Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jan 2007
ReviewChronic administration of ketamine for analgesia.
Use of the dissociative anesthetic ketamine in subanesthetic doses has demonstrated efficacy in neuropathic pain. This article reviews the scientific and clinical literature on ketamine. ⋯ Studies of ketamine analgesia in postherpetic neuralgia, phantom pain, complex regional pain syndrome and cancer pain are reviewed. A range of administration methods for ketamine including neuroaxial administration are described.
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J Pain Palliat Care Pharmacother · Jan 2007
ReviewPalliative care pharmacotherapy literature summaries and analyses.
Timely and important studies are reviewed and commentaries provided by leading palliative care clinicians. Symptoms and treatment side effects addressed in this issue are: cardiovascular risk due to NSAIDs or COX-2 inhibitors; prolongation of the QT interval due to methadone use; depression and its treatment with scopolamine; adverse drug reactions related to cardiovascular medications, and their association with ethnicity; and medication nonadherence in Medicare enrollees due to cost considerations.
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Queries from European physicians about analgesic pharmacotherapy and responses from the author are presented. The topics addressed are the safety of propoxyphene, the risk of opioid dependence in nonmalignant pain, the role of ziconotide in pain management, and titration of sustained acting opioids.
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J Pain Palliat Care Pharmacother · Jan 2007
The Declaration of Venice: palliative care research in developing countries.
In May 2006 at the Fourth Research Forum of the European Association for Palliative Care (EAPC) in Venice Italy, recognizing that the World Health Organization definition of palliative care calls for "impeccable assessment and treatment of physical symptoms and of psychological, social and spiritual problems," the EAPC and the International Association for Hospice and Palliative Care (IAPC) introduced a declaration to develop a global palliative care research initiative.
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Life expectancy in Japan is highest in the world. Cancer is the leading cause of mortality in Japan, accounting for about 30 percent of all deaths. Many Japanese cancer patients experience severe pain although they and their families hope to be pain free at the end of their lives. ⋯ Patients often do not participate in decision making about medical treatment because of remaining paternalism in the relationship between Japanese doctors and patients. Thus, cancer pain management in Japan is not as effective as it can be and not all Japanese cancer patients receive appropriate management for their cancer pain. To improve outcomes for Japanese patients, it is necessary for health professional and social work students and practicing professionals to receive contemporary education including an introduction to palliative care and ethics.