Результаты поиска

Management of painful neuropathies.

Neuropathic pain is the most common type of pain in neuropathy. In painful polyneuropathies the pain usually has a "glove and stocking" distribution. The pain may be predominantly spontaneous, e.g., with a burning, pricking, or shooting character or characterized by evoked pain such as mechanical or cold allodynia. In the clinical setting, the prevention of painful neuropathies and treatment of underlying neuropathy remains inadequate and thus symptomatic treatment of the pain and related disability needs to be offered. Most randomized, double-blind, placebo-controlled trials (RCTs) published

Mu-opioid antagonists for opioid-induced bowel dysfunction in people with cancer and people receiving palliative care.

BackgroundOpioid-induced bowel dysfunction (OIBD) is characterised by constipation, incomplete evacuation, bloating, and gastric reflux. It is one of the major adverse events (AEs) of treatment for pain in cancer and palliative care, resulting in increased morbidity and reduced quality of life. This review is a partial update of a 2008 review, and critiques as previous update (2018) trials only for people with cancer and people receiving palliative care.ObjectivesTo assess for OIBD in people with cancer and people receiving palliative care the effectiveness and safety of mu-opioid antagonists

Emergency Department Management of Common End-of-Life and Palliative Care Symptoms: Three Cases

Аннотация не предоставлена источником. Откройте карточку для перехода к публикации.

Совпадение в полном тексте источника
… Unfortunately, patients can have refractory opioid-induced constipation. These patients should be first evaluated for bowel obstruction as appropriate based on the history and physical examination and with imaging as appropriate. … As illustrated in case 1, in patients with refractory opioid-induced constipation, peripherally acting mu-opioid receptor antagonists (PAMORAs), such as methylnaltrexone, are effective agents for ED use [ 13 ]. …

Tapentadol: A Review of Experimental Pharmacology Studies, Clinical Trials, and Recent Findings.

Tapentadol is an analgesic compound that acts centrally to attenuate pain. Previous studies have shown that tapentadol has dual mechanisms of action as a mu-opioid receptor agonist and noradrenaline re-uptake inhibition. Therefore, tapentadol provides a great advantage over classic opioids in pain management from nociceptive to neuropathic. Cumulative evidence from in vitro data suggests that tapentadol effect of norepinephrine re-uptake could be a new target that overcomes other classic opioids in chronic neuropathic pain. Compared to tramadol and other opioids, tapentadol is associated with

Cancer Pain Is Not One-Size-Fits-All: Evolving from Tradition to Precision.

Cancer pain remains a significant challenge in oncology, profoundly affecting patients' quality of life, function, and prognosis. Historically under-recognized and managed with a uniform, opioid-centric approach, cancer pain was often inadequately treated. Advances in pain assessment, multimodal analgesia, and supportive care have improved outcomes, yet traditional algorithms frequently fail to address the complex, heterogeneous nature of cancer pain. Contemporary management is shifting toward precision and personalized medicine, integrating genetic, molecular, and biomarker data with individu

Tapentadol prolonged release for patients with multiple myeloma suffering from moderate-to-severe cancer pain due to bone disease.

CONTEXT: Myeloma bone disease (MBD) is a devastating complication of multiple myeloma that leads to severe pain. OBJECTIVES: The aim of this study was to evaluate the efficacy and tolerability of tapentadol prolonged release (PR) in the management of patients with MBD suffering from moderate-to-severe cancer pain. METHODS: A 12-week prospective study was carried out in 25 opioid-naïve MBD patients. Patients initially received twice-daily doses of tapentadol PR 50 mg. Doses were then managed to maintain adequate relief or dose-limiting toxicity. The following parameters were recorded at weekl

Side effects of analgesia may significantly reduce quality of life in symptomatic multiple myeloma: a cross-sectional prevalence study.

BACKGROUND: Pain is a common symptom in patients with multiple myeloma (MM). Many patients are dependent on analgesics and in particular opioids, but there is limited information on the impact of these drugs and their side effects on health-related quality of life (HRQoL). METHOD: In a cross-sectional study, semi-structured interviews were performed in 21 patients attending the hospital with symptomatic MM on pain medications. HRQoL was measured using items 29 and 30 of the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30. RESULTS: Patients were able to recall a med

Совпадение в полном тексте источника
… Apart from its detrimental effect on wellbeing, opioid-induced constipation (OIC) has a significant health economic cost to society [ 21 ]. Unfortunately, the evidence base for current management of OIC using conventional laxatives is poor [ 22 ]. … The direct and indirect costs of opioid-induced constipation. J Pain Symptom Manag. 2010;40:696–703. doi: 10.1016/j.jpainsymman.2010.02.019. 22. Ahmedzai SH, Boland J. (2010) Constipation in people prescribed opioids. Clin Evid. PMC2907601 23. …

Управление болью у пациентов с множественными миеломами: обзор литературы.

Устранение боли у больных раком с множественной миеломой (ММ) представляет собой серьезную проблему. В ходе этого обзора тщательно изучаются нынешние стратегии борьбы с обезболиванием, трудности и будущие направления деятельности на местах. В обзоре стратегии лечения обезболивающих делятся на фармацевтические и нефармакологические. Заглядывая в будущее, следует отметить многообещающие области для будущих исследований и разработок, такие, как включение точной медицины в обезболивающие методы и изучение новаторских методов лечения. Несмотря на существующие ограничения, прогресс в борьбе с обезбо

Antitumoral Agent-Induced Constipation: A Systematic Review.

BackgroundConstipation is a common symptom in patients receiving antitumoral treatment. The mechanisms underlying antitumoral agent-induced constipation (ATAIC) are poorly defined. This systematic review aimed to analyze and synthesize the available information related to the prevalence, etiology, and treatment of ATAIC.MethodsA systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines was conducted. The review included human studies written in English, French, or Spanish involving patients with cancer and containing information abou

Совпадение в полном тексте источника
… The use of PAMORAs could be the most reasonable approach focused on the mechanism of opioid-induced constipation. … As far as acupuncture is concerned, studies in patients with opioid-induced constipation also reported benefits with acupuncture in a recent meta-analysis [ 76 ]. …

Neuropathic cancer pain: What we are dealing with? How to manage it?

Cancer pain is a serious health problem, and imposes a great burden on the lives of patients and their families. Pain can be associated with delay in treatment, denial of treatment, or failure of treatment. If the pain is not treated properly it may impair the quality of life. Neuropathic cancer pain (NCP) is one of the most complex phenomena among cancer pain syndromes. NCP may result from direct damage to nerves due to acute diagnostic/therapeutic interventions. Chronic NCP is the result of treatment complications or malignancy itself. Although the reason for pain is different in NCP and non

Pain in blood cancers.

Patients with blood-related cancers (BRC) suffer from a substantial symptom burden, including several pain syndromes sustained by different causes and pathogenetic mechanisms. So, with regard to pain, a multifaceted clinical scenario may be observed in this setting. Indeed, pain may be correlated to disease itself, to disease-associated complications, to iatrogenic causes or may be due to unrelated clinical conditions. A close diagnostic procedure for the assessment of the underlying causes of the pain and of its pathogenetic mechanisms may direct the treatment approach which should be based o

MyPainPal, a Novel mHealth App to Improve Pain in Patients With Advanced Cancer: Single-Arm Pilot Study.

BackgroundPain is common among patients with advanced cancer and is often inadequately controlled. Opioids are central to treatment; yet, self-management is challenging, and clinicians lack scalable tools to monitor and support patients between visits.ObjectiveThis study aimed to evaluate the feasibility and acceptability of MyPainPal (Dana-Faber Cancer Institute), a novel mobile health app designed to optimize cancer pain management. MyPainPal combines daily surveys assessing symptoms and analgesic use, algorithmic self-management support, tailored psychoeducation, and clinician monitoring. S

Совпадение в полном тексте источника
… To enable self-management support for opioid-induced constipation, patients indicated the number of days since their last bowel movement, stool characteristics, and laxative doses used in the past 24 hours. … To enable self-management support for opioid-induced constipation, participants reported constipation severity, days since their last bowel movement, and doses of laxatives taken. …

The Burden of Metastatic Cancer-Induced Bone Pain: A Narrative Review.

Bone pain is one of the most common forms of pain reported by cancer patients with metastatic disease. We conducted a review of oncology literature to further understand the epidemiology of and treatment approaches for metastatic cancer-induced bone pain and the effect of treatment of painful bone metastases on the patient's quality of life. Two-thirds of patients with advanced, metastatic, or terminal cancer worldwide experience pain. Cancer pain due to bone metastases is the most common form of pain in patients with advanced disease and has been shown to significantly reduce patients' qualit

Совпадение в полном тексте источника
… Opioid-induced constipation in advanced cancer patients. Cureus . 2021;13(4):e14386. doi: 10.7759/cureus.14386 83. Khan F, Mehan A. Addressing opioid tolerance and opioid-induced hypersensitivity: recent developments and future therapeutic strategies. …

Pharmacological Treatments and Therapeutic Drug Monitoring in Patients with Chronic Pain.

Pain is an unpleasant sensory and emotional experience that affects every aspect of a patient's life and which may be treated through different pharmacological and non-pharmacological approaches. Analgesics are the drugs most commonly used to treat pain, and in specific situations, the use of opioids may be considered with caution. These drugs, in fact, do not always induce optimal analgesia in patients, and several problems are associated with their use. The purpose of this narrative review is to describe the pharmacological approaches currently used for the management of chronic pain. We rev

Совпадение в полном тексте источника
… Pathophysiology, diagnosis, and management of opioid-induced constipation Lancet Gastroenterol. Hepatol. 2018 3 203 212 10.1016/S2468-1253(18)30008-6 29870734 24. Hang A. Wang Y.J. He L. Liu J.G. The role of the dynorphin/κ opioid receptor system in anxiety Acta Pharmacol. …

Clinical Validation of Quality Indicators for the Pharmacological Management of Chronic Non-Cancer Pain in Older Adult Inpatients.

PurposeChronic non-cancer pain (CNCP) affects up to 88% of older adults. Pharmacological therapies are frequently prescribed long-term despite being considered second-line treatments and carrying significant risks, particularly for older adults. The present study aimed to clinically validate a set of quality indicators (QIs) that are used to improve the detection of medication-related problems during medication reviews performed by pharmacists for older adult inpatients with CNCP.Patients and methodsWe evaluated a set of medication review QIs-with previously established face and content validi

Совпадение в полном тексте источника
… O6 revealed that 14% of patients on opioids did not have a bowel regimen to prevent opioid-induced constipation, a frequent adverse event. 31 Implementation will focus on increasing sensibility of pharmacists to address this MRP. …

When to Use Methadone for pain: A Case-Based Approach.

The case studies are written in this article to illustrate how methadone might be used for pain in the Indian context. These cases might be used for discussion in a multidisciplinary team, or for individual study. It is important to understand that pain requires a multidisciplinary approach as opioids will assist only with physical, i.e. neuropathic and nociceptive pain, but not emotional, spiritual, or relational pain or the pain of immobility. The social determinants of pain were included to demonstrate how emotional, relational, and psychological dimensions of pain amplify the physical aspe

Pharmacovigilance in oncology.

Background Side effects of cancer therapy are one of the most important issues faced by cancer patients during their illness. Pharmacovigilance, namely the science and activities aimed at monitoring the safety of drugs, is particularly important in oncology, due to the intrinsic biologic toxicity of antineoplastic agents, their narrow therapeutic windows, and the high doses and rigid timing of treatment regimens. Aim of the review To identify the main issues in carrying out an effective pharmacovigilance activity in oncology. Method We searched PubMed for articles about pharmacovigilance in re

Совпадение в полном тексте источника
… For constipation: laxatives (osmotic or stimulant), opioid antagonists (e.g. methylnaltrexone) for opioid-induced constipation Fatigue Microtubule agents Consider concomitant factors (e.g. pain, anxiety) Suggest behavioral modifications; provide nutritional, physical and psychological support; consider … For constipation: laxatives (osmotic or stimulant), opioid antagonists (e.g. methylnaltrexone) for opioid-induced constipation Fatigue | Microtubule agents | Consider concomitant factors (e.g. pain, anxiety) | Suggest behavioral modifications; provide nutritional, physical and psychological support; …

Adverse drug reactions and drug-related problems with supportive care medications among the oncological population.

AimThe current study emphasizes the impact of adverse drug reactions (ADRs) and Drug-Related Problems (DRPs) caused by supportive care medications administered with chemotherapy.MethodThis is a longitudinal observational study carried out at the Ramaiah Medical College Hospital in Bengaluru, Karnataka, India, at the Department of Oncology. The data was recorded using a specifically created data collecting form. Based on the PCNE (Pharmaceutical Care Network Europe), DRPs are identified. The WHO probability scale, Modified Hartwig and Siegel for ADR severity assessment, Naranjo's algorithm for

Tapentadol in the management of cancer pain: current evidence and future perspectives.

Thanks to the progress in early diagnosis and treatment of cancer, the life expectancy of cancer patients has now increased. Patients are, therefore, more likely to experience their individual cancer pain as a chronic pain. As a consequence, long-term treatment of cancer-related pain and oncological therapy-related pain are a major need for all patients and a challenge to all healthcare professionals. Tapentadol is a centrally acting analgesic drug characterized by two synergistic mechanisms of action, since it acts at the µ-opioid receptor (MOR) and inhibits noradrenalin re-uptake (NRI). Ther

Evaluation of the Enhanced Recovery After Surgery (ERAS) Guidance for Patients With Spinal Metastasis.

Surgery continues to remain the most effective treatment for spinal metastasis (SM). As the number of surgeries continues to grow, the need for consensus guidelines for optimal perioperative care is imperative. Enhanced recovery after surgery (ERAS) protocols were created for this purpose. The objective of this study is to review evidence-based ERAS guidelines for SM surgery. A group of multiple experienced spine surgeons was invited to participate in this study. This group identified 19 ERAS items for SM surgery. The principal literature search utilized MEDLINE, Embase, and Cochrane databases