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Text
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<a href="http://doi.org/10.1200/jco.1996.14.10.2836" target="_blank" rel="noreferrer">http://doi.org/10.1200/jco.1996.14.10.2836</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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Clinical experience with oral methadone administration in the treatment of pain in 196 advanced cancer patients
Publisher
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Journal Of Clinical Oncology
Date
A point or period of time associated with an event in the lifecycle of the resource
1996
Subject
The topic of the resource
Female; Humans; Male; Analgesics; Aged; Middle Aged; Administration; Oral; retrospective studies; Neoplasms/complications; Methadone/therapeutic use; Opioid/therapeutic use; Pain/etiology/prevention & control
Creator
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De Conno F; Groff L; Brunelli C; Zecca E; Ventafridda V; Ripamonti C
Description
An account of the resource
PURPOSE: The aims of this study were to describe the analgesia, side effects, and dosage and the causes of suspension of treatment in a large sample of advanced cancer patients with pain after treatment with oral methadone from 7 to 90 days. PATIENTS AND METHODS: In a retrospective study, data collected for 196 advanced cancer outpatients with moderate to severe pain treated at 8-hour intervals with oral methadone in solution form from February 1993 to February 1995 were analyzed at baseline (time 0) and then at 7, 15, 30, 45, 60, and 90 days. The following parameters were assessed: Karnofsky Performance Status, intensity of pain (using the Integrated Pain Score [IPS], intensity of pain, insomnia, drowsiness, confusion, dry mouth, nausea, vomiting, constipation, and dyspnea (using the Therapy Impact Questionnaire [TIQ], mean daily dose of drug administered, and reasons for withdrawal from study. The period when pain was reduced by > or = 35% with respect to baseline was evaluated with the Palliation Index. The association of the degree of palliation of pain with the age of the patients, tumor site, analgesic treatment taken at baseline, and daily mean dose of methadone administered during the follow-up period was analyzed by means of the Kruskal-Wallis test. RESULTS: A reduction in pain intensity with respect to baseline occurred at each analysis time, and in 55.1% of the patients the reduction during the follow-up period was > or = 35% according to the Palliation Index. The mean dose of oral methadone ranged from 14 mg at day 7 to 23.65 mg at day 90. There was an overall worsening of the other symptoms, but a high percentage of the patients reported an amelioration of insomnia with respect to baseline. There was a statistically significant association (P < .0001) between the Palliation Index and the analgesic therapy administered at baseline. Only 11.2% of the patients withdrew from the study due to analgesic inefficacy and 6.6% due to methadone-related side effects (10 patients with drowsiness and three with severe constipation. CONCLUSION: Oral methadone administered every 8 hours was shown to be an appropriate analgesic therapy in the treatment of advanced cancer-related pain. The worsening of the other symptoms under study can be considered linked to the progression of the disease, and in fact, only a small percentage of the patients reported methadone-related side effects that warranted suspension of treatment. We consider oral methadone to be a useful analgesic therapy, and it should be considered in clinical practice for the treatment of cancer pain.
1996
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1200/jco.1996.14.10.2836" target="_blank" rel="noreferrer">10.1200/jco.1996.14.10.2836</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
1996
Administration
Aged
Analgesics
Backlog
Brunelli C
De Conno F
Female
Groff L
Humans
Journal Article
Journal Of Clinical Oncology
Male
Methadone/therapeutic use
Middle Aged
Neoplasms/complications
Opioid/therapeutic use
Oral
Pain/etiology/prevention & control
Retrospective Studies
Ripamonti C
Ventafridda V
Zecca E
-
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/s0304-3959(96)03286-1" target="_blank" rel="noreferrer">http://doi.org/10.1016/s0304-3959(96)03286-1</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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An update on the clinical use of methadone for cancer pain
Publisher
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Pain
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; Non-U.S. Gov't; Research Support; Evaluation Studies; Administration; Oral; Neoplasms/drug therapy; Methadone/administration & dosage/adverse effects/therapeutic use; Opioid/administration & dosage/adverse effects/therapeutic use; Rectal; Palliative Care/trends
Creator
An entity primarily responsible for making the resource
Ripamonti C; Zecca E; Bruera E
Description
An account of the resource
Methadone is a synthetic opioid agonist considered a second choice drug in the management of cancer pain. Methadone has a number of unique characteristics including excellent oral and rectal absorption, no known active metabolites, high potency, low cost, and longer administration intervals, as well as an incomplete cross-tolerance with respect to other mu-opioid receptor agonist drugs. For these reasons, methadone has the potential of playing a major role in the treatment of cancer pain. However, its use is limited by the remarkably long and unpredictable half-life, large inter-individual variations in pharmacokinetics, the potential for delayed toxicity, and above all by the limited knowledge of correct administration intervals and the equianalgesic ratio with other opioids when administered chronically. Recent findings suggest that standard equianalgesic tables are unreliable for methadone titration in patients tolerant to high doses of opioid agonists and that switchovers should take place slowly and should be personalized. Future research has to better define the variation in both bioavailability and elimination of methadone in different patient populations, the interaction between methadone and the most commonly used drugs in cancer patients, the type and activity of potential methadone metabolites, and the equianalgesic doses between methadone and the most commonly used opioids.
1997
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/s0304-3959(96)03286-1" target="_blank" rel="noreferrer">10.1016/s0304-3959(96)03286-1</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
Analgesics
Backlog
Bruera E
Evaluation Studies
Humans
Journal Article
Methadone/administration & dosage/adverse effects/therapeutic use
Neoplasms/drug therapy
Non-U.S. Gov't
Opioid/administration & dosage/adverse effects/therapeutic use
Oral
Pain
Palliative Care/trends
Rectal
Research Support
Ripamonti C
Zecca E