Journals Journal of Pain & Palliative C...

Journal of Pain & Palliative Care Pharmacotherapy
Ngozi A Okoroma, Phap Nguyen, Eric J Roeland, Joseph D Ma
The Commercially Insured health Plan Risk Index for Overdose or Serious Opioid-induced Respiratory Depression (CIP-RIOSORD) is an evidence-based tool to determine serious opioid-induced respiratory depression (OIRD) or overdose risk. The CIP-RIOSORD total score determines a risk class and estimates the probability for an OIRD event within the next 6 months. We performed a single-center, retrospective analysis to determine CIP-RIOSORD baseline scores and the most common predictive factors in patients with cancer...
May 9, 2024: Journal of Pain & Palliative Care Pharmacotherapy
Yoshihiro Yamamoto, Hiroaki Watanabe, Norio Watanabe, Yasuyuki Asai, Motozumi Ando, Masami Kawahara, Yuko Deguchi, Takuya Odagiri
Myoclonus is a relatively rare involuntary movement that is often observed in palliative care settings and that can cause patient distress. The purpose of this study is to investigate the occurrence of myoclonus and countermeasures against it in terminally ill patients with cancer diagnosed by palliative care specialists at Komaki City Hospital, Japan. We retrospectively reviewed patients with terminal cancer who received palliative care consultations between January 2018 and May 2019 and who were diagnosed with myoclonus by palliative care specialists, using electronic medical records...
May 9, 2024: Journal of Pain & Palliative Care Pharmacotherapy
Lana Ferguson, Stacey Hooper
This report describes the use of subcutaneous lidocaine infusion to manage complex pain associated with checkpoint inhibitor inflammatory arthritis. In addition, the safe administration of lidocaine in the home setting is described. A 49-year-old man with metastatic melanoma to lung, right axilla and posterior chest wall on regular pembrolizumab developed checkpoint inhibitor inflammatory arthritis. Pain associated with this was unresponsive to simple analgesia, escalating opioids and adjuvant analgesics. Lidocaine infusion was used on separate occasions (inpatient unit and home setting) to gain rapid and sustained control of inflammatory pain...
May 8, 2024: Journal of Pain & Palliative Care Pharmacotherapy
Emilie Chan, Coleton Waggoner, Paul M Boylan
Methocarbamol is an antispasmodic muscle relaxant and was the fourth most-prescribed muscle relaxant by volume in the United States in 2021. Intravenous (IV) methocarbamol contains the excipient, polyethylene glycol (PEG), which has been implicated in metabolic acidosis and nephrotoxicity. Intravenous methocarbamol was first approved by the US Food and Drug Administration in 1959 and at that time the IV methocarbamol prescribing information warned of PEG-associated adverse drug events in patients living with renal impairment; however, the manufacturer acknowledged data were lacking to objectively support this claim...
May 8, 2024: Journal of Pain & Palliative Care Pharmacotherapy
Ann Francis, Simon Erridge, Carl Holvey, Ross Coomber, Wendy Holden, James Rucker, Michael Platt, Mikael Sodergren
Osteoarthritis accounts for 0.6% of disability-adjusted life years globally. There is a paucity of research focused on cannabis-based medicinal products (CBMPs) for osteoarthritic chronic pain management. This study aims to assess changes in validated patient-reported outcome measures (PROMs) and CBMP clinical safety in patients with osteoarthritis. A prospective case series from the UK Medical Cannabis Registry was analyzed. Primary outcomes were changes in the Brief Pain Inventory (BPI), McGill Pain Questionnaire (MPQ2), EQ-5D-5L, Generalized Anxiety Disorder-7 (GAD-7) questionnaire, and Single-Item Sleep Quality Scale (SQS) at 1-, 3-, 6-, and 12-month follow-ups from baseline...
April 26, 2024: Journal of Pain & Palliative Care Pharmacotherapy
Atefe Salimi Akinabadi, Sorour Khari, Mehdi Azizmohammad Looha, Mitra Zandi
Mental imagery and relaxation are noninvasive methods and can easily be used by the patient. Accordingly, this study aimed to detect the effect of guided mental imagery (GI) and progressive muscle relaxation (PMR) on sedation in patients undergoing noninvasive mechanical ventilation (NIV). This clinical trial study was carried out in the Shahid Modarres Hospital in 2022 and encompassed 80 patients with COVID-19 undergoing NIV, who were assigned to two intervention and control groups. The sedation survey scale was used to collect the required data...
April 26, 2024: Journal of Pain & Palliative Care Pharmacotherapy
Anuja Damani, Arunangshu Ghoshal, Raghu Thota, Parmanand N Jain
Pain management constitutes a pivotal aspect of palliative care. Certain instances of distressing pain are significantly relieved through interventional pain methodologies, demanding the expertise of pain specialists. Our perspective revolves around the integration of these 2 facets, envisaging a symbiotic relationship that could enhance patient outcomes. A prospective assessment was carried out within a collaborative clinic, uniting the realms of pain management and palliative medicine. Anonymized patient information was scrutinized to grasp the advantages of this amalgamation and identify strategies to address any inherent deficiencies...
April 1, 2024: Journal of Pain & Palliative Care Pharmacotherapy
Samantha Grable, Gary Houchard, Zach Rossfeld
Alpha-2 agonists are under-recognized for their class effects yet offer potential benefit in specialty palliative care via decreasing sympathetic output, inducing sedation, and modulating pain. Especially in clinical contexts where agitation predominates and patients are intolerant of oral medication route, transdermal medication delivery is advantageous. We report a case of agitated behaviors in setting of mixed Alzheimer/vascular-type dementia limiting hospital discharge to nursing facility that were ameliorated with transdermal clonidine...
March 14, 2024: Journal of Pain & Palliative Care Pharmacotherapy
Rajeev Shrestha, Sunil Shrestha
Palliative care is essential for life-threatening illnesses. However, Nepal still faces significant challenges in accessing primary palliative care services, including required medications, particularly in rural areas. This commentary highlights the need for policies and guidelines to ensure equitable access to palliative care with medicines. While limited studies in Nepal confirmed the demand, challenges persist in rural areas with deficient access to quality healthcare. This article discusses the existing efforts and noteworthy initiatives implemented by healthcare institutions...
March 5, 2024: Journal of Pain & Palliative Care Pharmacotherapy
Miguel Julião, Patrícia Calaveiras, Eduardo Bruera, Paulo Faria de Sousa
Subcutaneous patient-controlled analgesia (SCPCA) in home-based palliative care is a potentially valuable option for providing effective pain relief to some patients, particularly when conventional analgesic approaches prove ineffective or are refused. Our case report illustrates the use of SPCA for the management of breakthrough pain in a patient receiving palliative care at home with no improvement after multiple previous treatments. SCPCA was found to be safe and successful. Future research is essential to explore its precise role, appropriate indications, prescription guidelines, and safety considerations across various palliative care contexts...
February 26, 2024: Journal of Pain & Palliative Care Pharmacotherapy
Miranda Hetrick
No abstract text is available yet for this article.
February 21, 2024: Journal of Pain & Palliative Care Pharmacotherapy
Khaled AlGhamdi, Kim Sadler
Chronic pain in children continues to pose significant challenges. The pharmacological approach most often revolves around trials and errors, expert opinions, and extrapolation of adult study findings. Ketamine is one of the agents used for chronic pain, especially with a neuropathic component. This article aims to provide an overview of its properties and highlight the current evidence for its use in malignant and nonmalignant chronic pain management. A search on the use of ketamine for chronic pain in children up to 18 years of age covering the period from January 1, 2000, to December 14, 2022, was performed through PubMed, Cochrane Library, EBSCO, EBM Review, Wiley, BMJ, Web of Science, Google Scholar, and the Saudi Digital Library...
March 2024: Journal of Pain & Palliative Care Pharmacotherapy
Kenneth Skov, Astrid Lyager
We present two cases, in which end-of-life patients were inadvertently treated with bolus infusions of undiluted subcutaneous levetiracetam. The patients were treated for three and four days respectively. In both cases, the course of treatment was uneventful. Especially, no seizures, nor local irritation was observed. Administration of undiluted subcutaneous levetiracetam as intermittent bolus infusions by hand holds alluring properties for end-of-life patients. Amongst others reducing patient discomfort, increasing freedom of movement, and accessibility to essential seizure prophylaxis by eliminating the need for a syringe driver, thereby helping accommodate many patients wish to die in their own home...
February 12, 2024: Journal of Pain & Palliative Care Pharmacotherapy
Laura Meyer-Junco
No abstract text is available yet for this article.
February 12, 2024: Journal of Pain & Palliative Care Pharmacotherapy
Swarali Yatin Chodnekar, Nityanand Jain, Edouard Lansiaux, Deepkanwar Singh Panag, Valdis Gibietis
While morphine is the recommended first-line treatment for pain management in patients with acute coronary syndrome, recent studies have raised concerns about its association with adverse outcomes. Morphine has been found to cause delayed antiplatelet effects, decreased ticagrelor absorption, increased platelet reactivity, and compromised efficacy of dual antiplatelet therapy (DAPT). Alternative analgesics, such as lidocaine, fentanyl, and acetaminophen, have begun to emerge as viable alternatives, each with unique mechanisms and potential benefits...
February 8, 2024: Journal of Pain & Palliative Care Pharmacotherapy
Madison N Irwin, David A Cooke, Daniel Berland, Vincent D Marshall, Michael A Smith
Naltrexone is a mu-opioid receptor antagonist increasingly used as an analgesic for chronic pain at low doses. This retrospective, observational cohort study was conducted at an academic medical center to evaluate low-dose naltrexone (LDN) efficacy and describe its use in routine clinical practice. Adults receiving LDN, doses <10 mg for ≥1 month, seen at an outpatient pain clinic from January 1, 2014 to April 1, 2022 were included. The primary outcome was change in the Pain, Enjoyment of Life, and General Activity (PEG) score after LDN...
February 1, 2024: Journal of Pain & Palliative Care Pharmacotherapy
Belal Dakroub, Abigail Brooks, Christine M Vartan, Sandra DiScala
The objective of this quality improvement (QI) project was to assess the impact of an evidence based clinical pharmacist practitioner (CPP) model applied to perioperative pain management by integrating a CPP into the perioperative orthopedic surgery clinical pathway. Secondary objective was to assess the effect of CPP pain management service on surgical team satisfaction. This QI project expanded CPP pain management services for patients who were scheduled for an orthopedic surgery. Surgical provider satisfaction of CPP pain management services was assessed through a provider survey...
January 22, 2024: Journal of Pain & Palliative Care Pharmacotherapy
Katsuya Makihara, Yoshihiro Yamamoto, Masayuki Miyazaki, Maho Taguchi, Junya Sato, Hisamitsu Takase, Yasuhito Uezono
Polypharmacy is becoming increasingly troublesome in the treatment of cancer. The aim of this study was to explore the effects of concomitant polypharmacy comprising drugs that inhibit CYP3A4 and/or CYP2D6 on the oxycodone tolerability in patients with cancer. We conducted a multicenter retrospective study encompassing 20 hospitals. The data used for the study were obtained during the first 2 wk of oxycodone administration. The incidence of oxycodone discontinuation or dose reductions due to side effects and oxycodone-induced nausea and vomiting (OINV) were compared between patients not treated with either inhibitor and those treated with concomitant CYP3A4 or CYP2D6 inhibitors...
January 16, 2024: Journal of Pain & Palliative Care Pharmacotherapy
Gabriela Cerdà, Joaquim Julià-Torras, Jesús González-Barboteo, Margarita Romeo, Agnès Calsina-Berna
QT prolongation is related to the development of ventricular arrhythmias such as Torsade de Pointes (TdP) that can lead to sudden cardiac death. Several drugs used in the treatment of patients with advanced cancer may induce QT prolongation due to their interference with cardiac ion channels. Some patients may be at higher risk if predisposing factors are present. Herein we present the case of a patient with advanced cancer under anti-tumor treatment with radical intention that developed a reversible drug-induced QT prolongation when simultaneously treated with methadone, haloperidol and fluoxetine that presented with chest pain and bradycardia...
January 5, 2024: Journal of Pain & Palliative Care Pharmacotherapy
Angela Riveras, Mirjam Crul, Jozien van der Kloes, Monique Steegers, Bregje Huisman
Treating palliative cancer patients with antithrombotics is challenging because of the higher risk for both venous thromboembolism and major bleeding. There is a lack of available guidelines on deprescribing potentially inappropriate antithrombotics. We have therefore created an antithrombotics scheme to aid in (de)prescribing antithrombotics. A retrospective single-center clinical cohort observational study was performed to evaluate it. Patients with solid tumors with a life expectancy of less than 3 months seen by the palliative team were included...
December 18, 2023: Journal of Pain & Palliative Care Pharmacotherapy
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