Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Mar 2015
CommentTime to declare victory and unite pain and palliative medicine.
The value and importance of improved communication and collaboration among pain management and palliative care clinicians is presented. The commentator uses the case report in this issue of the journal on the use of indwelling catheters for continuous interscalene blocks in cancer pain management as an example of why these two medical subspecialties need improved collaboration and integration.
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J Pain Palliat Care Pharmacother · Mar 2015
Case ReportsTreat the whole patient and be aware of drug interactions.
The case of an elderly male with bilateral shoulder pain is presented. The pain had been successfully treated years earlier with surgery, but a repeat rotator cuff procedure when the pain recurred was not effective. ⋯ Cardiovascular and renal risks of NSAOIDs are discussed as are potential toxicities of tramadol and too rapid withdrawal from it. Drug interactions of medications used are described.
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J Pain Palliat Care Pharmacother · Mar 2015
Implications of bariatric surgery on chronic pain and opioid use.
Questions from patients about pain conditions, pain treatment, and responses from authors are presented to help educate patients and make them effective self-advocates. The topics addressed in this report are implications of bariatric surgery or weight loss surgery on chronic pain and opioid use, what to expect with regards to pain control, and the need to change opioid dose after bariatric surgery.
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Definitions and difficulties relating to managing acute and chronic pain in patients with current or past substance abuse disorders are discussed. Problems with too rapid discontinuation of drugs are described. An interdisciplinary approach involving pain specialists, substance abuse clinicians and mental health professional is advocated.
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J Pain Palliat Care Pharmacother · Mar 2015
New DEA rules expand options for controlled substance disposal.
Prescription drug abuse and overdose are rapidly growing problems in the United States. The United States federal Disposal of Controlled Substances Rule became effective 9 October 2014, implementing the Secure and Responsible Drug Disposal Act of 2010 (Disposal Act). These regulations target escalating prescription drug misuse by reducing accumulation of unused controlled substances that may be abused, diverted or accidentally ingested. ⋯ Retail pharmacies and hospitals or clinics with an onsite pharmacy may also place and maintain collection receptacles at long-term care facilities. The Act and Rule are intended to increase controlled substance disposal methods and expand local involvement in collection of unused controlled substances. Potential barriers to participating in controlled substance collection include acquisition of suitable collection receptacles and liners, lack of available space meeting the necessary criteria, lack of employee time for verification and inventory requirements, and program costs.