Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jan 2004
ReviewOpioid insights:opioid-induced hyperalgesia and opioid rotation.
Opioid analgesics are an irreplaceable component of pharmacotherapy of numerous pain-producing conditions. Clinicians and patients must contend with the imperfect nature of this class of drugs, trying to balance benefits and burdens on a continual basis. New literature related to evidence-based selection of opioids and the neurobiological phenomenon of opioid induced hyperalgesia are reviewed. A matrix describing critical elements in the selection of opioid analgesics, both for initial therapy and for opioid rotation, is presented.
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J Pain Palliat Care Pharmacother · Jan 2004
Comparative StudyCancer pain intensity measurements in outpatients: preferences and comparison of pain scales among patients, caregivers, physicians and nurses in southern India.
Pain is frequently encountered in outpatient oncology practice and its management often is inadequate. Effective analgesia often could be provided for these patients through simple practices like pain intensity monitoring, documentation and treatment accordingly. A survey was carried out among cancer patients attending outpatient pain clinic to evaluate scale preferences, comparison of different scales as well as proxy reporting by caregiver, health professionals, for pain management. ⋯ VAS was the preferred pain assessment tool. In the absence of VAS scale, VDS also could be used. Proxy reports could be relied upon for management of pain.
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J Pain Palliat Care Pharmacother · Jan 2004
Evidence-based pain management and palliative care in The Cochrane Library.
The Cochrane Library of systematic reviews is published quarterly. Issue 2 for 2003 of the library was published in May 2003. That issue contains 2395 reviews of which 1669 are in full text. ⋯ Issue 3 contains 85 new reviews, five are relevant to practitioners in pain and palliative care. References are published in the same format as the citation for Cochrane reviews. The Cochrane trials database now stands at over 375,000 records with an additional 4100 one-page summaries of non-Cochrane reviews in the NHS database of reviews of effectiveness (DARE).
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J Pain Palliat Care Pharmacother · Jan 2004
OxyContin abuse and diversion and efforts to address the problem: highlights of a government report.
Representative Frank R. Wolf, Chairman of the U. S. ⋯ On December 23, 2003, the GAO submitted a 57 page report to the Representatives describing the outcomes of the investigation. The full report includes appendices that describe the scope and methodology of the investigation, summaries of FDA changes to the original approved OxyContin label, databases used to monitor abuse and diversion of OxyContin and oxycodone, and comments from the FDA and DEA. This special report is an abstract of the GAO report and includes the conclusions and recommendations for action form the full report.
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J Pain Palliat Care Pharmacother · Jan 2004
Extemporaneously compounded sterile medications: relevance of new United States pharmacopeial standards to pain clinicians.
The United States Pharmacopeia (USP) is the United States' congressionally authorized book of standards for pharmaceutical manufacturing in the United States. The most current edition of the USP includes a new chapter entitled Pharmaceutical Compounding-Sterile Preparations that sets standards for all health care professionals who prepare, store or dispense sterile preparations. Extemporaneously compounded sterile formulations are sometimes needed for symptom control in pain and palliative practice. The implications and relevance of this new USP chapter to pain and palliative care clinicians-and the importance of all clinicians understanding the implications of how their patient's compounded sterile products are prepared-are discussed.