Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jan 2011
Computational opioid prescribing: a novel application of clinical pharmacokinetics.
We implemented a pharmacokinetics-based mathematical modeling technique using algebra to assist prescribers with point-of-care opioid dosing. We call this technique computational opioid prescribing (COP). ⋯ We conclude that COP is a new technique for the quantitative assessment of opioid dosing regimen design evaluation and adjustment, which may help prescribers to manage acute and chronic pain at the point-of-care. Potential benefits include opioid dose optimization and minimization of adverse opioid drug events, leading to potential improvement in patient treatment outcomes and safety.
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J Pain Palliat Care Pharmacother · Jan 2011
Food and Drug Administration recommends against the continued use of propoxyphene.
Following receipt of a Citizens' petition, the Food and Drug Administration (FDA) convened an advisory committee to address the safety of propoxyphene. This led to a comprehensive review that culminated in a November 19, 2910, press release in which the FDA recommended against continued use of the drug. The FDA release contains a data summary (background), a safety announcement, additional Information for Patients, additional information for health care professionals, and references. All dosage forms of the drug have now been withdrawn from the United States market.
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Recent passage of a House Bill in the state of Washington led to a commentary on whether mandates for urine drug testing of pain patients represented a breach of the Fourth and Fourteenth Amendment rights of patients. Issues over true consent to such tests and potential view of warrantless searches were discussed. The authors address these concerns in a broader context of risk management and stratification efforts, along with discussion about the need for a tailored approach in this arena and consideration of cost burden for such tests. Finally, the argument is made that social justice issues need to be considered (along with issues of autonomy, beneficence, and nonmaleficence).
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J Pain Palliat Care Pharmacother · Jan 2011
Awareness and utilization of a prescription monitoring program among physicians.
In 2011, 5 years after the implementation of a statewide prescription monitoring program (PMP) in Ohio, a survey was distributed to physicians in five specialty areas. During the study period, 95 of 156 surveys were returned, for a 61% response rate. The purpose of the questionnaire was to assess utilization rates as well as reasons for accessing the PMP database and any influence the database may have had on prescribing practices. ⋯ However less than 59% of the respondents who were aware of the program had ever used it. Medical specialty was found to have a significant impact on both awareness and utilization of the system, with pediatric physicians least likely, and emergency physicians most likely, to be aware of and utilize the state PMP. Recommendations based on the authors' survey results include targeting pediatric and internal medicine providers for increased education regarding awareness and benefits of PMP utilization.
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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 query is ziconotide, a novel approach to the management of severe and chronic pain prepared from snail venom, its uses and possible side effects.