Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jun 2015
Observational StudyA pilot evaluation of a hydromorphone dose substitution policy and the effects on patient safety and pain management.
Hydromorphone is a potent opioid analgesic commonly utilized in the hospital setting for the management of acute pain. Initial dose recommendations range from 0.1 to 2 mg of hydromorphone for opioid-naïve patients. This creates a challenge to optimally dose hydromorphone in opioid-naïve patients with the goals of avoiding opioid toxicities while also providing adequate pain management. ⋯ The primary outcome of the study was the incidence of opioid toxicity. The secondary outcome of the study was adequate pain management. The results of this study showed no difference in opioid toxicity; however, patients required less per day hydromorphone and other opioids while still adequately managing patients' pain.
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J Pain Palliat Care Pharmacother · Jun 2015
Case ReportsTrigeminal neuralgia: unilateral episodic facial pain.
Trigeminal neuralgia is a rare cause of episodic unilateral facial pain and often in the initial presentation dental causes need to be eliminated, as it frequently presents in the lower trigeminal divisions. The pain description is characteristic of electric shock-like pain that is light-touch provoked, paroxysmal, and occurring daily; the condition can go into remission for weeks or months, however. The first-line drug is either carbamazepine or oxcarbazepine and has to be started in low doses. ⋯ Patients need to be given information about all treatment options so they can make a decision about treatment. This report is adapted from paineurope 2014; Issue 4, © Haymarket Medical Publications Ltd., and is presented with permission. paineurope is provided as a service to pain management by Mundipharma International, Ltd., and is distributed free of charge to health care professionals in Europe. Archival issues can be viewed via the Web site: www.paineurope.com , at which health professionals can find links to the original articles and request copies of the quarterly publication and access additional pain education and pain management resources.
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J Pain Palliat Care Pharmacother · Jun 2015
Case ReportsHerpes zoster immunization in older adults has big benefits.
The value and importance of providing herpes zoster immunization to reduce the incidence and severity of acute herpes zoster neuralgia, especially in older patients, is described. The prevention of postherpetic neuralgia can profoundly impact patients' quality of life. This report is adapted from paineurope 2014; Issue 4, © Haymarket Medical Publications Ltd, and is presented with permission. paineurope is provided as a service to pain management by Mundipharma International, LTD and is distributed free of charge to healthcare professionals in Europe. Archival issues can be viewed via the website: www.paineurope.com at which health professionals can find links to the original articles and request copies of the quarterly publication and access additional pain education and pain management resources.
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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.