Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Sep 2020
Case ReportsPeripheral Neuropathy Associated with Hypereosinophilic Syndrome: A Clinical Therapeutic Success with Capsaicin 8% Patch.
Neuropathic pain is defined as a direct consequence of an injury or disease that affects the somatosensory system, which may affect 7 to 10% of the world population. Regardless of its origin, it is often described as disabling, chronic, difficult to treat and with a noticeable impact on patients' quality of life. This case report describes a patient with peripheral polyneuropathy associated with hypereosinophilic syndrome, a medical condition scarcely described in literature. Capsaicin 8% patches therapy, never mentioned before in the literature in such clinical cases, proved to be significantly successful, and of major relevance for clinical practice.
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J Pain Palliat Care Pharmacother · Sep 2020
Improving Pain Management with Pharmacogenomics: A General Introduction.
Tailoring an individual patient's pain treatment is paramount to decreasing patient suffering and diminishing morbidity. Performing pharmacogenomic (PGx) testing can help guide prescribing decisions for current and future medication therapy by assisting dosage adjustments to increase therapeutic efficacy, decrease adverse drug reactions and avoid potentially ineffective medications. Pharmacogenomics is the study of inherited genetic information that influences drug response. ⋯ Genes of interest associated with pain medications include cytochrome P450 (CYP) enzymes, OPRM1, COMT, ABCB1, UGT, COX, OPRK1, OPRD1. To properly use PGx results in clinical application requires the healthcare provider to distinguish the difference between types of PGx tests, interpret test results, be familiar with PGx databases to use for prescribing guidance, and evaluate the level of evidence for specific gene-drug associations. This article introduces these concepts to assist the healthcare provider with incorporating PGx into practice to improve pain management.
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J Pain Palliat Care Pharmacother · Sep 2020
Attitudes toward and Barriers to Acetaminophen Use in the Chronic Pain Population: A Cross-Sectional Study.
The use of acetaminophen is recommended in pain management, particularly acute pain management, to reduce opioid utilization and opioid related adverse drug events. Acetaminophen's role in chronic pain conditions is understudied. This cross-sectional study was performed in a pain management office to explore how chronic pain patients use acetaminophen. ⋯ Patients who were recommended taking acetaminophen by a physician were 3.60 times as likely (95% CI 1.58, 8.25) to be a current or ever user of acetaminophen as compared to those who did not receive such a recommendation from their physician. There were no significant differences between current, ever, and never users on their knowledge of the maximum daily dose of acetaminophen of 4 g (p = .925). The study suggests that patients are often unaware of acetaminophen's role in the treatment of their chronic pain.
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J Pain Palliat Care Pharmacother · Sep 2020
ReviewChemotherapy-Induced Peripheral Neuropathy: Causative Agents, Preventative Strategies, and Treatment Approaches.
Chemotherapy-induced peripheral neuropathy (CIPN) is a chronic symptom associated with chemotherapy treatment. Symptoms and severity vary based on chemotherapeutic agent used and dose. At present, effective options for the prevention and treatment of CIPN are inadequate and clinical guidance is limited. ⋯ For treatment of CIPN, pharmacological agents duloxetine and topical combination product containing baclofen, amitriptyline, and ketamine have data supporting use. Early stage trials have shown initial promise for non-pharmacological therapies Scrambler Therapy and Photobiomodulation. Significant research is required as CIPN symptoms can lead to decreased quality of life, chemotherapy dose reduction, and discontinuation of drug therapy.
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J Pain Palliat Care Pharmacother · Sep 2020
The Clinical Pharmacist's Role in Perioperative Surgical Pain Management.
The purpose of this quality improvement initiative was to demonstrate the value of having a clinical pain pharmacist in transitional perioperative pain management. Patients were referred to the pain pharmacist prior to elective surgery. The pharmacist worked with the patients to develop an individualized perioperative analgesic plan and provided education regarding surgery. ⋯ Greater than 90% of patients reported they were "very appreciative" of the pharmacist talking to them about a pain management plan both before surgery and after discharge. One hundred percent of referring providers who responded to the survey reported they were satisfied with the pharmacist role in perioperative pain management. Pain management pharmacy specialists contribute to positive pain management outcomes for patients and surgical provider satisfaction.