Journal of pain & palliative care pharmacotherapy
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Corticosteroids have been used extensively since cortisone was first synthesized in the 1950s. Glucocorticoids are derived from cortisone and are used in treatments for inflammation, dermatitis, allergic reactions, asthma, hepatitis, lupus erythematosus, nausea, vomiting and inflammatory bowel diseases. In the setting of palliative care, glucocorticoids have many uses, including many symptoms of malignancy, nausea, vomiting, depression, fatigue, anorexia and cachexia.
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J Pain Palliat Care Pharmacother · Jan 2007
Pregabalin and duloxetine for the treatment of neuropathic pain disorders.
Clinical studies investigating the use of pregabalin and duloxetine for the management of diabetic peripheral neuropathy and post-herpetic neuralgia are reviewed. The benefits and potential drawbacks associated with these agents are discussed.
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J Pain Palliat Care Pharmacother · Jan 2007
Correlates of nonmedical use of hydromorphone and hydrocodone:results from a national household survey.
Over the past decade, the misuse and abuse of opioid medications in the United States has risen dramatically. Although data show a substantial variation in the nonmedical use of individual opioids, relatively little is known about risk factors for the nonmedical use of specific opioid products. This study compared the prevalence and correlates of the nonmedical use of oral immediate-release hydromorphone (marketed under the brand name of Dilaudid), versus that of hydrocodone combination products using a nationally representative sample of the civilian noninstitutionalized United States population aged 12 years or older. ⋯ Of these, 2.9 percent reported lifetime nonmedical use of Dilaudid, and 51.9 percent reported lifetime nonmedical use of hydrocodone combination products exclusive of nonmedical Dilaudid use. Nonmedical Dilaudid users were likely to be older, Caucasian, and to have reported a higher lifetime prevalence of heroin, cocaine and injection drug use, as well as nonmedical use of other opioids. Nonmedical Dilaudid users were at higher risk for engaging in more serious substance abuse-related behaviors than those who reported lifetime nonmedical use of hydrocodone combination products.
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J Pain Palliat Care Pharmacother · Jan 2007
The federal Drug Enforcement Administration "prescription series" proposal: continuing concerns.
Two leading health and pain policy analysts discuss the implications of the federal Drug Enforcement Administration proposed position on the legality of practitioners writing series of controlled substance prescriptions for the purpose of providing ongoing pain management without the necessity for unneeded patient visits to their prescribers. This issue led to a series of regulatory proposals that engendered great concern in the pain management community. The proposed positive outcome from the DEA is described.
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Respiratory depression remains one of the most feared effects of opioids. Guidelines for safe use of these important drugs are presented and clinicians are encouraged to not fear using opioids when they are clinically indicated.