Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jun 2015
Tools for "decloaking" the elephant in the room: conflict of interest, shared decision-making, and patient-centered care.
Recently, apparent failures in ethical conduct appear to have impacted the public trust of health care professionals. In particular, conflict of interest, whether actual or perceived, is hindering effective relationships between patients, clinicians, and society. Clinicians are poised to experience further damage to the goodwill and reputation of their professions if direct actions and changes to practice philosophy are not taken. ⋯ These are shared decision-making (SDM), and patient-centered care (PCC). These are more than tools; they are logical frameworks for organizing the patient-clinician relationship. It is important for all clinicians to increase their understanding of these tools and incorporate in all facets of their professional practice.
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Questions from patients about pain conditions and analgesic pharmacotherapy and responses from authors are presented to help educate patients and make them more effective self-advocates. This article provides information to patients regarding the treatment of neuropathic pain syndrome. It narrates how a doctor might explain neuropathic pain to a patient and particularly discusses the use of anticonvulsants.
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J Pain Palliat Care Pharmacother · Jun 2015
Review Case ReportsOlanzapine in the treatment of refractory nausea and vomiting: a case report and review of the literature.
The role of olanzapine in chemotherapy-induced nausea and vomiting (CINV) is supported from randomized controlled trials and national consensus guidelines such as the National Comprehensive Cancer Network. In contrast, the role of olanzapine in refractory non-CINV is limited to case reports/series, retrospective studies, one pilot study, and one randomized controlled trial in patients with major depressive disorder. ⋯ We aim to contribute to the growing evidence supporting the use of olanzapine for refractory non-CINV. Furthermore, we review and summarize the literature regarding olanzapine in the CINV and non-CINV settings.
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J Pain Palliat Care Pharmacother · Jun 2015
ReviewFentanyl-induced hyperalgesia in acute pain management.
There are safety concerns with the use of fentanyl, including respiratory depression, nausea, constipation, and possibly opioid-induced hyperalgesia (OIH). The purpose of this review is to evaluate the occurrence and significance of opioid-induced hyperalgesia (OIH) after acute fentanyl exposure. A literature search was conducted from October 1995 through January 2015 using MEDLINE, Embase, and Scopus with the terms hyperalgesia, fentanyl, pronociceptive, acute tolerance, and acute. ⋯ The data on OIH after acute fentanyl exposure are limited and conflicting. Hyperalgesia should be considered in patients with uncontrolled pain despite escalating fentanyl doses, since the possibility of fentanyl-induced OIH exists in the acute setting. Well-designed trials are needed to determine the clinical significance of this phenomenon.