Journal of pain & palliative care pharmacotherapy
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When cancer is not curable, the focus of care shifts from cure to care. Patients and family members then have many questions about end-of-life care. The following information provided by the National Cancer Institute addresses life expectancy, when caregivers should ask for help, how caregivers can be attentive to patients' emotional needs, signs of dying and death, what to do after death, and where additional resources on end-of-life care can be found.
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J Pain Palliat Care Pharmacother · Jan 2006
Nitric oxide levels in serum of patients with symptomatic irreversible pulpitis.
Nitric oxide (NO) affects both pain and inflammation in human tissues. Pharmacotherapy that decreases NO concentrations may have utility in treating inflammatory painful conditions. To determine the types of disorders in which such an approach should be studied, changes in NO serum levels before and after the painful inflammatory condition resolves would be helpful. ⋯ Before treatment, patients had severe symptoms of inflammation, but at the end of treatment no symptoms of inflammation were observed. NO concentrations were measured in serum of patients with irreversible pulpitis, before and after treatment. Differences in serum NO concentrations were not statistically significantly different before and after treatment.
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J Pain Palliat Care Pharmacother · Jan 2006
Hospice and palliative care: an expert interview with Louis W. Sullivan, MD. Interview by Perry G. Fine.
At the National Hospice and Palliative Care Organization's 6th Clinical Team Conference on Hospice and Palliative Care, held April 21-23, 2005, in Atlanta, Georgia, Perry G. Fine, MD, Professor in the Department of Anesthesiology at the University of Utah in Salt Lake City and Vice President of Medical Affairs for the National Hospice and Palliative Care Organization interviewed Louis W. ⋯ Fine and Dr. Sullivan discussed the importance of hospice and palliative care, along with some of the practical issues facing clinicians who wish to use the hospice care system.
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Methadone is a synthetic opioid that is effective for the relief of moderate-to-severe pain and for the treatment of opioid dependence. The pharmacokinetics of methadone differ from those of morphine in that methadone has a higher bioavailability, a much longer half-life, and is hepatically metabolized by cytochrome P450 enzymes. The pharmacokinetics of methadone are variable and an understanding of the factors that impact the onset, magnitude, and duration of analgesia is required to optimize therapy. ⋯ AMEDLINE search was performed to identify literature published between 1966 and May 2005 relevant to the pharmacokinetics of methadone. These publications were reviewed and the literature summarized regarding unique and clinically important elements of methadone disposition including its absorption profile, distribution, and metabolism/excretion. General dosing guidelines, dosage conversions from other opioids and pharmacokinetic issues in special populations are discussed.