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Pain and Therapy

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https://www.readbyqxmd.com/read/28409480/genetic-testing-for-opioid-pain-management-a-primer
#1
Deepti Agarwal, Mercy A Udoji, Andrea Trescot
Patients see their primary care physicians (PCPs) for a variety of medical conditions, chronic pain being one of the most common. An increased use of prescription medications (especially opioids) has led to an increase in adverse drug reactions and has heightened our awareness of the variability in response to medications. Opioids and other pain adjuvants are widely used, and drug-drug interactions involving these analgesics can be problematic and potentially lethal. Pharmacogenetics has improved our understanding of drug efficacy and response, opened doors to individual tailoring of medical management, and created a series of ethical and economic considerations...
April 13, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/28341939/the-basic-pharmacology-of-opioids-informs-the-opioid-discourse-about-misuse-and-abuse-a-review
#2
REVIEW
Joseph V Pergolizzi, Jo Ann LeQuang, Garrett K Berger, Robert B Raffa
Morphine and other opioids are widely used to manage moderate to severe acute pain syndromes, such as pain associated with trauma or postoperative pain, and they have been used to manage chronic pain, even chronic nonmalignant pain. However, recent years have seen a renewed recognition of the potential for overuse, misuse, and abuse of opioids. Therefore, prescribing opioids is challenging for healthcare providers in that clinical effectiveness must be balanced against negative outcomes-with the possibility that neither are achieved perfectly...
March 24, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/28260158/valuing-individuals-preferences-and-health-choices-of-physical-exercise
#3
Emmanuel Aboagye
The efficacy of physical exercise for the prevention and treatment of non-specific low back pain (LBP) is well documented, but little is known about how individuals value specific components of physical exercise, such as the type and design or the intensity and frequency of exercise. Other factors that influence individual differences in health choices and adherence are associated with individuals' attitudes toward and likelihood of performing recommended exercise regimens. Current evidence shows that efficacy is similar among exercise interventions, but their features vary widely...
March 4, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/28255955/parecoxib-provides-analgesic-and-opioid-sparing-effects-following-major-orthopedic-surgery-a-subset-analysis-of-a-randomized-placebo-controlled-clinical-trial
#4
Efrain Diaz-Borjon, Armando Torres-Gomez, Margaret Noyes Essex, Patricia Salomon, Chunming Li, Raymond Cheung, Bruce Parsons
INTRODUCTION: Orthopedic surgeries are among the most common and most painful surgeries performed. A multimodal analgesic approach is recommended to reduce opioid consumption, provide effective pain relief, and improve outcomes following surgery. This study examined the efficacy and opioid-sparing effects of parecoxib following major orthopedic surgery. METHODS: This subset analysis of a large, multicenter, randomized, double-blind, placebo-controlled study of parecoxib examined treatment effects on postoperative pain severity, pain interference with function, opioid consumption, occurrence of opioid-related symptoms, safety, and patient satisfaction following major orthopedic surgery...
March 2, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/28185130/frequency-of-shoulder-corticosteroid-injections-for-pain-and-stiffness-after-shoulder-surgery-and-their-potential-to-enhance-outcomes-with-physiotherapy-a-retrospective-study
#5
John G Skedros, Micheal G Adondakis, Alex N Knight, Michael B Pilkington
INTRODUCTION: What is the rate of injecting patients with shoulder corticosteroid injections to alleviate excessive stiffness and pain within 6 months after shoulder surgery? METHODS: Retrospective 10-year review of a shoulder surgeon's practice. Participants included 754 patients who had 945 non-arthroplasty shoulder surgeries. Outcome measures included the rate of injections, diagnoses, patient characteristics, and efficacy via questionnaire. RESULTS: Approximately one in five patients received a subacromial and/or glenohumeral corticosteroid injection...
February 9, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/28004310/high-body-mass-index-and-use-of-fentanyl-iontophoretic-transdermal-system-in-postoperative-pain-management-results-of-a-pooled-analysis-of-six-phase-3-3b-trials
#6
Eugene R Viscusi, Li Ding, J Bradley Phipps, Loretta M Itri, Philip R Schauer
INTRODUCTION: Postoperative pain management can be challenging in patients with a high body mass index (BMI) especially as a result of poor venous access and delayed ambulation that can result in serious complications. Fentanyl iontophoretic transdermal system (ITS) is a needle-free, patient-controlled analgesic method available for use in acute postoperative pain. The primary objective of these analyses was to determine if there were any differences between patients with high BMI (>40 kg/m(2)) and lower BMIs (<30 kg/m(2) and 35-40 kg/m(2)) in terms of efficacy or safety...
December 21, 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27873179/oxycodone-deterx-%C3%A2-a-novel-abuse-deterrent-extended-release-analgesic-option-for-the-treatment-of-patients-with-chronic-pain
#7
REVIEW
Jeff Gudin
BACKGROUND: Extended-release (ER) opioid analgesics are commonly used to provide safe and effective pain relief to treat pain severe enough to require around-the-clock, long-term dosing. These ER opioid formulations usually contain more drug per dosage unit than immediate-release (IR) agents, and therefore bring with them challenges related to both opioid abuse and misuse, often through manipulation of the dosage form. Oxycodone DETERx(®) (Xtampza(®) ER, Collegium Pharmaceutical, Inc...
December 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27830531/treatment-of-severe-pain-and-opioid-induced-constipation-an-observational-study-of-quality-of-life-resource-use-and-costs-in-sweden
#8
Frida Hjalte, Gunnel Ragnarson Tennvall, Karl-Olof Welin, Dagmar Westerling
INTRODUCTION: Opioid-induced constipation (OIC) is a common and costly side effect of opioid treatment affecting patients' quality of life (QoL). The combination oxycodone/naloxone reduces OIC while providing effective analgesia in patients with moderate to severe pain. The objective of this observational study was to compare health-related quality of life (HRQoL), healthcare resource use, and costs in patients with severe pain who were initially treated with oxycodone and laxatives and then subsequently switched to treatment with oxycodone/naloxone...
December 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27822619/the-5-lidocaine-medicated-plaster-its-inclusion-in-international-treatment-guidelines-for-treating-localized-neuropathic-pain-and-clinical-evidence-supporting-its-use
#9
REVIEW
Ralf Baron, Massimo Allegri, Gerardo Correa-Illanes, Guy Hans, Michael Serpell, Gerard Mick, Victor Mayoral
When peripheral neuropathic pain affects a specific, clearly demarcated area of the body, it may be described as localized neuropathic pain (LNP). Examples include postherpetic neuralgia and painful diabetic neuropathy, as well as post-surgical and post-traumatic pain. These conditions may respond to topical treatment, i.e., pharmaceutical agents acting locally on the peripheral nervous system, and the topical route offers advantages over systemic administration. Notably, only a small fraction of the dose reaches the systemic circulation, thereby reducing the risk of systemic adverse effects, drug-drug interactions and overdose...
December 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27817153/use-of-fentanyl-iontophoretic-transdermal-system-its-ionsys-%C3%A2-in-the-management-of-patients-with-acute-postoperative-pain-a-case-series
#10
Steven Poplawski, Matthew Johnson, Philip Philips, Leopold H J Eberhart, Tilo Koch, Loretta M Itri
Fentanyl iontophoretic transdermal system (ITS) [IONSYS(®), The Medicines Company, Parsippany, NJ, USA] is a needle-free, patient-controlled, postoperative opioid pain management treatment. It is indicated for the short-term management of acute postoperative pain in adults requiring opioid analgesia in the hospital. The safety and effectiveness of fentanyl ITS for acute postoperative pain management has been demonstrated in a range of surgery and patient types studied in seven phase 3 trials (three placebo-controlled trials and four active-comparator trials)...
December 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27743137/change-pain-ever-evolving-an-update-for-2016
#11
EDITORIAL
Joseph V Pergolizzi, Antonella Paladini, Giustino Varrassi, Robert B Raffa
Since 1986, the pharmacological management of pain was mainly based on the WHO "analgesic ladder", with very few drugs available. The huge development of the basic knowledge on pain and its therapy, especially in the past 15 years, has made the "guidelines" of WHO obsolete. That's why, during the presidency of EFIC of one of the authors (GV), an international advisory board was proposed to review the document, but mainly to ameliorate the approach to the pain patients.
December 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27704485/health-care-utilization-and-costs-associated-with-nausea-and-vomiting-in-patients-receiving-oral-immediate-release-opioids-for-outpatient-acute-pain-management
#12
Elizabeth Marrett, Winghan Jacqueline Kwong, Feride Frech, Chunlin Qian
INTRODUCTION: Nausea and vomiting (NV) are common side effects of opioid use and limiting factors in pain management. This study sought to quantify the frequency of antiemetic prescribing and the impact of NV on health care resource utilization and costs in outpatients prescribed opioids for acute pain. The perspective was that of a commercial health plan. METHODS: Medical and pharmacy claims from IMS PharMetrics Plus were used to identify patients initiating opioid therapy with a prescription for an oxycodone-, hydrocodone- or codeine-containing immediate-release product for acute use (≤15-day supply) between October 1, 2013 and September 30, 2014...
December 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27650441/the-cold-pressor-test-as-a-predictor-of-prolonged-postoperative-pain-a-prospective-cohort-study
#13
Cameron MacLachlan, Edward A Shipton, J Elisabeth Wells
INTRODUCTION: Presently, it is difficult to predict which patients are at increased risk of ongoing pain problems postoperatively. This study followed a group of patients from the week before their operation until 3 months after it, to identify potential risk variables. METHODS: Fifty-four patients undergoing moderate-major gynaecological surgery at Christchurch Women's Hospital were recruited and assessed preoperatively over an 11-week period. At this initial assessment, participants were subjected to a cold pressor test (CPT)...
December 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27550176/practice-based-research-networks-integrating-clinical-data-for-improved-pharmacoepidemiology
#14
Tiago Sousa-Veloso
Pharmacovigilance is concerned with the detection, assessment, understanding, and prevention of adverse reactions to medicines. It is helpful to prevent undesired harm sustained by the patient due to inappropriate or unsafe use of medicinal agents. As the use of drugs and polypharmacy increase in prevalence, pharmacovigilance gains relevance and momentum. Practice-based research networks have the potential to enhance health research by promoting earlier detection of adverse events at a decreased level of cost...
December 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27515841/encountering-a-neglected-area-of-a-healthcare-system-a-decade-of-improvement-in-cancer-pain-clinical-practice-in-iran
#15
Farid A Gharehdaghi, Mansoureh Gorginzadeh, Saeid Safari
BACKGROUND: With the increase in the prevalence of cancer, cancer-related issues also deserve more attention especially in developing countries where there is already limited access to high-quality healthcare. Cancer-related pain, the most common and the most annoying one, is not only a symptom but also an important subspecialty and its management is still challenging. OBJECTIVES: To assess the level of pain and cancer pain knowledge in Iran in comparison with the whole world...
December 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27295264/how-resistant-to-tampering-are-codeine-containing-analgesics-on-the-market-assessing-the-potential-for-opioid-extraction
#16
Andreas Kimergård, Paolo Deluca, Peter Hindersson, Torben Breindahl
INTRODUCTION: Misuse of opioid analgesics, in combination with diversion, dependence, and fatal overdoses, presents a serious problem for public health, which affects many countries worldwide. Within this context, tampering with opioids has been associated with serious harm. The aim of the present study was to assess the tampering potential of codeine combination analgesics on the market (containing codeine/non-opioid analgesics) by the extraction of codeine. METHODS: Codeine was extracted from three combination formulations sold lawfully from licensed pharmacies without a medical prescription in Denmark and the UK...
December 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27900726/survey-on-german-palliative-care-specialists-experiences-with-advance-directives
#17
Julia Zenz, Michael Zenz
INTRODUCTION: Advance directives (AD) play a central role in end-of-life treatments, intensive care, and palliative care. However, little is known about the experiences of healthcare professionals with ADs. This study reports on palliative care professionals' views on advance directives (AD). METHODS: A questionnaire was handed out to attendants of a palliative care symposium. RESULTS: Complete answers were obtained from 126 physicians and 276 nurses...
November 29, 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27229350/should-the-general-practitioner-consider-mesotherapy-intradermal-therapy-to-manage-localized-pain
#18
Massimo Mammucari, Enrica Maggiori, Marzia Lazzari, Silvia Natoli
Wide variations in the types of pain and response to analgesic pharmacotherapy mean that a variety of treatment strategies are needed. One approach is mesotherapy (intradermal therapy). This consists of microinjections into the skin and is ideally suited to the management of localized pain. Advantages include increasing the duration of drug activity, reduced risk of adverse events and interactions, and possible synergy with other therapies. Mesotherapy provides general practitioners with another tool for the treatment of local pain...
June 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27160684/oxycodone-and-naloxone-combination-a-12-week-follow-up-in-20-patients-shows-effective-analgesia-without-opioid-induced-bowel-dysfunction
#19
Gareth P Jones, Shiva S Tripathi
INTRODUCTION: Opioid analgesics are widely regarded to be highly effective but are equally known for their side effects on the bowel. A new combination of the opioid analgesic oxycodone and naloxone has been developed to combat opioid-induced bowel dysfunction (OIBD) whilst still being effective as an analgesic. The aim of this observational study was to assess the analgesic efficacy of this new combination and to analyze its effect on bowel function. METHODS: Twenty-six patients underwent a trial of this new combination, with 21 patients reaching week 8 and 18 reaching week 12...
June 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27001634/ultrasound-guided-parasternal-block-allows-optimal-pain-relief-and-ventilation-improvement-after-a-sternal-fracture
#20
Kurian P Thomas, Shaji Sainudeen, Suraj Jose, Mansour Y Nadhari, Philippe B Macaire
INTRODUCTION: Sternal fractures are a painful condition which can result in pulmonary morbidity if not treated promptly. The management of isolated fractures has changed from hospital to home-based treatment, provided other major injuries have been excluded. Pain management is the mainstay of treatment. In this case report, we describe how a parasternal block under ultrasound guidance for sternal fracture provided better analgesia thereby improving ventilation. CASE REPORT: A 26-year-old man was admitted to the emergency department following a road traffic accident...
June 2016: Pain and Therapy
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