Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jan 2004
Patterns of opioid analgesic prescription among patients with osteoarthritis.
This study describes patterns of opioid analgesic prescription during a one-year period among a sample of patients with osteoarthritis (OA). The study sample included 3,061 patients with prior ICD-9 codes indicating a diagnosis of OA who were treated at a federal Veterans Affairs Medical Center. Specific opioid variables included: any opioid prescription, number of specific opioid drugs prescribed, total number of opioid prescriptions, total number of days supply of opioids, and daily opioid doses. ⋯ Daily opioid doses were, on average, below recommended daily doses for the treatment of OA. Findings of this study suggest that opioids are frequently prescribed to individuals with OA and that these drugs may be gaining acceptability for the treatment of chronic musculoskeletal pain. Additional research is needed to examine reasons for racial differences in opioid prescribing, as well as the prescription of these medications at fairly low doses.
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J Pain Palliat Care Pharmacother · Jan 2004
Clinical TrialTopical lidocaine patch therapy for myofascial pain.
An open label study of topical lidocaine 5% patches was conducted for myofascial pain management based on the hypothesis that electrical dysfunction is a component of myofascial pain and therefore sodium channel blockade may be useful in managing myofascial pain. The efficacy of topical lidocaine patch therapy for myofascial pain impact of the therapy on associated quality of life were investigated in the one-month trial. Principal outcome measures were Brief Pain Inventory- Short Form for pain intensity and quality of life score changes. ⋯ Two patients reported complete pain relief and 3 reported a lot of relief. Mean improvements for average pain intensity (7, 14, and 28 days), general activity (7 and 28 days), mood and sleep (7, 14, and 28 days), walking (14 and 28 days), and ability to work, relationships, and enjoyment of life (28 days) were significant (P < 0.05). These results suggest lidocaine patches may be useful in the management of myofascial pain.
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J Pain Palliat Care Pharmacother · Jan 2004
Comparative StudyPrescribing and self-administration of morphine in Hispanic and non Hispanic Caucasian patients treated with patient-controlled analgesia.
The purpose of this study was to determine whether differences in either prescribing or self-administration of morphine exist between Hispanic and White (Caucasian) post-operative patients treated with patient-controlled analgesia (PCA). A review of the medical records of 30 Hispanic and 30 White patients who received postoperative PCA was conducted. ⋯ No differences in the amount of morphine prescribed (11.23 +/- 3.22 mg/hr in Hispanic patients, 11.05 +/- 4.28 mg/hr in White patients; p = 0.8503) or self-administered (2.58 +/- 2.02 mg/hr in Hispanic patients, 3.32 +/- 3.00 mg/hr in White patients; p = 0.2711) were discovered. This study identified no statistically significant difference in either opioid prescribing or self-administration between Hispanic and White post-operative patients.
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J Pain Palliat Care Pharmacother · Jan 2004
Case ReportsSerotonin mechanisms in pain and functional syndromes: management implications in comorbid fibromyalgia, headache, and irritable bowl syndrome - case study and discussion.
A young woman presented with multiple central hypersensitivity disorders, including fibromyalgia, headache, pelvic pain and several smooth muscle spasm disorders, including irritable bowel syndrome, irritable bladder and Raynaud's phenomenon. She also had significant fatigue and sleep problems. ⋯ This experience illustrates the value of serotonin receptor type 2 (5HT2) inhibition with atypical neuroleptics, of neural cation channel and glutamate inhibition with anticonvulsants, and the potential usefulness of antidepressants after establishing 5HT2 control to enhance downward inhibitory tracts. Medications with combined usefulness for both bipolar mood and pain disorders were highly effective for her multiple hypersensitivity problems.
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Myths and misinformation about pain and its management often lead to poor therapy for patients in pain. Nine common myths about pain and its management are described and refuted.