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Journal of Pain & Palliative Care Pharmacotherapy最新文献

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The Effect of Concurrent Use of Opioids and Gabapentin on Fall Risk in Older Adults. 同时使用阿片类药物和加巴喷丁对老年人跌倒风险的影响
IF 1.1
Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2024-06-10 DOI: 10.1080/15360288.2024.2358953
Jacob T Painter, Cheng Peng, Mary Burlette, Callie Clement, Lisa Luciani, Gohar Azhar, Lindsey Dayer
{"title":"The Effect of Concurrent Use of Opioids and Gabapentin on Fall Risk in Older Adults.","authors":"Jacob T Painter, Cheng Peng, Mary Burlette, Callie Clement, Lisa Luciani, Gohar Azhar, Lindsey Dayer","doi":"10.1080/15360288.2024.2358953","DOIUrl":"https://doi.org/10.1080/15360288.2024.2358953","url":null,"abstract":"<p><p>Falls pose a significant threat to older adults, resulting in injuries and mortality. Concurrently prescribed opioids and gabapentin for pain management may increase fall risks in older patients. This study aimed to estimate fall risks associated with the concurrent use of gabapentin and opioids, comparing them to opioid monotherapy in older adults. A retrospective case-control study of 1,813 patients aged 65-89 on chronic opioid therapy (2017-2020), excluding those with a fall history, analysis focused on the first fall occurrence. Logistic regression assessed the association between concurrent gabapentin and opioid use and fall events. Out of eligible patients, 122 (6.73%) experienced falls during opioid therapy, with 232 (12.80%) having concurrent gabapentin use. Concurrent use significantly increased fall risk (AOR = 1.73; 95% CI: 1.08-2.78). Being female, aged ≥81, and having more chronic conditions also increased risk. Mitigating fall risk in older adults requires education on prevention, exploring alternative pain management, and careful consideration of prescribing. Further research is crucial to understand adverse events linked to combined opioid and gabapentin use in the geriatric population.</p>","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"1-7"},"PeriodicalIF":1.1,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Utilization Review of Patients That Respond to Low-Dose Naltrexone (LDN) for Chronic Pain at a Single Institution. 一家机构对低剂量纳曲酮（LDN）治疗慢性疼痛患者的使用情况回顾。
IF 1.1
Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2024-06-05 DOI: 10.1080/15360288.2024.2358941
Joshua Pogue, Diane Johnson, Andrew Burch
{"title":"A Utilization Review of Patients That Respond to Low-Dose Naltrexone (LDN) for Chronic Pain at a Single Institution.","authors":"Joshua Pogue, Diane Johnson, Andrew Burch","doi":"10.1080/15360288.2024.2358941","DOIUrl":"https://doi.org/10.1080/15360288.2024.2358941","url":null,"abstract":"<p><p>Studies have demonstrated the benefits of LDN for various pain indications. This review describes the utilization of and response to LDN in patients with chronic pain within the William S. Middleton Memorial Veterans Hospital (Madison VA). This was a retrospective, single center, chart review of patients that were prescribed LDN for chronic pain. The primary outcome, change in subjective pain report via numeric rating scale (NRS), was analyzed through Wilcoxon Signed Rank Test and descriptive statistics. A total of 136 participants were included. Patients had an average pain score of 7.1 per NRS at baseline. At the initial follow up visit, participants had an average pain of 6.4 (<i>p</i> < 0.001). Additionally, 17.1% of patients had a greater than or equal to 30% pain reduction from baseline. At subsequent follow up, patients reported an average pain of 5.5 (<i>p</i> < 0.0001) per NRS. At the end of the study, 31.6% of patients were maintained on LDN at an average dose of 3.8 mg. This retrospective review demonstrated that LDN may be an effective modality for some chronic pain indications. Reported pain scores were significantly lower at initial follow up compared to baseline for the total population, and for patients with fibromyalgia (FM) specifically.</p>","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"1-8"},"PeriodicalIF":1.1,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Effects of Music Therapy on Patients Undergoing Colonoscopy in a Tertiary Care Hospital at Karachi, Pakistan: A Comparative Study. 音乐疗法对巴基斯坦卡拉奇一家三级医院结肠镜检查患者的影响：比较研究。
IF 1.1
Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2024-06-03 DOI: 10.1080/15360288.2024.2357551
Afsheen A A Hirani, Faisal W Ismail, Faris Abdulaziz, Rubina Barolia, Dilshad Begum, Lubna Kamani
{"title":"The Effects of Music Therapy on Patients Undergoing Colonoscopy in a Tertiary Care Hospital at Karachi, Pakistan: A Comparative Study.","authors":"Afsheen A A Hirani, Faisal W Ismail, Faris Abdulaziz, Rubina Barolia, Dilshad Begum, Lubna Kamani","doi":"10.1080/15360288.2024.2357551","DOIUrl":"10.1080/15360288.2024.2357551","url":null,"abstract":"<p><p>A colonoscopy is a procedure commonly used for the diagnosis of colorectal diseases but may be associated with high levels of anxiety and discomfort, which can lead to complications during sedation and decreased patient comfort and cooperation. This study was conducted at a tertiary care hospital in Karachi to assess the effectiveness of music therapy on pre-procedural anxiety, sedation requirements, pain, and procedure duration among patients undergoing colonoscopies. This comparative study included 110 outpatients. The intervention arm received non-lyrical soft music through earphones before and during the colonoscopy procedure, while the control group did not receive any music. In the intervention arm, significant reductions were seen in pre-procedural anxiety scores (<i>p</i> < 0.001), physiological measures (<i>p</i> < 0.001), sedation doses (<i>p</i> < 0.001), and procedure durations (<i>p</i> < 0.05). Control arm showed an increase in heart rate and systolic blood pressure (<i>p</i> < 0.001). Pain scores were similar for both groups. Music therapy is an effective tool to reduce patient anxiety pre- procedure. It is a simple, safe, and noninvasive relaxing intervention that could be used as an adjunct to sedative medications before and during the colonoscopy procedure.</p>","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"1-11"},"PeriodicalIF":1.1,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Subcutaneous Bolus Infusions of Undiluted Levetiracetam for End-of-Life Patients: Two Cases. 为临终患者皮下注射未稀释的左乙拉西坦：两个病例
IF 0.9
Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2024-06-01 Epub Date: 2024-02-12 DOI: 10.1080/15360288.2024.2311379
Kenneth Skov, Astrid Lyager
{"title":"Subcutaneous Bolus Infusions of Undiluted Levetiracetam for End-of-Life Patients: Two Cases.","authors":"Kenneth Skov, Astrid Lyager","doi":"10.1080/15360288.2024.2311379","DOIUrl":"10.1080/15360288.2024.2311379","url":null,"abstract":"<p><p>We present two cases, in which end-of-life patients were inadvertently treated with bolus infusions of undiluted subcutaneous levetiracetam. The patients were treated for three and four days respectively. In both cases, the course of treatment was uneventful. Especially, no seizures, nor local irritation was observed. Administration of undiluted subcutaneous levetiracetam as intermittent bolus infusions by hand holds alluring properties for end-of-life patients. Amongst others reducing patient discomfort, increasing freedom of movement, and accessibility to essential seizure prophylaxis by eliminating the need for a syringe driver, thereby helping accommodate many patients wish to die in their own home. However, pharmacokinetics, efficacy, and safety, including the optimum dilution and administration time of the subcutaneous preparation remains to be determined in clinically controlled trials.</p>","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"138-142"},"PeriodicalIF":0.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139723053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Frequency of Myoclonus and its Countermeasures in Terminally Ill Patients with Cancer: A Single-Center Retrospective Study. 癌症晚期患者肌阵挛的发生频率及其对策：单中心回顾性研究
IF 1.1
Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2024-06-01 Epub Date: 2024-05-09 DOI: 10.1080/15360288.2024.2345326
Yoshihiro Yamamoto, Hiroaki Watanabe, Norio Watanabe, Yasuyuki Asai, Motozumi Ando, Masami Kawahara, Yuko Deguchi, Takuya Odagiri
{"title":"Frequency of Myoclonus and its Countermeasures in Terminally Ill Patients with Cancer: A Single-Center Retrospective Study.","authors":"Yoshihiro Yamamoto, Hiroaki Watanabe, Norio Watanabe, Yasuyuki Asai, Motozumi Ando, Masami Kawahara, Yuko Deguchi, Takuya Odagiri","doi":"10.1080/15360288.2024.2345326","DOIUrl":"10.1080/15360288.2024.2345326","url":null,"abstract":"<p><p>Myoclonus is a relatively rare involuntary movement that is often observed in palliative care settings and that can cause patient distress. The purpose of this study is to investigate the occurrence of myoclonus and countermeasures against it in terminally ill patients with cancer diagnosed by palliative care specialists at Komaki City Hospital, Japan. We retrospectively reviewed patients with terminal cancer who received palliative care consultations between January 2018 and May 2019 and who were diagnosed with myoclonus by palliative care specialists, using electronic medical records. Patient demographics, time from onset of myoclonus to death, daily opioid use, countermeasures, and outcome of myoclonus were assessed. Of 360 patients examined during this period, 45 (12.5%) were diagnosed with myoclonus. Median age was 71 (range, 43-88) years; median time from onset of myoclonus to death was 8 days (range, 0-56); opioid usage was present in 39 patients (morphine, oxycodone, and fentanyl: <i>n</i> = 6, 21, and 12, respectively); and median oral morphine equivalent at onset of myoclonus was 60 mg (range, 12-336 mg). Myoclonus treatment was administered to 21 patients (opioid dose reduction, opioid switching, and others: <i>n</i> = 14, 3, and 4, respectively). Myoclonus is a common complication in patients with terminal cancer.</p>","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"117-122"},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140898756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lidocaine Infusion: An Analgesic Option for Checkpoint Inhibitor Arthritis: A Case Report. 利多卡因输注：检查点抑制剂关节炎的镇痛选择：病例报告。
IF 0.9
Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2024-06-01 Epub Date: 2024-05-08 DOI: 10.1080/15360288.2024.2345334
Lana Ferguson, Stacey Hooper
{"title":"Lidocaine Infusion: An Analgesic Option for Checkpoint Inhibitor Arthritis: A Case Report.","authors":"Lana Ferguson, Stacey Hooper","doi":"10.1080/15360288.2024.2345334","DOIUrl":"10.1080/15360288.2024.2345334","url":null,"abstract":"<p><p>This report describes the use of subcutaneous lidocaine infusion to manage complex pain associated with checkpoint inhibitor inflammatory arthritis. In addition, the safe administration of lidocaine in the home setting is described. A 49-year-old man with metastatic melanoma to lung, right axilla and posterior chest wall on regular pembrolizumab developed checkpoint inhibitor inflammatory arthritis. Pain associated with this was unresponsive to simple analgesia, escalating opioids and adjuvant analgesics. Lidocaine infusion was used on separate occasions (inpatient unit and home setting) to gain rapid and sustained control of inflammatory pain. Inflammatory pain responded well to 2 mg/kg/h lidocaine infusion over 4 days with sustained response between infusions of up to 6 wk. Resulting in improved mobility, functional status, and overall quality of life. Lidocaine infusion should be considered as an option for analgesic management of checkpoint inhibitor inflammatory arthritis in patients for whom usual treatment is ineffective, and as an opioid-sparing intervention.</p>","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"153-156"},"PeriodicalIF":0.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Initial Experiences With Integration of Palliative Medicine and Specialist Pain Services in a Tertiary Cancer Care Center in India. 印度一家三级癌症护理中心整合姑息医学和疼痛专科服务的初步经验。
IF 1.1
Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2024-06-01 Epub Date: 2024-04-01 DOI: 10.1080/15360288.2024.2320379
Anuja Damani, Arunangshu Ghoshal, Raghu Thota, Parmanand N Jain
{"title":"Initial Experiences With Integration of Palliative Medicine and Specialist Pain Services in a Tertiary Cancer Care Center in India.","authors":"Anuja Damani, Arunangshu Ghoshal, Raghu Thota, Parmanand N Jain","doi":"10.1080/15360288.2024.2320379","DOIUrl":"10.1080/15360288.2024.2320379","url":null,"abstract":"<p><p>Pain management constitutes a pivotal aspect of palliative care. Certain instances of distressing pain are significantly relieved through interventional pain methodologies, demanding the expertise of pain specialists. Our perspective revolves around the integration of these 2 facets, envisaging a symbiotic relationship that could enhance patient outcomes. A prospective assessment was carried out within a collaborative clinic, uniting the realms of pain management and palliative medicine. Anonymized patient information was scrutinized to grasp the advantages of this amalgamation and identify strategies to address any inherent deficiencies. Furthermore, an illustrative case study was delineated, spotlighting the collaborative dynamics at a systemic level. During the period spanning from November 2020 to June 2021, a total of 43 patients received consultations at this collaborative clinic. Each patient was exposed to a comprehensive pain management regimen, with the most frequently conducted procedure being an intercostal nerve block, which was administered in 9.30% of cases. For the provision of effective pain relief within the palliative care context, the confluence of joint consultations from cancer pain specialists emerges as a requisite measure. This approach carries the promise of optimizing pain control and augmenting the quality of palliative care.</p>","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"95-102"},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140336034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Alpha Alert: Utilization of Transdermal Clonidine for Refractory Agitation. 阿尔法警报：利用透皮氯硝安定治疗难治性躁动。
IF 0.9
Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2024-06-01 Epub Date: 2024-03-14 DOI: 10.1080/15360288.2024.2327868
Samantha Grable, Gary Houchard, Zach Rossfeld
{"title":"Alpha Alert: Utilization of Transdermal Clonidine for Refractory Agitation.","authors":"Samantha Grable, Gary Houchard, Zach Rossfeld","doi":"10.1080/15360288.2024.2327868","DOIUrl":"10.1080/15360288.2024.2327868","url":null,"abstract":"<p><p>Alpha-2 agonists are under-recognized for their class effects yet offer potential benefit in specialty palliative care <i>via</i> decreasing sympathetic output, inducing sedation, and modulating pain. Especially in clinical contexts where agitation predominates and patients are intolerant of oral medication route, transdermal medication delivery is advantageous. We report a case of agitated behaviors in setting of mixed Alzheimer/vascular-type dementia limiting hospital discharge to nursing facility that were ameliorated with transdermal clonidine. We suggest palliative clinicians routinely conceptualize the seemingly disparate alpha-2 agonists as a class for effective symptom palliation especially as new clinical evidence becomes available.</p>","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"149-152"},"PeriodicalIF":0.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140131669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Commentary: Is Polyethylene Glycol Toxicity From Intravenous Methocarbamol Fact or Fiction? 评论：静脉注射甲氧苄啶引起的聚乙二醇中毒是事实还是虚构？
IF 1.1
Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2024-06-01 Epub Date: 2024-05-08 DOI: 10.1080/15360288.2024.2345322
Emilie Chan, Coleton Waggoner, Paul M Boylan
{"title":"Commentary: Is Polyethylene Glycol Toxicity From Intravenous Methocarbamol Fact or Fiction?","authors":"Emilie Chan, Coleton Waggoner, Paul M Boylan","doi":"10.1080/15360288.2024.2345322","DOIUrl":"10.1080/15360288.2024.2345322","url":null,"abstract":"<p><p>Methocarbamol is an antispasmodic muscle relaxant and was the fourth most-prescribed muscle relaxant by volume in the United States in 2021. Intravenous (IV) methocarbamol contains the excipient, polyethylene glycol (PEG), which has been implicated in metabolic acidosis and nephrotoxicity. Intravenous methocarbamol was first approved by the US Food and Drug Administration in 1959 and at that time the IV methocarbamol prescribing information warned of PEG-associated adverse drug events in patients living with renal impairment; however, the manufacturer acknowledged data were lacking to objectively support this claim. Clinicians prescribing and dispensing IV methocarbamol may encounter the warning for PEG-associated metabolic acidosis and nephrotoxicity without knowing the potential risks, or lack thereof, supporting or disavowing this phenomenon. This commentary debates the merits supporting and arguments refuting PEG-associated metabolic acidosis and nephrotoxicity in patients treated with IV methocarbamol.</p>","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"180-184"},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Yay, or Nay? Over-the-Counter Naloxone Nasal Spray. 赞成，还是反对？非处方纳洛酮鼻腔喷雾剂。
IF 0.9
Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2024-06-01 Epub Date: 2024-02-21 DOI: 10.1080/15360288.2024.2317149
Miranda Hetrick
{"title":"Yay, or Nay? Over-the-Counter Naloxone Nasal Spray.","authors":"Miranda Hetrick","doi":"10.1080/15360288.2024.2317149","DOIUrl":"10.1080/15360288.2024.2317149","url":null,"abstract":"","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"185-186"},"PeriodicalIF":0.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139912860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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