Cases: "Do you have something stronger than this dilaudid?" The case for opioid rotation
Discussion:
Opioid rotation, or trial of an alternative opioid, is commonly practiced when a patient’s pain responds poorly to one opioid or intolerable side effects develop. These intolerable side effects may include nausea, vomiting, sedation, or even hyperalgesia. Although rotation is a common practice, a Cochrane review in 2004 found that evidence to support the practice for opioid rotation was anecdotal and in non-controlled studies. Randomized trials were suggested. Since that time, several prospective studies have been performed where opioid analgesic effect was inadequate or side effects to the opioid were intol...
Source: Pallimed: A Hospice and Palliative Medicine Blog - September 6, 2013 Category: Palliative Carer Workers Authors: Christian Sinclair Source Type: blogs
Pain Predicament
A family doctor calls to give us a heads up about a patient coming to the emergency department. He was obviously upset and sounded frustrated. He started in with the story …
I used some lidocaine a pair of tweezers, and some small scissors to remove a small lesion from a patient’s tongue. There was a little bleeding afterwards, but that seemed to stop with pressure. Then the patient said that it felt like her tongue was swelling. I thought it was from the lidocaine, so I kept her in the office and watched her for a half hour, then sent her home. They wanted some pain medication. She was allergic to codeine, so I presc...
Source: WhiteCoat's Call Room - July 31, 2013 Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: Patient Encounters Source Type: blogs
Funny Allergy Quotes, Jokes, Stories and a List of Crazy Reactions.
If you're looking for funny allergy quotes, jokes and stories you've come to the right place. I asked my readers from facebook to provide me with their experiences they've had regarding crazy allergy reactions and they did not let me down. They relayed dozens of incidents they've experienced through the years. Over the years I've discovered several funny allergies myself, including allergies to prednisone, diet products and the color red. Some patients have dozens of allergies. My experience is that most of these allergies are not allergies in the physiological sense. The te...
Source: The Happy Hospitalist - July 2, 2013 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs
The Mental Health of Lonely Marijuana Users
This study contained some limitations. First, it only assessed self-ratings of both self-worth and mental health. If marijuana use weakens the relationship between social pain and self-reported psychological well-being, then there should also be a lower rate of validated clinical diagnoses of poor psychological well-being.. . .To address the limitation of Study 1, Study 2 sought to show that marijuana buffered lonely participants from experiencing a standardized diagnosis of poor psychological well-being. Study 2 used a different nationally representative sample from Stu...
Source: The Neurocritic - May 22, 2013 Category: Psychiatrists and Psychologists Authors: The Neurocritic Source Type: blogs
Medications that Increase the Risks of Patient Falls
Falls are the leading cause of both fatal and non-fatal injuries for adults 65 and older.
Alzheimer's Reading Room
“Falls are the leading cause of both fatal and non-fatal injuries for adults 65 and older, and research suggests that those taking four or more medications are at an even greater risk than those who don’t – perhaps two to three times greater,” said Susan Blalock, Ph.D., an associate professor at the UNC Eshelman School of Pharmacy.
In 2007, more than 21,700 Americans died as a result of falls and more than 7.9 million were injured by a fall including over 1.8 million older adults who had a fall-rela...
Source: Alzheimer's Reading Room, The - February 14, 2013 Category: Dementia Authors: Bob DeMarco Source Type: blogs
Gray Days
It's been a rough 1.2 weeks. Begun,of course, with a sore throat & a mild cough,moved to the runny nose, followed by the 101 degree fevers & the addition of some hard core throat pain, losing my taste on Super Bowl Sunday,(I did not go to the party & how sad is that,when the whole of Baltimore was stark Raven mad?Methinks it may never happen again ) The cough set in & Sunday night I probably got two hours of sleep. Monday I went to the doc & they gave me codeine syrup & an antibiotic for my "sinus infection." Sinus infection-really? Yep,within a day my head felt like a literal bomb & the discharge turned a disgusting color...
Source: The D-Log Cabin - February 7, 2013 Category: Diabetes Authors: HVS Source Type: blogs
Drugs for Diabetes Pain
By David Spero
Pain researcher Rebecca Sudore, MD, says, "Adults living with Type 2 diabetes are suffering from incredibly high rates of pain, at levels similar to patients living with cancer." Sounds awful. But what can we do about it? Actually, quite a bit.
Let's look at medications first. Because chronic pain involves emotions, thoughts, stress, general health, and the entire body, there are at least six different categories of drugs that can help with pain. They include: narcotics, anxiolytics (“tranquilizers"), antidepressants, anti-inflammatories, medicines for seizures, and alternative treatments.
With all tho...
Source: Diabetes Self-Management - February 6, 2013 Category: Diabetes Authors: David Spero Source Type: blogs
Is Codeine Safe for Children?
More than half a million tonsillectomies are performed each year on children in the U.S. More than sixty percent of those children report significant pain in the days that follow. Acetaminophen with codeine is in widespread use for post-operative pain, but the U.S. Food and Drug Administration is now investigating the safety of codeine for post-operative pain relief in children following reports of three deaths in children related to its use after tonsil surgery.
Kids deserve pain relief, both for comfort and to speed up healing — pain negatively impacts breathing and kids are less likely to eat and drink after surge...
Source: Conversations with Dr Greene - August 15, 2012 Category: Child Development Authors: Dr. Alan Greene Tags: Dr. Greene's Blog Handling Fear & Pain Medical Treatment OTC Meds Parenting Safety Source Type: blogs
