Low-Dose Ketamine Infusion for Adjunct Management during Vaso-occlusive Episodes in Adults with Sickle Cell Disease: A Case Series.
This article reports a retrospective case series of five patients admitted to the intensive care unit (ICU) with prolonged vaso-occlusive episodes (VOEs). Patients were treated with a continuous-infusion of low-dose ketamine (up to 5 µg/kg/min) after insufficient pain control with opioid analgesic therapy. Outcomes studied included impact on opioid analgesic use, a description of ketamine dosing strategy, and an analysis of adverse events due to opioid or ketamine analgesia. Descriptive statistics are provided. During ketamine infusion, patients experienced a lower reported pain score (mean numeric rating scale ...
Source: Journal of Pain and Palliative Care Pharmacotherapy - May 25, 2018 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Provider Perspectives on Topical Analgesics.
Authors: Smith MA, Cho K, Rodgers P Abstract Topical analgesics are effective and alternative means to systemic therapy, often minimizing the adverse drug effects and complications of systemic analgesic use. Despite the number of available topical analgesics, there is little direction provided in practice guidelines on their appropriate use and little is known about patterns of their prescribing. To begin understanding these knowledge gaps, we sought provider perspectives on topical analgesic use at a large academic medical center. This electronic survey seeks to explore the perceptions and prescription patterns of...
Source: Journal of Pain and Palliative Care Pharmacotherapy - May 24, 2018 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Successful Improvement of Pain Symptomatology in a Suspected Case of Cramp-Fasciculation Syndrome via Interventional Pain Treatment.
Authors: Gupta A, First L, Swain CA Abstract Peripheral nerve hyperexcitability (PNH) syndromes are a rare set of neuromuscular disorders that include cramp-fasciculation syndrome (CFS) and Isaacs syndrome (IS). Successful treatment of these diseases has been achieved with antiepileptic medications; however, chronic pain symptoms can persist. We provide a case report of a 25-year-old female who has suffered from painful severe muscle spasms and fasciculations since childhood. With CFS as our working diagnosis, a treatment regimen using interventional pain techniques, including sympathetic chain blocks, ketamine inf...
Source: Journal of Pain and Palliative Care Pharmacotherapy - May 19, 2018 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Use of Methadone to Reverse Opioid Escalation in a Patient With Surgical Pain.
Authors: Jaffar M, Cunningham G, Chandler M, Webb T Abstract Acute pain is a prevalent issue for patients recovering from surgical procedures. Methadone has been recognized as a unique option for treatment of surgical pain due to its multiple mechanisms of analgesia and its potential to decrease tolerance to other opioids. Studies of methadone use in postoperative settings are sparse in part due to safety concerns, such as complex pharmacokinetics, risk of respiratory depression, and association with arrhythmias. In this case study of a 70-year-old male with postsurgical abdominal pain, methadone utilization over a...
Source: Journal of Pain and Palliative Care Pharmacotherapy - May 18, 2018 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Prescribing Trends of Palliative Care Team's Use of Dexamethasone for Cancer-Related Pain.
Authors: Barghi K, Edmonds KP, Ajayi TA, Atayee RS Abstract Opioids are first-line therapy for cancer-related pain. In addition, corticosteroids are commonly utilized as adjuvant analgesics for pain and other symptoms in the oncology setting with limited supporting data. A retrospective analysis was conducted evaluating adult hospitalized patients receiving opioids who received once-daily dexamethasone on the recommendation of a specialty palliative care team during their hospitalization from January 1, 2015, to January 1, 2016. Primary end point was to describe prescribing patterns of dexamethasone in this patient...
Source: Journal of Pain and Palliative Care Pharmacotherapy - May 9, 2018 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Case Report: Utility of Ketamine, Lidocaine, and Mexiletine as Nonopioid Adjuvants in Complex Cancer-Associated Pain.
Authors: Hakim RC, Edmonds KP, Atayee RS Abstract Ketamine, lidocaine, and mexiletine are potential nonopioid adjuvant medications for the use of refractory cancer-related pain, particularly when opioids are demonstrating limited objective benefit. This is a case report of a single patient admitted to a large academic medical center in the United States. The patient is a 43-year-old woman with a history of Crohn's disease complicated by rectal squamous cell carcinoma and complex, progressive, and intractable pelvic and rectal pain. Over the course of hospitalization, her pain demonstrated limited opioid responsiven...
Source: Journal of Pain and Palliative Care Pharmacotherapy - May 9, 2018 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Systematic Reviews Published in the Cochrane Library April-May 2017.
This report attempted to identify all relevant reviews published in the 2 months to May 31, 2017. Eight reviews have been identified that have potential relevance for practitioners in pain and palliative medicine. Readers are encouraged to access the full report for any articles of interest, as only a brief commentary is provided. PMID: 29381131 [PubMed - in process] (Source: Journal of Pain and Palliative Care Pharmacotherapy)
Source: Journal of Pain and Palliative Care Pharmacotherapy - February 1, 2018 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Writhing.
Authors: Haroutounian S PMID: 29381132 [PubMed - in process] (Source: Journal of Pain and Palliative Care Pharmacotherapy)
Source: Journal of Pain and Palliative Care Pharmacotherapy - February 1, 2018 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Gabapentin for Cough in Cancer.
Authors: Razzak R, Waldfogel JM, Doberman DJ, Feliciano JL, Smith TJ Abstract Cough is a common problem among cancer patients, especially lung cancer patients. Gabapentin has been shown to be effective in reducing cough number and severity in patients with idiopathic refractory cough. The authors report here the successful use of gabapentin at usual doses to treat cough in cancer patients, including two with lung cancer, with minimal side effects. Gabapentin may be a useful addition to the symptom management toolbox for palliation of cancer symptoms. PMID: 29381133 [PubMed - in process] (Source: Journal of Pain...
Source: Journal of Pain and Palliative Care Pharmacotherapy - February 1, 2018 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Serotonin Syndrome in Tapentadol Literature: Systematic Review of Original Research.
This study aimed to review the literature and identify methodological issues that could lead to inaccurately reported rates of serotonin syndrome associated with tapentadol use. A systematic review of English articles using MEDLINE, Cochrane Controlled Trials Register, and Scopus was performed. Additional studies were identified by cross-referencing article bibliographies. Original research that examined the safety of tapentadol in patients with nonconfounding indications were examined. In total, 22 studies met inclusion criteria. There were 13 randomized clinical trials, 7 open-label trials, and 2 observational studies. A...
Source: Journal of Pain and Palliative Care Pharmacotherapy - January 18, 2018 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Urinary Retention and Medication Utilization on a Palliative Care Unit: A Retrospective Observational Study.
Authors: Bergstra TG, Gutmanis I, Byrne J, Faulds C, Whitfield P, McCallum S, Shadd J Abstract Urinary retention is a common problem at end-of-life that may be a result of medications used to control other symptoms. To determine whether use of retention-causing drugs was associated with catheterization for urinary retention among palliative care unit (PCU) patients, the authors reviewed charts of 91 consecutively admitted patients to a hospital-based PCU. Utilization of eight classes of retention-causing medications (opioids, antidopaminergics, benzodiazepines, anticholinergics, antidepressants, calcium channel ant...
Source: Journal of Pain and Palliative Care Pharmacotherapy - January 18, 2018 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Prevalence of and Comorbid Health Conditions Associated With Pediatric Prescription Opioid Use in the US.
Authors: Banerjee S, Roland CL, Willke R, Mardekian J, Garrison LP Abstract Prescription opioids are among the most effective analgesics to treat moderate to severe pain; however, little is known about the use of prescription opioids in children, particularly those receiving an extended-release formulation for the treatment of chronic pain. In this retrospective study, the authors determined the prevalence of prescription opioid use among 7-17-year-old children and associated comorbid health conditions from 2010 to 2013 using Truven Health MarketScan (MarketScan) and Optum Clinformatics DataMart (Optum). The primar...
Source: Journal of Pain and Palliative Care Pharmacotherapy - December 22, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

A New Publisher and New Opportunities for the Journal.
Authors: Lipman AG PMID: 28792804 [PubMed] (Source: Journal of Pain and Palliative Care Pharmacotherapy)
Source: Journal of Pain and Palliative Care Pharmacotherapy - August 11, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Probiotics to Prevent Antibiotic-Related Diarrhea.
Authors: Abernethy AP PMID: 28792805 [PubMed] (Source: Journal of Pain and Palliative Care Pharmacotherapy)
Source: Journal of Pain and Palliative Care Pharmacotherapy - August 11, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

News and Innovations.
Authors: PMID: 28792806 [PubMed] (Source: Journal of Pain and Palliative Care Pharmacotherapy)
Source: Journal of Pain and Palliative Care Pharmacotherapy - August 11, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

The NIH Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT).
This study was designed to determine if glucosamine and chondroitin are effective for osteoarthritis pain. This report was adapted from an online publication by the National Center for Complimentary and Alternative Medicine of the National Institutes of Health to inform the general public about the GAIT trial and its findings. Participants taking the positive control, celecoxib, experienced statistically significant pain relief versus placebo, about 70% of those taking celecoxib had a 20% or greater reduction in pain versus about 60% for placebo. Overall, there were no significant differences between the other treatments t...
Source: Journal of Pain and Palliative Care Pharmacotherapy - August 11, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

So You've Got Chronic Pain-What's Next?
Authors: Collen MR PMID: 28792808 [PubMed] (Source: Journal of Pain and Palliative Care Pharmacotherapy)
Source: Journal of Pain and Palliative Care Pharmacotherapy - August 11, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

A Review of: "The Weeping Willow: Encounters with Grief".
A Review of: "The Weeping Willow: Encounters with Grief". J Pain Palliat Care Pharmacother. 2008;22(1):65-68 Authors: Glajchen M PMID: 28792809 [PubMed] (Source: Journal of Pain and Palliative Care Pharmacotherapy)
Source: Journal of Pain and Palliative Care Pharmacotherapy - August 11, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

IL10 and Neuropathic Pain.
Authors: Fine PG PMID: 28792810 [PubMed] (Source: Journal of Pain and Palliative Care Pharmacotherapy)
Source: Journal of Pain and Palliative Care Pharmacotherapy - August 11, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Randomized Controlled Trial of Acupuncture for Chronic Neck Pain.
Authors: Abernethy AP Abstract Timely and important studies are reviewed and commentaries provided by leading palliative care clinicians. Symptoms, interventions, mechanisms of action, and treatment-related adverse events addressed in this issue are: acupuncture for neck pain, role of IL-10 in neuropathic pain, treatments for diabetic neuropathy, probiotics for antibiotic-related diarrhea, and risk of fatal drug poisoning with opioid analgesics. PMID: 28792811 [PubMed] (Source: Journal of Pain and Palliative Care Pharmacotherapy)
Source: Journal of Pain and Palliative Care Pharmacotherapy - August 11, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Opioids and Fatal Drug Poisoning.
Authors: Davis M PMID: 28792812 [PubMed] (Source: Journal of Pain and Palliative Care Pharmacotherapy)
Source: Journal of Pain and Palliative Care Pharmacotherapy - August 11, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Systematic Comparison of Interventions for Painful Diabetic Neuropathy.
Authors: Peppin JF PMID: 28792813 [PubMed] (Source: Journal of Pain and Palliative Care Pharmacotherapy)
Source: Journal of Pain and Palliative Care Pharmacotherapy - August 11, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Safety Alert for Fentanyl Buccal Tablets.
Authors: U S Food And Drug Administration Abstract On September 13, 2007, the United States Food and Drug Administration posted a safety alert for fentanyl buccal tablets (Fentora). The announcement and hyperlinks to the Dear Doctor and Dear Healthcare Professional Letters that were distributed by the sponsor are presented. PMID: 28792814 [PubMed] (Source: Journal of Pain and Palliative Care Pharmacotherapy)
Source: Journal of Pain and Palliative Care Pharmacotherapy - August 11, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Evidence-Based Pain Management and Palliative Care in Issue Three for 2007 of The Cochrane Library.
Authors: Wiffen PJ Abstract The Cochrane Library of Systematic Reviews is published quarterly. Issue 3 2007 contains 3197 complete reviews, 1744 protocols for reviews in production and 6312 one-page summaries of systematic reviews published in the general medical literature. In addition there are citations of 503,000 randomized controlled trials, and 9628 cited papers in the Cochrane methodology register. The health technology assessment database contains 6817 citations. This edition of the Library contains 103 new reviews of which 11 have potential relevance for practitioners in pain and palliative medicine. P...
Source: Journal of Pain and Palliative Care Pharmacotherapy - August 11, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Indexed Pain Journals.
Authors: National Library Of Medicine Abstract The U.S. National Library of Medicine (NLM) lists only 19 periodicals in its electronic databases (MEDLINE, PubMed) that are classified as pain journals. Only papers published in journals that are indexed in the databases are accessible through electronic literature searches utilizing those databases. Those 19 journals are listed with their NLM abbreviations and their print and electronic ISSNs. PMID: 28792816 [PubMed] (Source: Journal of Pain and Palliative Care Pharmacotherapy)
Source: Journal of Pain and Palliative Care Pharmacotherapy - August 11, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Conversations on Dying: A Palliative Care Pioneer Faces His Own Death.
Authors: Woodruff R Abstract Editor's Note The journal is delighted to continue a collaboration with the International Association for Hospice and Palliative Care (IAHPC) in publication of book reviews relevant to symptom control in advanced disease. These reviews are adapted from the work of Roger Woodruff, MD, FRACP, FAChPM, an internationally recognized oncologist and palliative care specialist physician from Australia. Dr. Woodruff's reviews appear concurrently or did so previously in the IAHPC Newsletter, which is accessible through the IAHPC Web site: http://hospicecare.com . PMID: 28644746 [PubMed - in p...
Source: Journal of Pain and Palliative Care Pharmacotherapy - June 25, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Pain Management and Prescription Opioid-Related Harms: Exploring the State of the Evidence: Proceedings of a Workshop-In Brief.
Authors: Lipman AG PMID: 28644747 [PubMed - in process] (Source: Journal of Pain and Palliative Care Pharmacotherapy)
Source: Journal of Pain and Palliative Care Pharmacotherapy - June 25, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Paediatric Palliative Medicine, 2nd ed.
Authors: Woodruff R Abstract Editor's Note The journal is delighted to continue a collaboration with the International Association for Hospice and Palliative Care (IAHPC) in publication of book reviews relevant to symptom control in advanced disease. These reviews are adapted from the work of Roger Woodruff, MD, FRACP, FAChPM, an internationally recognized oncologist and palliative care specialist physician from Australia. Dr. Woodruff's reviews appear concurrently or did so previously in the IAHPC Newsletter, which is accessible through the IAHPC Web site: http://hospicecare.com . PMID: 28644748 [PubMed - in p...
Source: Journal of Pain and Palliative Care Pharmacotherapy - June 25, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Breakfast, Lunch, and Dinner.
Authors: PMID: 28644749 [PubMed - in process] (Source: Journal of Pain and Palliative Care Pharmacotherapy)
Source: Journal of Pain and Palliative Care Pharmacotherapy - June 25, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Medical Cannabis for Pain: Anecdote or Evidence.
Authors: Lipman AG PMID: 28644751 [PubMed - in process] (Source: Journal of Pain and Palliative Care Pharmacotherapy)
Source: Journal of Pain and Palliative Care Pharmacotherapy - June 25, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Doctor-Related Medication Safety Incidents on a Specialist Palliative Medicine Inpatient Unit: A Retrospective Analysis of Three Years of Voluntary Reporting.
Authors: O'Brien H, Kiely F, Carmichael A Abstract Patients receiving palliative care and those at the end of life are known to be susceptible to medical errors. Errors related to medications are the most avoidable cause of patient harm. This retrospective study examined reported anonymized medication safety incidents, related to physician errors, assessed by the risk committee in a specialist palliative care unit over a 3-year time period. The aim of the study was to describe medication errors, with specific attention paid to what type of errors occurred and when these errors happened. Of the 218 reported medicati...
Source: Journal of Pain and Palliative Care Pharmacotherapy - June 2, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Systematic Reviews Published in the Cochrane Library January-March 2017.
This report attempted to identify all relevant reviews published in the last 3 months to March 30, 2017. The current version contains 7243 complete reviews and 2544 protocols for reviews in production. In addition, there are citations of 1,036,153 randomized controlled trials (first time passing the million mark) and 15,700 cited papers in the Cochrane Methodology Register. The Health Technology Assessment database contains some 17,000 citations. Six reviews have been identified that have potential relevance for practitioners in pain and palliative medicine. The impact factor of the Cochrane Library stands at 6.1. Rea...
Source: Journal of Pain and Palliative Care Pharmacotherapy - May 20, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Propofol-Based Palliative Sedation to Treat Antipsychotic-Resistant Agitated Delirium.
Authors: Covarrubias-Gómez A, López Collada-Estrada M Abstract Delirium is a common problem in terminally ill patients that is associated with significant distress and, hence, considered a palliative care emergency. The three subtypes of delirium are hyperactive, hypoactive, and mixed, depending on the level of psychomotor activity and arousal disturbance. When agitated delirium becomes refractory in the setting of imminent dying, the agitation may be so severe that palliative sedation (PS) is required. Palliative sedation involves the administration of sedative medications with the purpose of reducin...
Source: Journal of Pain and Palliative Care Pharmacotherapy - May 17, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Complications of Psychotropic and Pain Medications in an Ultrarapid Metabolizer Patient at the Upper 1% of Cytochrome P450 (CYP450) Function Quantified by Combinatorial CYP450 Genotyping.
Authors: Ruaño G, Larsen K, Kocherla M, Graydon JS, Kost J Abstract A 44-year-old Caucasian woman presented with a history of empirical treatment with 20 pain and psychotropic medications, as well as dual comorbidity of intractable pain and depression. A multiple gain-of-function profile in the CYP450 family of cytochrome P450 (CYP450) drug metabolism isoenzymes was discovered. The patient was a homozygote of suprafunctional alleles for both CYP2D6 ((*)35/(*)35) and CYP2C19 ((*)17/(*)17) genes and functional alleles for CYP2C9 ((*)1/(*)1), which account for aggregate drug metabolism function at the upper 1% ...
Source: Journal of Pain and Palliative Care Pharmacotherapy - May 17, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Intrathecal Injection of Gadobutrol: A Tale of Caution.
We report a case of an intrathecal gadobutrol injection resulting in neurotoxic manifestations.A 60-year-old female with a history significant for lumbar post-laminectomy syndrome and intrathecal drug delivery implantation was admitted for lumbar fusion and kyphoplasty. Postoperatively, the patient had escalating pain medication requirements. A pump and intrathecal catheter contrast study was completed to assess the integrity and proper placement of the intrathecal catheter. Due to patient.s allergy to iodinated contrast, the physician requested gadolinium contrast dye. Unknown to the staff was that Magnevist had recently ...
Source: Journal of Pain and Palliative Care Pharmacotherapy - May 12, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Benefits of Thoracic Epidural Analgesia in Patients Undergoing an Open Posterior Component Separation for Abdominal Herniorrhaphy.
In conclusion, for patients undergoing an open PCS, the inclusion of TEA in the postoperative analgesic regimen did not by itself hasten the return of bowel function. However, when TEA was utilized and systemic opioids were avoided, bowel recovery occurred significantly sooner and resulted in a shortened hospital LOS. PMID: 28489476 [PubMed - as supplied by publisher] (Source: Journal of Pain and Palliative Care Pharmacotherapy)
Source: Journal of Pain and Palliative Care Pharmacotherapy - May 12, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Combined Sciatic and Lumbar Plexus Nerve Blocks for the Analgesic Management of Hip Arthroscopy Procedures: A Retrospective Review.
Authors: Jaffe JD, Morgan TR, Russell GB Abstract Hip arthroscopy is a minimally invasive alternative to open hip surgery. Despite its minimally invasive nature, there can still be significant reported pain following these procedures. The impact of combined sciatic and lumbar plexus nerve blocks on postoperative pain scores and opioid consumption in patients undergoing hip arthroscopy was investigated. A retrospective analysis of 176 patients revealed that compared with patients with no preoperative peripheral nerve block, significant reductions in pain scores to 24 hours were reported and decreased opioid consumpt...
Source: Journal of Pain and Palliative Care Pharmacotherapy - May 12, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Continuous Intravenous Lidocaine Infusion for the Management of Pain Uncontrolled by Opioid Medications.
The objective of this study was to evaluate the effect of use of continuous lidocaine infusions for pain management at a community teaching hospital. A retrospective chart review was performed that included adult patients receiving continuous systemic lidocaine infusions for the treatment of pain. Twenty-one patients were included in the analysis. Dosing ranged from 0.25 to 2.8 mg/kg/h, with a median infusion time of 64 hours. Eight patients (38%) experienced a response (≥20% reduction in pain score during the infusion compared with prior to the infusion). Among responding patients, there was a decrease in pai...
Source: Journal of Pain and Palliative Care Pharmacotherapy - May 12, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Ischemic Ulcer Pain Is Both Nociceptive and Neuropathic Pain Based on a Discriminant Function Analysis Using the McGill Pain Questionnaire.
Authors: Kogure T, Sumitani M, Abe H, Hozumi J, Inoue R, Mietani K, Kawahara K, Yamada Y Abstract The McGill Pain Questionnaire (MPQ) is composed of 78 words reflecting the mechanisms underlying chronic pain conditions. Ischemic ulcer pain is generally regarded as a nociceptive and inflammatory pain condition. However, it is sometimes refractory to nonsteroidal anti-inflammatory drug (NSAID) and opioid treatment. We categorized ischemic pain into nociceptive/inflammatory pain (NocP) or neuropathic pain (NeP), on the basis of patients' descriptions of their pain using the MPQ. We investigated pain characteristics of...
Source: Journal of Pain and Palliative Care Pharmacotherapy - April 26, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Oral Versus Topical Diclofenac Sodium in the Treatment of Osteoarthritis.
Authors: Tieppo Francio V, Davani S, Towery C, Brown TL Abstract Osteoarthritis (OA) is one of the most common causes of joint pain in the United States and non-steroidal anti-inflammatories (NSAIDs), such as Diclofenac sodium, which is currently available in two main routes of administration; oral and topical distribution have been established as one of the standard treatments for OA. Generally, oral NSAIDs are well tolerated; however our narrative review suggests that the topical solution had a better tolerability property than oral Diclofenac sodium, especially due to side effects of gastrointestinal bleeding wi...
Source: Journal of Pain and Palliative Care Pharmacotherapy - April 9, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Pain Management of Malignant Psoas Syndrome Under Epidural Analgesia During Palliative Radiotherapy.
Authors: Ota T, Makihara M, Tsukuda H, Kajikawa R, Inamori M, Miyatake N, Tanaka N, Tokunaga M, Hasegawa Y, Tada T, Fukuoka M Abstract Malignant psoas syndrome is a rare malignant condition presenting as lumbosacral plexopathy and painful fixed flexion of the hip. Metastasis to the psoas muscle is observed, which damages the nerve bundles in the lumbosacral plexuses. The syndrome presents as refractory lower back pain with several other neurological symptoms. The pain is difficult to control because it is a mixture of nociceptive and neuropathic pain, which indicates that treatment requires a versatile approach. Th...
Source: Journal of Pain and Palliative Care Pharmacotherapy - April 6, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

The Risks of Chronic Corticosteroid Exposure.
This article focuses on the use of corticosteroids to decrease inflammation and treat painful conditions as well as their long-term side effects and risks. Their long-term use can expose the body to side effects and can cause long-term health concerns. It therefore is important to be aware of the risks of long-term corticosteroid use. PMID: 28375794 [PubMed - as supplied by publisher] (Source: Journal of Pain and Palliative Care Pharmacotherapy)
Source: Journal of Pain and Palliative Care Pharmacotherapy - April 6, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Pathophysiology of Trigger Points in Myofascial Pain Syndrome.
Authors: Money S Abstract 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. Trigger point pathophysiology in myofascial pain syndrome, which involves muscle stiffness, tenderness, and pain that radiates to other areas of the body, is considered. The causes of trigger points and several theories about how they develop are reviewed, and treatment approaches, including stretching, physical therapy, dry needling, and injections, are offered. PMID: 28379050 [PubMed - as supplied by...
Source: Journal of Pain and Palliative Care Pharmacotherapy - April 6, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Intractable Acute Pain Related to Fluoroquinolone-Induced Peripheral Neuropathy.
Authors: Danesh A, Onyima C, Dukewich M, Gupta A Abstract Fluoroquinolones are widely prescribed antibiotics, used for various infectious etiologies. These antibiotics carry the possibility of the serious adverse effect of peripheral neuropathy, with a true incidence not known owing to its rare existence. Recently, the Food and Drug Administration (FDA) has required alterations to drug labels to highlight this adverse effect of fluoroquinolones. This is a case report of a single patient at an inpatient neurology service at an urban academic medical center in the United States. The patient is a 20-year-old male, wit...
Source: Journal of Pain and Palliative Care Pharmacotherapy - March 31, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Effectiveness of Corticosteroid Monotherapy for Dyspnea Relief in Patients with Terminal Cancer.
In this study, we retrospectively investigated whether corticosteroid monotherapy was effective for dyspnea palliation. The effectiveness rate of corticosteroid therapy was 45% in nine male and two female study subjects (mean age: 74.5 years; range: 64-86 years). No significant differences were found between responders and nonresponders in the first-day corticosteroid doses (25.5 ± 10.86 vs. 36.1 ± 16.39 mg, P = .29) or doses administered on 2 days (47.7 ± 25.99 vs. 72.2 ± 32.78 mg, P = .25). The mean ± standard error assessment score changed significantly from 2....
Source: Journal of Pain and Palliative Care Pharmacotherapy - March 31, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Strong in the Face of Adversity.
Authors: Binoy S Abstract Palliative care provides holistic care to individuals in life-threatening or life-limiting conditions. This narrative describes the journey of Kanchan. A strong lady and a doting mother, she came to the hospital by choice, in immense pain and with swelling. Her narrative illustrates how the palliative approach draws out the inner strengths of individuals by focusing on their issues and needs. Kanchan was able to benefit from physiotherapy to reduce the risk of lymphoedema after surgery for breast cancer. Her narrative illustrates how she found comfort and relief, ably supported by the dedi...
Source: Journal of Pain and Palliative Care Pharmacotherapy - March 28, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

One Needle is Better Than Two: The Philosophy Surrounding Use of Local Anesthesia in Northern India.
Authors: Story M Abstract The author, an internal medicine resident in the United States, participated in an international elective through her postgraduate training program in a rural hospital in northern India. While performing a thoracentesis, she notes that local anesthesia has not been administered, which is seemingly the standard of care at this hospital. Several questionnaire studies about pain services and pain management in India are reviewed, and they reveal insights and severe limitations to effective management of hospitalized patients' pain. PMID: 28346035 [PubMed - as supplied by publisher] (Sourc...
Source: Journal of Pain and Palliative Care Pharmacotherapy - March 28, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Book and Media Reviews.
Authors: Woodruff R Abstract Editor's Note The journal is delighted to continue a collaboration with the International Association for Hospice and Palliative Care (IAHPC) in publication of book reviews relevant to symptom control in advanced disease. These reviews are adapted from the work of Roger Woodruff, MD, FRACP, FAChPM, an internationally recognized oncologist and palliative care specialist physician from Australia. Dr. Woodruff's reviews appear concurrently or did so previously in the IAHPC Newsletter, which is accessible through the IAHPC Web site: http://hospicecare.com. PMID: 28287349 [PubMed - in pr...
Source: Journal of Pain and Palliative Care Pharmacotherapy - March 15, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

FDA Expands List of "Do Not Compound" Drug Products.
FDA Expands List of "Do Not Compound" Drug Products. J Pain Palliat Care Pharmacother. 2017 Mar;31(1):76-78 Authors: Food and Drug Administration, Public Health Service, U.S. Department of Health and Human Services Abstract EDITOR'S ABSTRACT On October 3, 2016, the U.S. Food and Drug Administration published in the Federal Register an expanded list of drug products that are not to be used in compounding extemporaneous dosage forms. This list contains numerous analgesic or anti-inflammatory agents and other chemicals sometimes used to manage pain and related symptoms. Because pharmacies are li...
Source: Journal of Pain and Palliative Care Pharmacotherapy - March 15, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Zoledronic Acid Treatment in Primary Bone Marrow Edema Syndrome.
Authors: Flores-Robles BJ, Sanz-Sanz J, Sanabria-Sanchinel AA, Huntley-Pascual D, Andréu Sánchez JL, Campos Esteban J, Blanco R, Merino-Argumanez C, Espinosa-Malpartida M, Ramos-Giráldez MC, Godoy-Tundidor H, Jiménez-Palop MM, Barbadillo Mateos C, Villa-Alcázar LF, Isasi CM, Mulero JB Abstract Primary bone marrow edema syndrome (BMES) is characterized by the combination of joint pain and distinctive magnetic resonance imaging changes. It has been suggested that the use of bisphosphonate drugs reduce symptom severity. Our objective was to review cases of patients diagnosed with BME...
Source: Journal of Pain and Palliative Care Pharmacotherapy - March 15, 2017 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research