioid/adverse effects/therapeutic use; Assisted; Refusal to Treat; Respiratory Insufficiency/chemically induced
Creator
An entity primarily responsible for making the resource
Fohr SA
Description
An account of the resource
The principle of double effect is used to justify the administration of medication to relieve pain even though it may lead to the unintended, although foreseen, consequence of hastening death by causing respiratory depression. Although a review of the medical literature reveals that the risk of respiratory depression from opioid analgesic is more myth than fact and that there is little evidence that the use of medication to control pain hastens death, the belief in the double effect of pain medication remains widespread. Applying the principle of double effect to end-of-life issues perpetuates this myth and results in the undertreatment of physical suffering at the end of life. The concept of double effect of opioids also has been used in support of legalization of physician-assisted suicide and euthanasia.
1998
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1089/jpm.1998.1.315" target="_blank" rel="noreferrer">10.1089/jpm.1998.1.315</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
1998
Analgesics
Assisted
Backlog
Death and Euthanasia
Double Effect Principle
Euthanasia
Fohr SA
Humans
Intention
Journal Article
Journal of Palliative Medicine
Opioid/adverse effects/therapeutic use
Pain/drug Therapy
Palliative Care/ethics
Refusal to Treat
Respiratory Insufficiency/chemically induced
Suicide
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1136/bmj.307.6908.815" target="_blank" rel="noreferrer">http://doi.org/10.1136/bmj.307.6908.815</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Optimal pain relief in infants and children
Publisher
An entity responsible for making the resource available
Bmj (clinical Research Ed.)
Date
A point or period of time associated with an event in the lifecycle of the resource
1993
Subject
The topic of the resource
Humans; infant; Pain Measurement; infant; Newborn; Pain/drug therapy; Analgesia/methods; Morphine/therapeutic use; Anesthesia/methods; Anesthetics/therapeutic use
Creator
An entity primarily responsible for making the resource
Burrows FA; Berde CB
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1136/bmj.307.6908.815" target="_blank" rel="noreferrer">10.1136/bmj.307.6908.815</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
Description
An account of the resource
1993
1993
Analgesia/methods
Anesthesia/methods
Anesthetics/therapeutic use
Backlog
Berde CB
Bmj (clinical Research Ed.)
Burrows FA
Humans
Infant
Journal Article
Morphine/therapeutic Use
Newborn
Pain Measurement
Pain/drug Therapy
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1177/026921639601000309" target="_blank" rel="noreferrer">http://doi.org/10.1177/026921639601000309</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Ketamine injection used orally
Publisher
An entity responsible for making the resource available
Palliative Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
1996
Subject
The topic of the resource
Humans; Male; Adult; Administration; Oral; Pain/drug therapy; hospice care; Drug Resistance; Excitatory Amino Acid Antagonists/administration & dosage; Ketamine/administration & dosage
Creator
An entity primarily responsible for making the resource
Broadley KE; Kurowska A; Tookman A
Description
An account of the resource
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 dose, it has not been given by this route on a regular basis. The use of ketamine administered orally is described for two patients with severe neuropathic pain who were intolerant of, or whose pain was unrelieved by, more commonly used agents. Pain relief was achieved without significant side effects.
1996
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1177/026921639601000309" target="_blank" rel="noreferrer">10.1177/026921639601000309</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
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
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1191/026921600666097479" target="_blank" rel="noreferrer">http://doi.org/10.1191/026921600666097479</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
A multicentre international study of sedation for uncontrolled symptoms in terminally ill patients
Publisher
An entity responsible for making the resource available
Palliative Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2000
Subject
The topic of the resource
Female; Humans; Male; Analgesics; Aged; Middle Aged; Treatment Outcome; Drug Therapy; Non-U.S. Gov't; Research Support; Pain/drug therapy; Opioid/therapeutic use; Hypnotics and Sedatives/therapeutic use; Terminal Care/methods; Combination; Anti-Anxiety Agents/therapeutic use; Consciousness/drug effects; Delirium/drug therapy; Dyspnea/drug therapy; Midazolam/therapeutic use; Nausea/drug therapy
Creator
An entity primarily responsible for making the resource
Fainsinger RL; Waller A; Bercovici M; Bengtson K; Landman W; Hosking M; Nunez-Olarte JM; deMoissac D
Description
An account of the resource
The issue of symptom management at the end of life and the need to use sedation has become a controversial topic. This debate has been intensified by the suggestion that sedation may correlate with 'slow euthanasia'. The need to have more facts and less anecdote was a motivating factor in this multicentre study. Four palliative care programmes in Israel, South Africa, and Spain agreed to participate. The target population was palliative care patients in an inpatient setting. Information was collected on demographics, major symptom distress, and intent and need to use sedatives in the last week of life. Further data on level of consciousness, adequacy of symptom control, and opioids and psychotropic agents used during the final week of life was recorded. As the final week of life can be difficult to predict, treating physicians were asked to complete the data at the time of death. The data available for analysis included 100 patients each from Israel and Madrid, 94 patients from Durban, and 93 patients from Cape Town. More than 90% of patients required medical management for pain, dyspnoea, delirium and/or nausea in the final week of life. The intent to sedate varied from 15% to 36%, with delirium being the most common problem requiring sedation. There were variations in the need to sedate patients for dyspnoea, and existential and family distress. Midazolam was the most common medication prescribed to achieve sedation. The diversity in symptom distress, intent to sedate and use of sedatives, provides further knowledge in characterizing and describing the use of deliberate pharmacological sedation for problematic symptoms at the end of life. The international nature of the patient population studied enhances our understanding of potential differences in definition of symptom issues, variation of clinical practice, and cultural and psychosocial influences.
2000
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1191/026921600666097479" target="_blank" rel="noreferrer">10.1191/026921600666097479</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2000
Aged
Analgesics
Anti-Anxiety Agents/therapeutic use
Backlog
Bengtson K
Bercovici M
Combination
Consciousness/drug Effects
Delirium/drug therapy
deMoissac D
Drug Therapy
Dyspnea/drug therapy
Fainsinger RL
Female
Hosking M
Humans
Hypnotics and Sedatives/therapeutic use
Journal Article
Landman W
Male
Midazolam/therapeutic use
Middle Aged
Nausea/drug therapy
Non-U.S. Gov't
Nunez-Olarte JM
Opioid/therapeutic use
Pain/drug Therapy
Palliative Medicine
Research Support
Terminal Care/methods
Treatment Outcome
Waller A
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1200/jco.1998.16.10.3216" target="_blank" rel="noreferrer">http://doi.org/10.1200/jco.1998.16.10.3216</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Switching from morphine to oral methadone in treating cancer pain: what is the equianalgesic dose ratio?
Publisher
An entity responsible for making the resource available
Journal Of Clinical Oncology
Date
A point or period of time associated with an event in the lifecycle of the resource
1998
Subject
The topic of the resource
Cross-Sectional Studies; Female; Humans; Male; Analgesics; Prospective Studies; Aged; Middle Aged; Therapeutic Equivalency; Time Factors; Analgesia; Non-U.S. Gov't; Research Support; Administration; Oral; Pain/drug therapy; Dose-Response Relationship; Drug; Neoplasms/complications; Opioid/administration & dosage; Morphine/administration & dosage; Methadone/administration & dosage
Creator
An entity primarily responsible for making the resource
Ripamonti C; Groff L; Brunelli C; Polastri D; Stavrakis A; De Conno F
Description
An account of the resource
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 morphine to oral methadone. PATIENTS AND METHODS: A cross-sectional prospective study of 38 consecutive cancer patients who switched from morphine to oral methadone was performed. The intensity of pain before, during, and after the switching period was assessed through a four-point verbal Likert scale. The relationship between previous morphine dose and the final equianalgesic methadone dose, dose ratio between morphine and methadone, and the number of days required to achieve equianalgesia have been examined by means of Pearson's correlation coefficient, scatter plots, and Cuzick's test for trend respectively. RESULTS: Before the switch, the median oral equivalent daily dose of morphine was 145 mg/d; after the switch, the median equianalgesic oral methadone dose was 21 mg/d. A median time of 3 days (range, 1 to 7 days) was necessary to achieve the equianalgesia with oral methadone; the lower the preswitching morphine dose, the fewer days necessary to achieve equianalgesia with oral methadone (P < .001). Dose ratios ranged from 2.5:1 to 14.3:1 (median, 7.75:1), which indicated that, in most cases, the dose ratio was much higher than that suggested by the published equianalgesic tables. A strong linear positive relationship between morphine and methadone equianalgesic doses was obtained (Pearson's correlation coefficient, 0.91). The dose ratio increased with the increase of the previous morphine dose with a much higher increase at low morphine doses. CONCLUSION: The results of our study confirm that methadone is a potent opioid, more potent than believed. Caution is recommended when switching from any opioid to methadone, especially in patients who are tolerant to high doses of opioids.
1998
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1200/jco.1998.16.10.3216" target="_blank" rel="noreferrer">10.1200/jco.1998.16.10.3216</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
1998
Administration
Aged
Analgesia
Analgesics
Backlog
Brunelli C
Cross-sectional Studies
De Conno F
Dose-Response Relationship
Drug
Female
Groff L
Humans
Journal Article
Journal Of Clinical Oncology
Male
Methadone/administration & Dosage
Middle Aged
Morphine/administration & dosage
Neoplasms/complications
Non-U.S. Gov't
Opioid/administration & dosage
Oral
Pain/drug Therapy
Polastri D
Prospective Studies
Research Support
Ripamonti C
Stavrakis A
Therapeutic Equivalency
Time Factors
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1200/jco.2001.19.11.2898" target="_blank" rel="noreferrer">http://doi.org/10.1200/jco.2001.19.11.2898</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Switching from morphine to methadone to improve analgesia and tolerability in cancer patients: a prospective study
Publisher
An entity responsible for making the resource available
Journal Of Clinical Oncology
Date
A point or period of time associated with an event in the lifecycle of the resource
2001
Subject
The topic of the resource
Female; Humans; Male; Analgesics; Prospective Studies; Middle Aged; Drug Administration Schedule; Non-U.S. Gov't; Research Support; Administration; Oral; Pain/drug therapy; Neoplasms/complications; Methadone/administration & dosage/pharmacology; Morphine/adverse effects/pharmacology; Opioid/administration & dosage/adverse effects/pharmacology
Creator
An entity primarily responsible for making the resource
Mercadante S; Casuccio A; Fulfaro F; Groff L; Boffi R; Villari P; Gebbia V; Ripamonti C
Description
An account of the resource
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 but with uncontrolled pain and/or moderate to severe opioid adverse effects were switched to oral methadone administered every 8 hours using different dose ratios. Intensity of pain and adverse effects were assessed daily, and the symptom distress score (DS) was calculated before and after switching. RESULTS: Data were analyzed for 50 patients. Switching was considered effective in 80% of the patients; results were achieved in an average of 3.65 days. In the 10 patients who switched to methadone because of uncontrolled pain, a significant reduction in pain intensity (P <.005) and an average of a 33% increase in methadone doses necessary (P <.01) were found after an average of 3.5 days. DS significantly decreased from an average of 8.4 to 4.5 (P <.0005). In the 32 patients switching because of uncontrolled pain and morphine-related adverse effects, significant improvement was found in pain intensity (P <.0005), nausea and vomiting (P <.03), constipation (P <.001), and drowsiness (P <.01), but a significant increase in the methadone dose of an average of 20% (P <.004) was required. CONCLUSION: In most patients with cancer pain referred for poor pain control and/or adverse effects, switching to oral methadone is a valid therapeutic option. In the clinical setting of poor pain control, higher doses of methadone are necessary with respect to the equianalgesic calculated dose ratios previously published.
2001
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1200/jco.2001.19.11.2898" target="_blank" rel="noreferrer">10.1200/jco.2001.19.11.2898</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2001
Administration
Analgesics
Backlog
Boffi R
Casuccio A
Drug Administration Schedule
Female
Fulfaro F
Gebbia V
Groff L
Humans
Journal Article
Journal Of Clinical Oncology
Male
Mercadante S
Methadone/administration & dosage/pharmacology
Middle Aged
Morphine/adverse effects/pharmacology
Neoplasms/complications
Non-U.S. Gov't
Opioid/administration & dosage/adverse effects/pharmacology
Oral
Pain/drug Therapy
Prospective Studies
Research Support
Ripamonti C
Villari P
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1542/peds.99.5.711" target="_blank" rel="noreferrer">http://doi.org/10.1542/peds.99.5.711</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Pain management in the emergency department: patterns of analgesic utilization
Publisher
An entity responsible for making the resource available
Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
1997
Subject
The topic of the resource
Child; Female; Humans; Male; Patient Discharge; Adult; Age Factors; Hospitals; Emergency Service; Comparative Study; Pain/drug therapy; Analgesics/administration & dosage/therapeutic use; Hospital/statistics & numerical data; Academic Medical Centers/statistics & numerical data; Community/statistics & numerical data; Drug Utilization/statistics & numerical data
Creator
An entity primarily responsible for making the resource
Petrack EM; Christopher NC; Kriwinsky J
Description
An account of the resource
OBJECTIVE: To compare the use of analgesia in children to adults in 3 different emergency department (ED) settings. METHODS: Forty adult and 40 pediatric ED charts were randomly selected for review at each of 3 institutions: an academic medical center with separate pediatric and adult EDs (SEP ED), a community academic medical center with a combined adult and pediatric ED (COMB ED), and a community hospital with a combined ED (COMTY ED). All patients presenting to the EDs from July 1993 to June 1994 within 12 hours of an isolated long bone fracture were eligible for inclusion. Data were collected on demographics, training of providers, analgesic use and dosing in the ED and on discharge, and time from triage to analgesic use. RESULTS: The mean pediatric and adult ages were 8.7 and 38.3 years, respectively. Overall, 152/240 (63%) patients received some form of analgesia in the ED, with the COMTY ED (41/80; 51%) offering significantly less analgesia than the COMB ED (58/80; 73%), but not the SEP ED (53/80; 66%). Pediatric patients (64/120; 53%) received significantly less analgesia in the ED than adult patients (88/120; 73%). This difference was significant at the COMB ED (pediatric 23/40; 58% vs adult 35/40; 88%) and COMTY ED (pediatric 15/40; 38% vs adult 26/40; 65%), but not at the SEP ED (pediatric 26/40; 65% vs adult 27/40; 68%). 195/240 (81%) patients received discharge pain medication. There were no differences between pediatric (93/120; 78%) and adult (102/120; 85%) discharge analgesic prescribing practices. Although there was no difference in appropriateness of analgesic doses in the ED, pediatric patients (20/74; 27%) were more likely than adult patients (3/88; 3%) to receive inadequate doses of analgesics on discharge from the ED. CONCLUSIONS: ED analgesia continues to be used less frequently in the pediatric compared with the adult population. Inadequate dosing of discharge analgesic medication in children is a significant problem. Patterns of analgesic utilization may differ in different types of ED settings.
1997
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1542/peds.99.5.711" target="_blank" rel="noreferrer">10.1542/peds.99.5.711</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
1997
Academic Medical Centers/statistics & numerical data
Adult
Age Factors
Analgesics/administration & dosage/therapeutic use
Backlog
Child
Christopher NC
Community/statistics & numerical data
Comparative Study
Drug Utilization/statistics & numerical data
Emergency Service
Female
Hospital/statistics & numerical data
Hospitals
Humans
Journal Article
Kriwinsky J
Male
Pain/drug Therapy
Patient Discharge
Pediatrics
Petrack EM
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.20968/rpm/2005/v3/i1/101038" target="_blank" rel="noreferrer">http://doi.org/10.20968/rpm/2005/v3/i1/101038</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
The map of dying
Publisher
An entity responsible for making the resource available
Journal Of The Royal College Of Physicians Of London
Date
A point or period of time associated with an event in the lifecycle of the resource
2000
Subject
The topic of the resource
Humans; Palliative Care; Practice Guidelines as Topic; Quality of Health Care; Euthanasia; Terminal Care; Pain/drug therapy
Creator
An entity primarily responsible for making the resource
Watkins P
Identifier
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<a href="http://doi.org/10.20968/rpm/2005/v3/i1/101038" target="_blank" rel="noreferrer">10.20968/rpm/2005/v3/i1/101038</a>
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Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
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Journal Article
Description
An account of the resource
2000
2000
Backlog
Euthanasia
Humans
Journal Article
Journal Of The Royal College Of Physicians Of London
Pain/drug Therapy
Palliative Care
Practice Guidelines As Topic
Quality Of Health Care
Terminal Care
Watkins P
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.2165/00003088-199733030-00005" target="_blank" rel="noreferrer">http://doi.org/10.2165/00003088-199733030-00005</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Pharmacokinetic optimisation of opioid treatment in acute pain therapy
Publisher
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Clinical Pharmacokinetics
Date
A point or period of time associated with an event in the lifecycle of the resource
1997
Subject
The topic of the resource
Humans; Pain; Analgesics; Drug Interactions; Analgesia; Drug Administration Schedule; Administration; Oral; Pain/drug therapy; Infusions; Injections; Intravenous; Dose-Response Relationship; Drug; Subcutaneous; Intramuscular; Patient-Controlled; Postoperative/drug therapy; Substance-Related Disorders; Opioid/pharmacokinetics/pharmacology/therapeutic use; Central Nervous System/drug effects/metabolism
Creator
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Upton RN; Semple TJ; Macintyre PE
Description
An account of the resource
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 interval, and titration for an effect in individual patients with the monitoring of pain and sedation scores, can greatly improve the efficacy of opioid administration. Optimising opioid use, therefore, entails optimising the titration process. Opioids have similar pharmacodynamic properties but have widely different kinetic properties. The most important of these is the delay between the blood concentrations of an opioid and its analgesic or other effects, which probably relate to the delay required for blood and brain and spinal cord (CNS) equilibrium. The half-lives of these delays range from approximately 34 minutes for morphine to 1 minute for alfentanil. The titration is influenced by the time needed after an initial dose before it is safe to administer a second dose and the duration of the effects of a single dose, which varies widely between opioids, doses and routes of administration. To compare opioids and routes of administration, we examined the relative CNS concentration profiles of opioids - the CNS concentration expressed as a percentage of its maximum value. The relative onset was the defined as the time the relative CNS concentration first rose to 80% of maximum, while the relative duration was defined as the length of time the concentration was above 80%. For an intravenous bolus dose, the relative onset varies from approximately 1 for alfentanil to 6 minutes for morphine, while their relative durations are approximately 2 and 96 minutes, respectively. Although all of the common opioids, perhaps with the exception of alfentanil, have kinetic and dynamic properties suitable for use in PCA with intravenous bolus doses, the long relative duration of morphine makes it particularly suited to an upgraded traditional approach using staff administered intramuscular or subcutaneous doses. There is a clear kinetic preference for regimens with a rapid onset and short duration (e.g. intravenous PCA) for coping with incident pain. It is shown that, in general, titration is improved by the more frequent administration of smaller doses, but it is important to use additional doses to initially 'load' a patient. The titration of opioids should always be accompanied by the monitoring of pain and sedation scores and ventilation.
1997
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.2165/00003088-199733030-00005" target="_blank" rel="noreferrer">10.2165/00003088-199733030-00005</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
1997
Administration
Analgesia
Analgesics
Backlog
Central Nervous System/drug effects/metabolism
Clinical Pharmacokinetics
Dose-Response Relationship
Drug
Drug Administration Schedule
Drug Interactions
Humans
Infusions
Injections
Intramuscular
Intravenous
Journal Article
Macintyre PE
Opioid/pharmacokinetics/pharmacology/therapeutic use
Oral
Pain
Pain/drug Therapy
Patient-Controlled
Postoperative/drug therapy
Semple TJ
Subcutaneous
Substance-Related Disorders
Upton RN
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.2165/00003495-199651050-00002" target="_blank" rel="noreferrer">http://doi.org/10.2165/00003495-199651050-00002</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Opioid analgesics: comparative features and prescribing guidelines
Publisher
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Drugs
Date
A point or period of time associated with an event in the lifecycle of the resource
1996
Subject
The topic of the resource
Humans; Analgesics; Prescriptions; Comparative Study; Pain/drug therapy; Drug; Opioid/administration & dosage/adverse effects/therapeutic use
Creator
An entity primarily responsible for making the resource
Cherny NI
Description
An account of the resource
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, opioids can be classified according to their receptor interactions (agonist, partial agonist, agonist-antagonist and antagonist), the pain intensity for which they are conventionally used (moderate or severe), and their half-life (short or long). Pure agonists conventionally used for moderate pain, short and long half-life pure agonists conventionally used for severe pain, mixed agonist-antagonists and partial agonist opioids are described in detail. The effective clinical use of opioid drugs requires familiarity with drug selection, routes of administration, dosage guidelines and potential adverse effects. Opioids are unequivocally indicated in the management of severe acute pain and moderate to severe pain associated with cancer. There is increasing acceptance of the role of opioids in the management of recurring acute pain, chronic nonmalignant pain of organic origin and severe neuropathic pain. The selection of opioids is influenced by pain intensity, pharmacokinetic and formulary considerations, previous adverse effects and the presence of coexisting disease. Some patients will require sequential trials of several different opioids before a drug which is effective and well tolerated is identified. Opioid agents should be administered by the most comfortable and convenient route that meets the specific needs of the patient. The regimen for opioid medications should generally provide around-the-clock analgesia with provision for rescue doses for the management of exacerbations of the pain not covered by the regular dosage. At all times, uncontrolled pain should be addressed by gradual increase in the opioid dose until either pain control is achieved or intolerable and unmanageable adverse effects supervene. The management of pain with opioid analgesics demands frequent patient assessment and a readiness to re-evaluate the therapeutic plan in the setting of either inadequate relief or adverse effects.
1996
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.2165/00003495-199651050-00002" target="_blank" rel="noreferrer">10.2165/00003495-199651050-00002</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
1996
Analgesics
Backlog
Cherny NI
Comparative Study
Drug
Drugs
Humans
Journal Article
Opioid/administration & dosage/adverse effects/therapeutic use
Pain/drug Therapy
Prescriptions
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.2165/00003495-199753010-00011" target="_blank" rel="noreferrer">http://doi.org/10.2165/00003495-199753010-00011</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Transdermal fentanyl. A review of its pharmacological properties and therapeutic efficacy in pain control
Publisher
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Drugs
Date
A point or period of time associated with an event in the lifecycle of the resource
1997
Subject
The topic of the resource
Humans; Analgesics; Pain/drug therapy; Opioid/administration & dosage; Fentanyl/administration & dosage/adverse effects/pharmacokinetics
Creator
An entity primarily responsible for making the resource
Jeal W; Benfield P
Description
An account of the resource
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 therapeutic system (TTS). These systems are designed to release the drug into the skin at a constant rate ranging from 25 to 100 micrograms/h, multiple systems can be applied to achieve higher delivery rates. Initially, much of the clinical experience with fentanyl TTS was obtained in patients with acute postoperative pain. However, because of the increased risk of respiratory complications, fentanyl TTS is contraindicated in this setting. Fentanyl TTS is recommended for use in chronic cancer pain. Moreover, in 11 countries worldwide including the US, its use is not restricted to chronic cancer pain; the drug is also available for treatment of general chronic pain, including that of nonmalignant origin. At the start of fentanyl TTS treatment, depot accumulation of the drug within skin tissue results in a significant delay (17 to 48 hours) before maximum plasma concentration is achieved. Approximately half of the cancer patients converted to transdermal fentanyl from other opioid agents required increased dosages after initial application of the patch. However, concomitant use of short-acting morphine maintained pain relief during the titration period, and the use of such supplementary medication decreased with the duration of fentanyl TTS treatment. In patients with chronic cancer pain, changes in visual analogue scale (VAS) pain scores ranged from a 10% increase (worse pain) to > 50% decrease (less pain) during transdermal fentanyl therapy compared with previous opioid treatment. In addition, patient preference for fentanyl TTS was indicated by the number of patient requests (up to 95%) for continued use of the drug at the end of the study. Although fentanyl TTS is contraindicated in patients postoperatively, the efficacy of fentanyl via the transdermal route was investigated in this patient group. Supplementary patient controlled analgesia was significantly reduced in patients who received fentanyl TTS 75 micrograms/h compared with placebo, although this was not apparent until > or = 12 hours after application. Data evaluating pain relief, which was assessed by VAS pain scores, were inconclusive. Preliminary data, although from relatively small numbers of patients, indicate that transdermal fentanyl may be useful in the management of chronic non-malignant pain. Indeed, some patients whose pain was previously uncontrolled became completely pain free. The most frequently occurring adverse events during fentanyl TTS therapy (as with other opioid agents) included vomiting, nausea and constipation, although vomiting and nausea were not clearly associated with the drug. The most serious adverse event was hypoventilation, which occurred more frequently in postoperative (4%) than in cancer patients (2%). In surgical patients, fentanyl-associated respiratory events (reduced respiratory rate and apnoea) generally occurred within 24 hours of patch application; however, there were isolated reports of late onset (> or = 36 hours postsurgery) fentanyl-associated respiratory depression. In cancer patients, the incidence of constipation was reduced by up to two-thirds after switching from oral morphine to transdermal fentanyl. Transient skin irritation associated with the plastic patch or the adhesive, rather than the drug, was reported in a maximum 3% of patients. In summary, transdermal fentanyl is a useful alternative to other opioid agents, which are also recommended on the third step of the WHO analgesic ladder, in the management of chronic malignant pain. Preliminary data indicate that it may be useful in the management of chronic nonmalignant pain. The advantages offered by fentanyl TTS over traditional methods of chronic pain control include its ease of administration, less constipation and the 3-
1997
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.2165/00003495-199753010-00011" target="_blank" rel="noreferrer">10.2165/00003495-199753010-00011</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
1997
Analgesics
Backlog
Benfield P
Drugs
Fentanyl/administration & dosage/adverse effects/pharmacokinetics
Humans
Jeal W
Journal Article
Opioid/administration & dosage
Pain/drug Therapy