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Journal of Pain & Palliative Care Pharmacotherapy

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https://read.qxmd.com/read/30998426/the-efficacy-of-vitamin-c-in-the-prevention-of-complex-regional-pain-syndrome-after-distal-radius-fractures-a-synthesis
#1
Thomas Keef, Stephen Keef
The current recommendation is to use daily doses of vitamin C to prevent the occurrence of the complex regional pain syndrome (CRPS) following a distal radius fracture. The study is a synthesis of the four primary studies that examine this issue. These studies have been previously examined in the meta-analysis literature. The incidence of CRPS is lower in patients treated with the vitamin C protocol compared with the control. The significance of the difference varies from P = .02 to P = .13. Our analysis points to the fact that the relative efficacy of vitamin C has decreased over the past 15 years (P < ...
April 18, 2019: Journal of Pain & Palliative Care Pharmacotherapy
https://read.qxmd.com/read/30896312/comparison-of-parenteral-opioid-dosing-in-adult-sickle-cell-disease-patients-with-vaso-occlusive-crisis
#2
Samarth P Shah, Jennifer D Twilla, Leonette Kemp, Gregory L Phelps, Anne Reaves
Sickle cell disease (SCD) is a chronic condition characterized by multiple vaso-occlusive complications, including acute pain crisis. The mainstay of treatment for patients presenting with vaso-occlusive crisis (VOC) is pain control and adequate hydration. Currently, there are no studies to determine an optimal pain control regimen in adult SCD patients. The main objective of this study is to evaluate whether outcomes differ in patients with VOC based on pain management treatment modality. A retrospective review of admissions with a primary diagnosis of VOC admitted to our facility was conducted...
March 21, 2019: Journal of Pain & Palliative Care Pharmacotherapy
https://read.qxmd.com/read/30735070/laxative-use-in-inpatients-on-oxycodone-naloxone-prolonged-release-and-oxycodone-prolonged-release-for-cancer-and-non-cancer-pain
#3
Joanne Patel, Catherine J Lucas, Maxwell Margalit, Jennifer H Martin
OBJECTIVE: To examine the laxative prescriptions in hospital inpatients with cancer and non-cancer pain on oxycodone compared to oxycodone plus naloxone combination. DESIGN: Retrospective case note review. SETTING: A palliative care inpatient unit and a general medical ward in a large tertiary referral hospital. PARTICIPANTS: Eighty-four patients receiving oxycodone or combination oxycodone/naloxone on general medical (45 patients) and palliative care wards (39 patients)...
February 8, 2019: Journal of Pain & Palliative Care Pharmacotherapy
https://read.qxmd.com/read/30702379/opioid-sparing-effects-of-topical-ketamine-in-treating-severe-pain-from-decubitus-ulcers
#4
Kira A Skavinski
Pain from pressure ulcers can severely impact a patient's quality of life. Evidence-based treatment of ulcer-related pain typically relies on systemic opioids with limiting side effects. Literature exists on the use of topical ketamine for neuropathic pain, but not for tissue injury in general and for decubitus ulcer pain specifically. Ketamine has a number of actions including blocking of the glutamate NMDA ionophore in the periphery. Preclinical evidence suggests that NMDA receptors located on peripheral sensory afferent terminals may play a role in initiating pain signaling in inflamed tissues...
January 31, 2019: Journal of Pain & Palliative Care Pharmacotherapy
https://read.qxmd.com/read/30702378/natural-language-processing-identified-problem-opioid-use-and-its-associated-health-care-costs
#5
Elizabeth T Masters, Arvind Ramaprasan, Jack Mardekian, Roy E Palmer, David E Gross, David Cronkite, Michael Von Korff, David S Carrell
Use of prescription opioids and problems of abuse and addiction have increased over the past decade. Claims-based studies have documented substantial economic burden of opioid abuse. This study utilized electronic health record (EHR) data to identify chronic opioid therapy (COT) patients with problem opioid use (POU) and compared costs with those for COT patients without POU. This study utilized EHR and claims data from an integrated health care system. Patients received COT (≥70 days' supply in ≥1 calendar quarter, 2006-2012)...
January 31, 2019: Journal of Pain & Palliative Care Pharmacotherapy
https://read.qxmd.com/read/30702377/ketamine-induced-diabetes-insipidus
#6
Vivek Kataria, Tep Kang, Kevin M Bradley
The authors report a case of diabetes insipidus (DI) associated with a ketamine infusion. A 42-year-old Asian man underwent an exploratory laparotomy and splenectomy who was admitted to the surgical intensive care unit (ICU) for postoperative management. Pain control was attempted with escalating dose of opioids but was inadequate, prompting the addition of a ketamine infusion. Shortly after initiation, a massive rise in urine output ensued in addition to a change in his urine electrolyte studies, leading to the diagnosis of drug-induced diabetes insipidus...
January 31, 2019: Journal of Pain & Palliative Care Pharmacotherapy
https://read.qxmd.com/read/30676844/the-association-of-joint-pain-and-dipeptidyl-peptidase-4-inhibitor-use-among-u-s-adults-with-type-2-diabetes-mellitus
#7
Pragya Rai, Xiaohui Zhao, Usha Sambamoorthi
The purpose of this study was to examine the association of dipeptidyl peptidase-4 inhibitors (DPP4Is) with joint pain in adults with type 2 diabetes mellitus (T2DM). This was a retrospective cross-sectional study design, pooling data from the 2012 and 2014 Medical Expenditure Panel Survey. The sample consisted of 4,559 T2DM patients older than 40 years with (n = 3,224) or without joint pain (n = 1,335). Chi-square test and logistic regression were used to describe association of DPP4I use with joint pain...
January 24, 2019: Journal of Pain & Palliative Care Pharmacotherapy
https://read.qxmd.com/read/30676178/public-policy-an-analgesia-for-opioid-diversion
#8
Ian Wee Jun Yan, Beverly Lim Tian Ying, Frank Brennan
Although opioids are a commonly prescribed form of analgesics among the armamentarium for their efficacy and safety when used responsibly, societal problems of drug diversion are highly prevalent. This review seeks to examine the importance of opioids and the extent of diversion and its impact, drawbacks, and controversies in law, public policies, and strategies. In particular, the law has skewed its focus toward the regulation of opioid suppliers (as compared to consumers), giving rise to a chilling effect where physicians are hesitant to prescribe opioids to patients with legitimate needs...
January 24, 2019: Journal of Pain & Palliative Care Pharmacotherapy
https://read.qxmd.com/read/30676174/adverse-drug-reactions-in-palliative-care
#9
Jordan O'Leary, Jayne Pawasauskas, Todd Brothers
Adverse drug reactions (ADRs) have an impact on patient morbidity and mortality. Palliative care patients constitute a vulnerable population due to the complexity of their care and treatments. This study sought to identify ADRs in palliative care, assess their severity and preventability, and identify specific medications most commonly involved. This retrospective cohort study included patients who received a consult by the hospital's palliative care service over a 1-year period. Records were reviewed to identify ADR occurrences, causative and resulting events, and variables used to determine preventability and severity...
January 24, 2019: Journal of Pain & Palliative Care Pharmacotherapy
https://read.qxmd.com/read/30645153/a-prospective-randomized-double-blind-placebo-controlled-trial-to-evaluate-intravenous-acetaminophen-versus-placebo-in-patients-undergoing-robotic-assisted-laparoscopic-prostatectomy
#10
Victor C Wang, Mark A Preston, Adam S Kibel, Xinling Xu, James Gosnell, R Jason Yong, Richard D Urman
Radical prostatectomy for prostate cancer is one of the most commonly performed operations in men. The objective of this study was to determine the impact of intravenous (IV) acetaminophen when added to the perioperative analgesic regimen for robotic-assisted laparoscopic prostatectomy (RALP) on hospital length of stay (LOS), postoperative pain scores, and opioid consumption. In this prospective, randomized, double-blind, placebo-controlled trial, a total of 86 patients undergoing RALP were prospectively enrolled and randomly assigned to receive either 1 g IV acetaminophen (study group; n = 43) or IV placebo (n = 43) within 15 minutes following the induction of anesthesia and prior to surgical incision...
January 15, 2019: Journal of Pain & Palliative Care Pharmacotherapy
https://read.qxmd.com/read/30645151/elevated-transaminases-with-topical-diclofenac-a-case-report
#11
Amanda M Daniels, Lawrence M Gibbs, Christopher M Herndon
Drug-induced liver injury (DILI) has been described with numerous nonsteroidal anti-inflammatory drugs (NSAIDs). Oral diclofenac has been associated with DILI more frequently than other NSAIDs and requires periodic monitoring of liver transaminases and judicious consideration of clinical signs and symptoms of hepatotoxicity. Here we describe a case in which elevated liver transaminases in a 79-year-old female returned to normal following discontinuation of topical diclofenac 1% gel. Using a widely accepted drug reaction causality instrument, a rating of "definite" was assigned given the temporal sequence of drug exposure and transaminase changes...
January 15, 2019: Journal of Pain & Palliative Care Pharmacotherapy
https://read.qxmd.com/read/30624123/things-to-consider-when-completing-an-advance-directive
#12
Leanne C Laramie, Kathryn M Smolinski
Questions from patients about pain conditions and analgesic pharmacotherapy and responses from authors are presented to help educate patients and make them more effective self-advocates. In response to a question about advance directives for a patient experiencing chronic pain, the authors discuss the importance of having legal documents in place.
January 9, 2019: Journal of Pain & Palliative Care Pharmacotherapy
https://read.qxmd.com/read/30596459/a-cost-and-quality-analysis-of-utilizing-a-rectal-catheter-for-medication-administration-in-end-of-life-symptom-management
#13
Natalie M Latuga, Mary Gordon, Paula Farwell, Megan O Farrell
Technology that can improve the ability to provide quick symptom control while decreasing the cost and burden of care could help hospice agencies deal with current hospice industry challenges. This paper describes how the use of a new rectal medication delivery technology at a large hospice in western New York has improved patient care and nursing efficiency while at the same time decreasing the cost of care.
December 31, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://read.qxmd.com/read/30592628/a-case-of-opioid-induced-hyperalgesia
#14
Jillian Wall, Alpna Chauhan
We report the case of a 76 year old lady with metastatic breast cancer, who presented to a hospice in severe distress from uncontrolled pain despite an increase in her opioid dose, alongside generalised hypersensitivity and delirium. The clinical presentation suggested opioid-induced hyperalgesia (OIH). After reduction of the opioid dose, our patient significantly improved to the extent she was discharged home a few weeks later. This report aims to increase awareness of OIH, a clinical phenomenon which remains poorly understood and probably under recognised...
December 28, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://read.qxmd.com/read/30589375/a-preliminary-study-of-pain-relieving-dressings-for-older-adults-with-chronic-leg-ulcers-from-the-provider-s-perspective-a-qualitative-study
#15
Rachael Docking, Joshua Boateng, Ovidio Catanzano, Patricia Schofield
Prevalence of leg ulcers increases with age due to an increase in risk factors, including immobility and venous disease. With an increasingly aging population, therefore, the number of older adults with leg ulcers is increasing. Older adults with leg ulcers experience frequent pain and discomfort, and yet pain in this population is poorly managed. The aim of this study was to explore the feasibility of the use of analgesic dressings in older adults with leg ulcers, including their perception of current pain management, feasibility of an analgesic dressing, and potential challenges...
December 27, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://read.qxmd.com/read/30589369/retrograde-intrathecal-drug-delivery-a-report-of-three-cases-for-the-management-of-cancer-related-sacropelvic-pain
#16
Uri Hochberg, Jordi Perez
We report three cases of sacral and pelvic pain resistant to oral medications successfully managed with intraspinal drug delivery through a catheter placed at the intrathecal sacral space to deliver low doses of bupivacaine and fentanyl with local effects.
December 27, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://read.qxmd.com/read/30395777/a-treatment-for-refractory-high-ileostomy-output
#17
Shana Semmens, Elizabeth Higgins, Patrick Coyne
We present a case where the glucagon-like peptide 2 (GLP-2) analog teduglutide was used successfully to decrease high ostomy output due to short bowel syndrome in a patient not entirely dependent on parenteral nutrition. Short bowel syndrome is known to decrease quality of life and is associated with high health care costs. Although use has been limited by cost, teduglutide appears to be a treatment option for palliative care practice if patients suffer from short bowel syndrome.
November 5, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://read.qxmd.com/read/30380977/intravenous-chlorpromazine-for-the-short-term-treatment-of-insomnia-in-end-stage-cancer-patients-with-difficulty-in-oral-administration
#18
Hideaki Hasuo, Ryohei Fujii, Kazuki Uchitani, Hiroko Sakuma, Kenji Kanbara, Mikihiko Fukunaga
The objective of the study was to evaluate effectiveness and safety of intravenous chlorpromazine for the short-term treatment of insomnia in end-stage cancer patients. Insomnia occurs as one of distressing symptoms in 70% of end-stage cancer patients. End-stage cancer patients often have difficulty in oral administration because of disease progress. We retrospectively evaluated 30 end-stage cancer patients with difficulty in oral administration who received intravenous chlorpromazine for the short-term treatment of insomnia...
October 31, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://read.qxmd.com/read/30380966/comment-on-gressler-et-al-serotonin-syndrome-in-tapentadol-literature-systematic-review-of-original-research
#19
Tatjana Radic, Ariane Stollenwerk, Christian Elling
No abstract text is available yet for this article.
October 31, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://read.qxmd.com/read/30198819/prescription-drug-monitoring-programs-relationships-among-program-awareness-use-and-state-mandates
#20
Kristi Skeel Williams, Selena Magalotti, Karyssa Schrouder, Michele Knox, Lance Feldman, Deepa Ujwal, Denis Lynch
The inappropriate use of opioids in the United States has increased markedly and has resulted in a tragic loss of lives. To combat this problem, prescription drug monitoring programs (PDMPs) have been instituted in most states. Use of the programs is voluntary for prescribers in some states, whereas in other states it is mandatory. The current study used a self-report survey instrument that was administered to 223 participant physicians. The goal of the study was to compare awareness and use of the PDMP in a state that mandates use (Ohio) with one that does not (North Carolina)...
September 10, 2018: Journal of Pain & Palliative Care Pharmacotherapy
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