Current pain and headache reports
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The use of intrathecal analgesics is an important treatment consideration for many patients with chronic cancer pain. This review describes the various opioid and nonopioid analgesics that have been used in this setting, including morphine, hydromorphone, fentanyl, meperidine, methadone, sufentanil, local anesthetics, clonidine, ketamine, baclofen, midazolam, betamethasone, and octreotide. We discuss available evidence for their analgesic and adverse effects.
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Burning mouth syndrome (BMS) is a chronic disease characterized by burning of the oral mucosa associated with a sensation of dry mouth and/or taste alterations. BMS occurs more frequently among postmenopausal women. The pathophysiology of the disease is still unknown, and evidence is conflicting; although some studies suggest a central origin, others point to a peripheral neuropathic origin. The efficacy of some medications in the treatment of BMS suggests that the dopaminergic system may be involved.
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Caffeine is the most widely consumed psychostimulant drug in the world. With intermittent exposures, caffeine may act as a mild analgesic for headache or as an adjuvant for the actions of other analgesics. ⋯ At dosages achieved by common dietary intake, caffeine acts as a potent antagonist of central and peripheral nervous system adenosine receptors. The complex effects of caffeine on headache disorders suggest important roles for adenosine in these disorders and in the induction of caffeine dependency.
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Curr Pain Headache Rep · Aug 2008
ReviewAssessment and management of psychiatric issues during cancer treatment.
Since its beginnings in the mid-1970s, the field of psycho-oncology has developed rapidly. A substantial body of literature has evolved toward identifying key issues for psychiatric treatment and care management of cancer patients. The spectrum of cancer care encompasses patient experiences through initial diagnosis, active treatment, after-care and survivorship, as well as palliative care and end-of-life. This article highlights recognition and management of psychiatric syndromes in the context of cancer care.
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Pain is highly prevalent in cancer patients and primarily managed by medical oncologists. This article reviews cancer pain syndromes related to cancer and sequelae of treatment. ⋯ There are numerous barriers to care, which arise from both the physician and patient. We review approaches that diminish these barriers to improve treatment of cancer pain.