Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jan 2004
Case ReportsProfound morphine tolerance following high-dose methadone therapy.
Cross-tolerance among opioid analgesics may be a barrier to effective pain management. Although the exact mechanism is unknown, methadone continues to remain a viable option when other opioids have failed. ⋯ A case of profound morphine tolerance following high-dose methadone therapy is described. The potential role of methadone-induced cross-tolerance is discussed.
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J Pain Palliat Care Pharmacother · Jan 2004
Report on the second joint scientific meeting of the American Pain Society and the Canadian Pain Society.
The American and Canadian Pain Societies held their annual scientific meetings jointly in May 2004 in Vancouver, British Columbia, Canada. This report summarizes highlights of the meeting.
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J Pain Palliat Care Pharmacother · Jan 2004
Evidence-based pain management and palliative care in issues three and four for 2003 of The Cochrane Library.
The Cochrane Library of systematic reviews is published quarterly. Issue 3 for 2003 of the library was published in May 2003. That issue contains 3058 reviews of which 1754 are in full text. ⋯ Annotated bibliographies for those seven reviews are provided. Issue 4 for 2003 of The Cochrane reviews and 1344 protocols. The Cochrane trials database now stands at over at over 378,000 records with an additional 4626 summaries of non-Cochrane systematic reviews published in the general medical literature [(Database of abstracts of reviews of effectiveness (DARE)].
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J Pain Palliat Care Pharmacother · Jan 2004
Multicenter StudyKnowledge and attitudes in pain management: Hong Kong nurses' perspective.
Effective pain management requires accurate knowledge, attitudes and assessment skills. To determine the current knowledge level and attitudes of nurses in pain management, 1,604 registered nurses working in three different hospitals in Hong Kong were invited to participate in this study. The sample consisted of 601 registered nurses, 63 nursing officers, and 14 nursing specialists (N = 678). ⋯ There was statistical significant in educational preparation and clinical experiences with correct scores. The findings of our study support the concern of inadequate knowledge and attitudes in relation to pain management. Further intensive continuing education and staff development is highly indicated for nurses in Hong Kong.
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J Pain Palliat Care Pharmacother · Jan 2004
ReviewTreatment of terminal restlessness: a review of the evidence.
Terminal restlessness is an important issue in the management of symptoms at the end of life with between 25% and 88% of dying patients exhibiting this condition. (1-5) The purpose of this review was to examine the empiric evidence about the pharmacological treatment for terminal restlessness. All available literature, in all languages, from 1966-2002 including randomized trials, concurrent observations, retrospective chart reviews, single case studies, clinical practice guidelines, expert consensus, single expert opinion articles, and editorials were reviewed as "best available evidence." Of the 72 articles reviewed, 14 met the criteria and were chosen for analysis. ⋯ There is insufficient evidence to suggest that a single medication or class of medications is appropriate for terminal restlessness. There is a clear need for additional trials of neuroleptics, benzodiazepines, barbiturates, and combination protocols to determine which protocols are the most effective and have the least side effects.