Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jun 2023
ReviewAnalgesic Treatment Approach for Postherpetic Neuralgia: A Narrative Review.
Post-herpetic neuralgia (PHN) is an entity derived from peripheral nerve damage that occurs during the reactivation of the Varicella Zoster Virus (VZV), which manifests itself through pain with neuropathic characteristics. This can prove to be very difficult to manage in the chronic stages of disease reappearance. There currently exists a multitude of treatment alternatives for PHN, however, prevention through the early initiation of antiviral regimens is vital. ⋯ Interventional procedures have become a cornerstone in difficult-to-manage cases, and have shown promising outcomes when used in a multimodal approach by experienced specialists. It is necessary to make an objective diagnosis of PHN and start early treatment. Additionally there is current evidence that vouches for interventional therapies as well as individualization, with a clear establishment of therapeutic objectives according to the needs of each patient.
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J Pain Palliat Care Pharmacother · Jun 2023
Case ReportsTreating Prehospital Pain in Children: A Retrospective Chart Review Comparing the Safety and Efficacy of Prehospital Pediatric Ketamine and Opioid Analgesia.
Prior to 2020, pain management in the Washtenaw/Livingston County Medical Control Authority (W/L MCA) Emergency Medical Service (EMS) system in Southeast Michigan was limited to morphine, fentanyl, ketorolac, and acetaminophen. Based on the increasing evidence describing its safety and efficacy, ketamine was added to local protocols for pain management. This study aimed to evaluate differences in pain management and adverse effects of ketamine and opioid administration. ⋯ The prevalence of adverse effects was higher among patients in the ketamine group (28.6%) compared to patients in the opioid group (2.4%, p < 0.001). Of 14 patients who received ketamine, one 17-year-old male experienced mild anxiety (7.1%), two teenage females experienced mild dissociation (14.3%), and one 20-year-old female experienced mild nausea (7.1%). Overall, ketamine is a safe and effective option compared to opioids for pediatric patients experiencing moderate to severe prehospital pain.
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J Pain Palliat Care Pharmacother · Jun 2023
Perceptions of West Virginia Teens and Adults Regarding the Risks of Over-the-Counter Pain Medications.
More than 1 billion people live with chronic pain, including 100 million Americans, with a majority utilizing prescription and over-the-counter (OTC) pain medications. OTC medications are readily available and facilitate generally positive efficacy, yet misuse leads to a high number of medication-related problems, with acetaminophen alone accounting for more than 50,000 emergency department visits annually. ⋯ Community survey screening data resulted in 85% answering two-thirds of the knowledge questions incorrectly, with 12% (140 of 1174 participants) answering every single knowledge survey question incorrectly. These data strongly exhibit not only the incredible need for OTC pain medication community education but also that this study's educational methods were very effective at teaching high school students, with possible applicability to the entirety of society.
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J Pain Palliat Care Pharmacother · Jun 2023
Review Case ReportsGabapentin-Induced Overflow Urinary Incontinence: A Case Report and Review of the Literature.
Gabapentin (GBP) is a structural analog of gamma-aminobutyric acid (GABA) that is commonly used in palliative care for symptom management indications including neuropathic pain syndromes, hiccups, cough, and anxiety. An uncommon adverse effect of GBP is urinary incontinence (UI). We report the case of a 61-year-old male with metastatic non-small cell lung cancer who developed probable overflow UI while receiving 1200 mg/day of GBP for chemotherapy-induced peripheral neuropathy. ⋯ The patient did not experience overflow UI while taking pregabalin despite the similar pharmacology and comparable doses to GBP. We believe this is the first case report to describe subsequent achievement of pain control by substituting pregabalin without recurrence of UI. Healthcare professionals should consider GBP as a potential cause when evaluating patients presenting with new onset overflow UI.
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J Pain Palliat Care Pharmacother · Jun 2023
Home Management and Prevention of Vaso-Occlusive Crisis of Sickle Cell Disease Knowledge among Nursing Students.
Sickle cell crisis, or vaso-occlusive crisis, is a painful complication of sickle cell disease that occurs in adolescents and adults, which is considered the most common reason these patients seek medical attention in an emergency room. Despite the high prevalence of sickle cell disease in the Jazan region, Saudi Arabia, there hasn't been a study looking at nursing students' knowledge about sickle cell disease and home management and prevention of vaso-occlusive crises associated with sickle cell disease. ⋯ A descriptive cross-sectional design was used in this study that involved 167 nursing students. The study revealed that Aldayer nursing students had adequate knowledge about the home management and prevention of sickle cell disease vaso-occlusive crises.