Journal of pain & palliative care pharmacotherapy
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In conjunction with World Cancer Day 2012, three leading pain and palliative care organizations developed a statement on access to analgesics to provide freedom from pain as a human right. Numerous other professional organizations subsequently signed this manifesto calling upon governments, the pharmaceutical industry, and health institutions to make available immediate-release morphine at affordable prices for all in need of pain relief. This report is reprinted with permission of the originating organizations. For more information see: http://palliumindia.org/manifesto/.
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J Pain Palliat Care Pharmacother · Jun 2012
Shared risk evaluation mitigation strategy for all immediate-release transmucosal fentanyl dosage forms.
The Food and Drug Administration approved a single shared Risk Evaluation Mitigation Strategy (REMS) for transmucosal immediate-release fentanyl dosage forms in December 2011. This report describes the goals, elements, and restricted distribution system of the REMS designed to reduce risk of abuse, misuse, addiction, and overdose with the drugs. Questions and answers about REMS also are presented. ⋯ That announcement is accessible at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm285345.htm. Concurrently the FDA posted a series of questions and answers on this shared REMS at: http://http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm284717.htm. Both documents are in the public domain.
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The November 2011 issue of the online bulletin CDC Vital Signs posted by the Centers for Disease Control and Prevention of the U. S. ⋯ A subsequent blog posting on the CDC Directors Blog entitled "Prescription Drug Overdose in the United States: Blog Q&A" also addresses this important issue. Statistics on overdose deaths and strategies for improvement by all stakeholders are provided.
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Questions from patients about analgesic pharmacotherapy and responses from authors are presented to help educate patients and make them more effective self-advocates. The topic addressed in this issue is untreated/undertreated chronic pain and the physical, emotional, and social consequences that can profoundly affect a patient's quality of life. ⋯ Chronic pain is the enemy of happiness. Further, chronic pain can activate the sympathetic nervous system, leading to the fight-or-flight response.
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J Pain Palliat Care Pharmacother · Jan 2012
ReviewReview of palliative sedation and its distinction from euthanasia and lethal injection.
Palliative sedation evolved from within the practice of palliative medicine and has become adopted by other areas of medicine, such as within intensive care practice. Clinician's usually come across this practice for dying patients who are foregoing or having life support terminated. A number of intolerable and intractable symptom burdens can occur during the end of life period that may require the use of palliative sedation. ⋯ Various sedative drugs can be employed in the provision of palliative sedation that can produce any desired effect, from light sedation to complete unconsciousness. Although there are some similarities in the pharmacotherapy of palliative sedation, euthanasia, physician-assisted suicide, and lethal injection, there is a difference in how the drugs are administered with each practice. There are some published guidelines about how palliative sedation should be practiced, but currently there is not any universally accepted standard of practice.