Journal of pain & palliative care pharmacotherapy
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Controlled-release oxycodone (OxyContin) is commonly used for pain relief in terminal cancer. This opioid may be considered as a treatment option for patients who prefer oral pain control, but who are unwilling to take oral morphine sulphate or cannot tolerate its side effects. However, little is documented about the use of high doses of this drug in terminal cancer patients. ⋯ Survival was not related to OxyContin doses (Log Rank test, p = 0.12; Breslow test, p = 0.37). We conclude that the use of high dose OxyContin for terminal cancer pain management is safe, efficient, and unrelated to shorter survival times. The results suggest that health care professionals may use higher OxyContin doses, when indicated, to enable better pain relief and quality end-of-life care.
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The concept of opioid equianalgesia, limitations in current dose conversion systems, equianalgesic dose tables, and computer assisted dose conversions are discussed. Conversions for methadone, fentanyl and hydromorphone are described.
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When cancer is not curable, the focus of care shifts from cure to care. Patients and family members then have many questions about end-of-life care. The following information provided by the National Cancer Institute addresses life expectancy, when caregivers should ask for help, how caregivers can be attentive to patients' emotional needs, signs of dying and death, what to do after death, and where additional resources on end-of-life care can be found.
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J Pain Palliat Care Pharmacother · Jan 2006
Nitric oxide levels in serum of patients with symptomatic irreversible pulpitis.
Nitric oxide (NO) affects both pain and inflammation in human tissues. Pharmacotherapy that decreases NO concentrations may have utility in treating inflammatory painful conditions. To determine the types of disorders in which such an approach should be studied, changes in NO serum levels before and after the painful inflammatory condition resolves would be helpful. ⋯ Before treatment, patients had severe symptoms of inflammation, but at the end of treatment no symptoms of inflammation were observed. NO concentrations were measured in serum of patients with irreversible pulpitis, before and after treatment. Differences in serum NO concentrations were not statistically significantly different before and after treatment.
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J Pain Palliat Care Pharmacother · Jan 2006
Hospice and palliative care: an expert interview with Louis W. Sullivan, MD. Interview by Perry G. Fine.
At the National Hospice and Palliative Care Organization's 6th Clinical Team Conference on Hospice and Palliative Care, held April 21-23, 2005, in Atlanta, Georgia, Perry G. Fine, MD, Professor in the Department of Anesthesiology at the University of Utah in Salt Lake City and Vice President of Medical Affairs for the National Hospice and Palliative Care Organization interviewed Louis W. ⋯ Fine and Dr. Sullivan discussed the importance of hospice and palliative care, along with some of the practical issues facing clinicians who wish to use the hospice care system.