Medizinische Monatsschrift für Pharmazeuten
-
In the last ten years opioid prescription has increased considerably. It is not that cancer patients would receive more analgesics, but it rather can be traced to a rising use of opioids for non cancer chronic pain (NCCP). There is evidence that serious opioid overuse may be present. Why should NCCP patients not benefit from opioid therapy and which side effects would justify to deprive NCCP patients of these strong analgesics? Our article summarizes the current discussion on opioid use in NCCP and outlines current evidence.
-
Fibromyalgia syndrome (FMS) is characterized by chronic widespread pain, unrefreshing sleep and mental/physical fatigue. Most patients report additional somatic and psychological symptoms. Fibromyalgia is a heterogeneous condition. ⋯ Non-pharmacological therapies such as low intensity aerobic exercise and meditative movement therapies such as Qi-Gong and Yoga are highly recommended for long-term self-management. Drug therapy is not mandatory. Recommended drugs are the antidepressants amitriptyline and duloxetine and the anticonvulsant pregabalin which act as pain modulators.
-
Life-threatening illness and the dying of a person presents a complex and particularly burdensome challenge for the person affected as well as for their relatives. This also applies to the professionals involved in caring and supporting the terminally ill patient. ⋯ The rapid supply of drugs is an essential part of the specialized outpatient palliative care concept (SAPV). This cooperation is exemplified in this article.
-
Pharmacists are an integral factor in palliative medical care, especially in the context of specialised outpatient palliative care (in Germany „SAPV“). As part of a multi professional team, pharmacists take care of patients especially in complex supply situations. ⋯ A 24/7 supply of urgently needed medicines needs to be ensured and clinical nutrition must be suited to the real needs of the patient. Prompt aseptic manufacturing of analgesic pumps and the supply of medical devices is a priority of regional specialised pharmacies, whilst the basic support can be provided by all pharmacies who wish to engage in this ethically demanding field.
-
Sepsis is newly defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. Organ dysfunction will be determined by an increase in the Sepsis-related Organ Failure Assessment (SOFA) score. ⋯ Sepsis should be treated as quickly and efficiently as possible as soon as it has been identified. This implies rapid administration of antibiotics and fluids.