Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Dec 2023
Oxycodone Extended-Release Capsule Utilization for Pain Management in a Cancer Palliative Care Clinic: A Retrospective Review.
Xtampza ER™, an oxycodone extended-release capsule (OERC), was the first long-acting opioid to feature abuse-deterrent properties and various routes of administration without pharmacokinetic alterations. The primary objective of this study was to evaluate changes in reported pain scores after initiation of or rotation to OERC from a previous opioid. Baseline scores were from patients' outpatient visits immediately before starting OERC and were compared to those at the next two follow-up visits. Secondary objectives identified variables that influenced pain scores. Methods included screening for cancer patients with outpatient OERC prescriptions seen in the palliative care clinic. ⋯ Most patients discontinued OERC at the first or second follow-up (35; 53%), and 12.1% of patients who started OERC were prescribed OERC at the end of the study. There were no significant variables identified to influence pain scores either statistically or clinically. Further studies are needed to determine the long-term efficacy and safety in cancer palliative-care patients.
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J Pain Palliat Care Pharmacother · Dec 2023
Using Interdisciplinary Teams to Mitigate the Effects of Drug Shortages in Palliative Care: The Case of Lorazepam Injection.
Given the rising frequency of drug shortages in hospitals, interdisciplinary collaboration is necessary to manage medications, modify electronic medical records, and evaluate safety outcomes. One such shortage impacted lorazepam injection, a medication commonly used in palliative care to treat anxiety, agitation, and seizures. In anticipation of the lorazepam shortage in the summer of 2022, pharmacy staff collaborated with palliative care physicians to identify alternative treatment recommendations when providers were prohibited from ordering lorazepam injection. ⋯ Moreover, no changes to the care experience were reported by patients, family/caregivers, providers, or staff. The collaborative effort between pharmacy and palliative care specialists resulted in alternative treatments for palliative care patients during the drug shortage. This preserved the hospital's supply of lorazepam injection for a patient population with no suitable alternatives while still allowing for management of palliative patients.
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J Pain Palliat Care Pharmacother · Dec 2023
Case Reports"I Just Don't Feel Heard": A Case Study on Opioid Use Disorder and Pain Management.
The nation's opioid epidemic requires a paradigm shift in the way patients with co-occurring opioid use disorder are treated during episodes of acute pain. Patients are often introduced to prescription opioids after an extremity fracture or sprain or resulting from musculoskeletal back, abdominal, or dental pain. ⋯ This case report will highlight one patient's journey including initial prescription opioid use, escalation into illicit opioids, entry to a recovery and treatment program, discussions with her physician about alternative therapies, and barriers to satisfactory pain relief. A shared decision-making model will be explored.
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J Pain Palliat Care Pharmacother · Dec 2023
Case ReportsSuspected Buprenorphine-Precipitated Opioid Withdrawal following Intercourse: A Case Report.
Buprenorphine, a partial mu-opioid receptor agonist, is a commonly prescribed medication for opioid use disorder (OUD). There is evidence that drugs may enter the male genitourinary tract by an ion-trapping process, based on the lipid solubility and degree of ionization (1). ⋯ Limited evidence exists surrounding cervical absorption of drugs via seminal fluid transmission. This also prompts survey of the frequency of this event and the influence on treatment within this population.
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J Pain Palliat Care Pharmacother · Dec 2023
Mpox Pain Management with Topical Agents: A Case Series.
With the recent spread in monkeypox cases, continuous efforts are made to manage the disease efficiently. Pain at the site of monkeypox lesions and in areas of skin breakdown can be severe. The origin of pain is likely neuropathic. ⋯ Guidelines circulated by the World Health Organization (WHO) suggest acetaminophen, tramadol, opioids, and/or topical lidocaine for symptomatic pain management. No first line agent with proven beneficial effect has been recommended in these patients. We present two patients' painful experiences with Monkeypox and suggest lessons learned.