The Consultant pharmacist : the journal of the American Society of Consultant Pharmacists
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The objective of this review is to examine the role of ketamine as an analgesic for palliative treatment in the hospice care setting. ⋯ When opioid therapy is no longer sufficient to improve quality of life in the hospice setting, the addition of ketamine may be considered as adjunctive therapy.
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To compare the risk of developing constipation between patients prescribed fentanyl transdermal system or oxycodone hydrochloride (HCl) controlled-release. ⋯ These findings suggest that patients prescribed transdermal fentanyl may have a significantly lower risk of developing constipation compared with oxycodone controlled-release, particularly in the elderly.
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To provide current information regarding the efficacy and tolerability of the anticonvulsant gabapentin in the management of neuropathic pain. ⋯ In human pain models using patients with neuropathic pain, gabapentin has been found effective against both spontaneous and evoked pain, and these effects are independent of the pain source. Gabapentin, in doses ranging up to 3.6 g/day, has demonstrated efficacy in a variety of neuropathic pain states, including those refractory to agents such as the tricyclic antidepressants (TCA) and other anticonvulsants. A major question today is whether gabapentin should be considered as first-line therapy (i.e., even before a trial of a TCA or carbamazepine) or as second-line therapy for individuals unresponsive to or intolerant of TCAs and/or carbamazepine.