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Naldemedine-induced opioid withdrawal with restlessness as the predominant symptom in a palliative care setting
We report a terminally ill cancer patient who was diagnosed with opioid withdrawal syndrome (OWS) based on symptoms centered around restlessness and sweating that developed 43 days after administration of naldemedine for OIC.RESULTS: The patient was a 78-year-old woman who was diagnosed with stage IVB uterine sarcoma in October, 1 year prior to her visit to our clinic, and underwent chemotherapy after surgery, but the disease became progressive. Thereafter, metastasis to the fourth thoracic vertebrae (Th4) was identified, and loxoprofen and acetaminophen were started for pain at the metastatic site. Oxycodone hydrochloride...
Source: Palliative and Supportive Care - June 23, 2023 Category: Palliative Care Authors: Ryota Sato Mayumi Ishida Nozomu Uchida Takehiko Sakimoto Takefumi Yamaguchi Yoshitaka Ooya Takao Takahashi Hideki Onishi Source Type: research

Morphine Versus Oxycodone for Cancer Pain Using a Catechol-O-methyltransferase Genotype Biomarker: A Multicenter, Randomized, Open-Label, Phase III Clinical Trial (RELIEF Study)
CONCLUSION: Using the COMT rs4680 genotype alone is not recommended for selecting between morphine and oxycodone for pain relief.PMID:36426809 | DOI:10.1093/oncolo/oyac233
Source: The Oncologist - November 25, 2022 Category: Cancer & Oncology Authors: Hiromichi Matsuoka Junji Tsurutani Yasutaka Chiba Yoshihiko Fujita Kiyohiro Sakai Takeshi Yoshida Miki Nakura Ryo Sakamoto Chihiro Makimura Yoichi Ohtake Kaoru Tanaka Hidetoshi Hayashi Masayuki Takeda Tatsuya Okuno Naoki Takegawa Koji Haratani Atsuko Koya Source Type: research

A Systematic Review of the Evidence Behind Use of Reduced Doses of Acetaminophen in Chronic Liver Disease.
Authors: Schweighardt AE, Juba KM Abstract Acetaminophen is among the most commonly used nonopioid analgesics, but significant variation exists in its prescribing practices for cirrhosis patients. Our primary objective was to describe the quality of evidence supporting or refuting the use of acetaminophen in patients with hepatic dysfunction. A comprehensive literature review of PubMed, Cochrane Library, Web of Science, and International Pharmaceutical Abstracts using the search terms "acetaminophen," "paracetamol," "chronic liver disease," "cirrhosis," and "hepatic disease" for studies describing changes in acetam...
Source: Journal of Pain and Palliative Care Pharmacotherapy - June 19, 2019 Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research

Systematic review: intravenous paracetamol versus intravenous morphine in the management of acute renal colic
Conclusion Review of the literature suggests intravenous paracetamol is as effective as intravenous morphine in providing analgesia in acute renal colic. This effect was associated with a reduced incidence of adverse events and need for supplemental analgesia.
Source: Emergency Medicine Journal - November 23, 2015 Category: Emergency Medicine Authors: Navaratnam, R., Parker, S. Tags: Pain (neurology), Pain (palliative care), Pain (anaesthesia) Rod Little Prize Source Type: research

LITFL Review 192
Welcome to the 192nd LITFL Review. Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM. The Most Fair Dinkum Ripper Beauts of the Week An excellent review from St. Emlyn’s of the NICE guidelines in major trauma. Far more progressive than ATLS. [AS] The Best of #FOAMed Emergency Medicine Neil Long posts a fantastic set of videos on orthopedic splinting on LITFL. [AS] Excellent d...
Source: Life in the Fast Lane - August 9, 2015 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review LITFL R/V Source Type: blogs

Relief From Death Anxiety: In Your Medicine Cabinet Already?
The radio show Wait, Wait....Don't Tell Me! has a weekly segment called "Bluff the Listener" during which a caller listens to three unbelievable stories and then guess which one of the three is actually true.  Much to my surprise, this week's "true" (yet unbelievable) story is about evidence that acetaminophen might relieve existential angst. (Here's a direct link to the audio segment.) Julius Axelrod (Source: National Institutes of Health) Really?  Good ole' Tylenol might relieve bothersome thoughts about the ultimate threat to our existence?  How could I not investigate this further, if only because t...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 5, 2013 Category: Palliative Carer Workers Authors: Lyle Fettig, MD Source Type: blogs