Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jan 2009
ReviewPalliative care pharmacotherapy literature summaries and analyses.
Timely and important studies are reviewed and commentaries provided by leading palliative care clinicians. Symptoms, interventions, and treatment-related adverse events addressed in this issue are computerized symptom management; anticholinergic agents in lung disease; neuropathic pain and morphine effectiveness; morphine dosing; inflammatory cytokines and pain; oral ghrelin-mimetics and sarcopenia; and opioid-induced bowel dysfunction.
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J Pain Palliat Care Pharmacother · Jan 2009
ReviewVariable use of opioid pharmacotherapy for chronic noncancer pain in Europe: causes and consequences.
According to the 2005 Pain in Europe Survey, the use of opioids to treat patients with chronic noncancer pain varies considerably among different countries in Europe. Undertreatment of chronic pain is common. ⋯ The validity of these restrictions is discussed in relation to the need to protect patients and society from harm due to adverse events, and the potential for misuse and abuse with prescribed opioids. This is balanced against the therapeutic goal of providing the best available pain-relieving treatment and to avoid the consequences of unnecessary suffering in patients with chronic noncancer pain.
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J Pain Palliat Care Pharmacother · Jan 2009
Drug enforcement administration liability for false arrest of physician.
Prescribing opioid analgesic medications brings with it a risk of regulatory oversight. A Florida Physician, Dr. Andrew Nguyen, was arrested in 2000 for allegedly violating controlled substance laws. ⋯ The United States Court of Appeals has now reinstated Dr. Nguyen's lawsuit against the DEA. The reinstatement of the lawsuit corrects a moral hazard that produces imbalanced regulatory perspectives on the enforcement of controlled substance laws.
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J Pain Palliat Care Pharmacother · Jan 2009
Guidelines for the diagnosis and management of neuropathic pain: consensus of a group of Latin American experts.
These consensus guidelines have been developed by a group of Latin American experts in pain management, to point out patterns and make practical recommendations to guide the diagnosis, identify warning signs (yellow and red flags), and establish comprehensive medical management (pharmacologic and nonpharmacologic treatment) and monitoring plans for patients enduring neuropathic pain. From the viewpoint of pharmacologic management, drugs are classified into groups according to efficacy, availability/accessibility, and safety criteria. Drugs are recommended for use depending on the disease and particular circumstances of each patient, with an approach that favors multimodal treatment while taking into consideration the idiosyncrasies of medical practice in Latin America.
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J Pain Palliat Care Pharmacother · Jan 2009
Prevalence, etiology, and management of neuropathic pain in an Indian cancer hospital.
Neuropathic pain is still an under-diagnosed and undertreated problem in third world countries. This retrospective study was undertaken to detect the prevalence, etiology and treatment profile of neuropathic pain in cancer. During January-December 2007, 716 new cancer pain patients were examined in Tata Memorial Hospital Pain Clinic. ⋯ Only 35% patients followed up more than once at the pain clinic. The most common and challenging patients were of orofacial pain. Nerve blocks techniques have a limited role in neuropathic pain.