Pain medicine : the official journal of the American Academy of Pain Medicine
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We investigated potential analgesics for chemotherapy-evoked neuropathic pain using rats treated with paclitaxel. ⋯ The present data and data from the literature review suggest that there are several potential treatments for chemotherapy-evoked neuropathic pain. Nonsteroidal anti-inflammatory drugs have little or no efficacy. Opioids have an effect, but probably only with high doses. At least some antidepressants are analgesic in these conditions. Some, but clearly not all, anticonvulsants and sodium channel blockers have efficacy. Tramadol is a particularly promising candidate. Topiramate, acetyl-L-carnitine, carbamazepine, and venlafaxine may have protective or restorative effects. Clinical trials of these candidates are needed to advance the treatment of chemotherapy-evoked pain.
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Despite a need for better physician pain management education, there are no widely accepted assessment or outcome measures to support this work. ⋯ This survey, the KnowPain-50, has good psychometric properties, correlates with clinical behaviors, and appears to distinguish between physicians with different levels of pain management expertise. It may be a useful measure of the effectiveness of physician pain management education programs.
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Randomized Controlled Trial
Subjective, psychomotor, and physiological effects profile of hydrocodone/acetaminophen and oxycodone/acetaminophen combination products.
To compare within the same individuals two typically prescribed doses of hydrocodone/acetaminophen and oxycodone/acetaminophen products for their subjective, psychomotor, and physiological effects in healthy volunteers. ⋯ The results of this study, albeit in pain-free individuals, may inform physicians who prescribe, and pharmacists who dispense, two widely prescribed opioid/acetaminophen combination products on how patients might be feeling from the drugs. Patients prescribed either of the two opioid/acetaminophen combination products may experience a number of subjective effects, including effects that would contraindicate certain activities, and they should be cautioned accordingly. However, this study documented rather large differences in magnitude of subjective effects between 10 mg oxycodone/650 mg acetaminophen and placebo, and physicians and pharmacists, and ultimately patients, should be aware of these differences.