Journal of opioid management
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Comparative Study
The prevalence and economic impact of prescription opioid-related side effects among patients with chronic noncancer pain.
To estimate the prevalence of opioid-related side effects among patients with chronic noncancer pain (CNCP) who initiated opioids and compare healthcare costs of patients with and without side effects using patient survey, medical charts, and claims data. ⋯ Prevalence of opioid-related side effects among patients with CNCP who initiated opioids was substantially higher based on patient survey than from charts or claims. Opioid-related side effects were associated with significantly higher healthcare costs.
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Increased methadone use in patients with pain has raised concerns that the effect of methadone on the QT interval duration and the potential risk of torsades de pointes (TdP) has been underestimated. Most studies on prolonged QT intervals by methadone are performed in maintenance patients; however, doses of methadone in pain treatment are much lower. Hardly any studies have prospectively addressed QT interval prolongation by methadone in patients with pain, and this study aims to address this literature gap. ⋯ The study found that in our patients with pain, with relatively low doses of methadone, 5 percent had QTc times ≥500 ms and were thus at serious at risk for TdP. ECGs have to be made in all patients with methadone therapy 1 week after introducing methadone (or after dosage increases).
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Despite the known high rates of substance misuse among individuals with borderline personality disorder (BPD), little empirical data are available regarding the explicit nature of such misuse with prescribed pain medications-the focus of the present study. ⋯ Individuals with BPD are at risk for misusing prescribed pain medications, and this is especially evident regarding particular forms of misuse among men with BPD symptomatology.
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Randomized Controlled Trial Comparative Study
Effect of intraoral and subcutaneous morphine on dyspnea at rest in terminal patients with primary lung cancer or lung metastases.
Dyspnea is considered as one of the most frequent and distressing symptoms in patients with advanced cancer, and systemic administration of morphine has been reported to have beneficial effect on this complaint. ⋯ The study confirms the beneficial effect of morphine on dyspnea in terminally ill patients, and we conclude that RMD is an attractive alternative to injected morphine, when self-administration is preferable.
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Randomized Controlled Trial Comparative Study
Pharmacokinetic evaluation of tapentadol extended-release tablets in healthy subjects.
To evaluate serum pharmacokinetics of tapentadol administered to healthy subjects as extended-release (ER) tablets. ⋯ The pharmacokinetics of tapentadol ER are consistent after repeated and single-dose administration. Tapentadol ER may be administered without regard to food intake. No clinically significant differences were observed in the pharmacokinetics of tapentadol between Japanese and Caucasian subjects.