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Morphine, hospice, methadone, fentanyl, oxycodone, cancer pain

Giovambattista Zeppetella
Breakthrough pain is a common and distinct component of cancer pain that is usually managed with normal release opioids (also known as rescue medication) either before or soon after its onset. A prospective survey of hospice inpatients with breakthrough pain was undertaken to characterize their pain and then compare the time to onset of pain relief of their rescue medication. Patients presented with, on average, 1.7 different types of breakthrough pains (range, 1-4). The average number of breakthrough pains was four per day (range, 1-8), and the average duration of breakthrough pain was 35 minutes (range, 15-60); most occurred suddenly and unpredictably...
May 2008: Journal of Pain and Symptom Management
M A Ashby, P Martin, K A Jackson
OBJECTIVE: To assess the effect of opioid substitution (substituting one member of the opioid class for another) on the incidence and severity of adverse effects in palliative care patients who experience unacceptable, refractory adverse effects when taking an opioid drug. DESIGN: Prospective audit of clinical records. SETTING: Palliative Care Program, Monash Medical Centre, Melbourne, Victoria (comprising an acute 10-bed palliative care unit and a palliative care consultative service)...
January 18, 1999: Medical Journal of Australia
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