The American journal of hospice & palliative care
-
Methadone is recommended as being free of some of the neuropsychological side effects noticed with morphine, which are attributed to active metabolites. A patient that received methadone for cancer-associated pain developed myoclonus as a side effect. This has rarely been reported before in the literature. The pathophysiology and management of myoclonus are discussed.
-
Am J Hosp Palliat Care · Jan 2001
ReviewDealing with AIDS-related loss and grief in a time of treatment advances.
Recent advances in the treatment of HIV/AIDS have dramatically changed the lives of many patients and their loved ones as well as those who care for them. However, not all patients respond successfully to the latest treatments. Hospice professionals need to understand the experience of AIDS patients and their loved ones in this period of hope and disappointment, and to find appropriate ways to support and care for them. This article explores the implications of treatment advances for AIDS patients, their loved ones, and professionals in dealing with loss and grief.
-
Am J Hosp Palliat Care · Jan 2001
Transdermal fentanyl in the hospice: a survey of rescue dosing and pain control.
The case records of 25 patients who received transdermal fentanyl as a primary analgesic during routine hospice care were surveyed for pain control and rescue medication use. The majority of patients (76 percent) had cancer-related pain and were treated in hospice for an average of approximately 30 days. Most received oral medications for supplemental rescue analgesia. ⋯ Over the same periods, patients required a mean of 6.1 (+/- 0.7) doses of rescue medication per day, with a range of zero to 12 doses per day. Five patients required rescue dosing every two hours on some treatment days. Although adequate pain control was generally accomplished with transdermal fentanyl in the group as a whole, the frequency of rescue dosing outside of the initial titration period appears unacceptably high.