keyword
https://read.qxmd.com/read/38070938/patients-perspectives-on-tapering-programmes-for-prescription-opioid-use-disorder-a-qualitative-study
#1
JOURNAL ARTICLE
Lisa Eveline Maria Davies, Ellen S Koster, Katinka Fm Damen, Harmen Beurmanjer, Vivienne Wt van Dam, Marcel L Bouvy, Arnt Fa Schellekens
OBJECTIVES: Approximately 10% of chronic pain patients who receive opioids develop an opioid use disorder (OUD). Tapering programmes for these patients show high drop-out rates. Insight into chronic pain patients' experiences with tapering programmes for prescription OUD could help improve such programmes. Therefore, we investigated the perspectives of chronic pain patients with prescription OUD to identify facilitators and barriers to initiate and complete a specialised OUD tapering programme...
December 9, 2023: BMJ Open
https://read.qxmd.com/read/37880811/variability-in-opioid-conversion-calculators-in-critically-ill-children-transitioned-from-fentanyl-to-hydromorphone
#2
JOURNAL ARTICLE
Madison Casten, Jamie L Miller, Stephen Neely, Maura Harkin, Peter N Johnson
DISCLAIMER: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE: Opioid conversion calculators (OCCs) are used to convert between opioids...
October 25, 2023: American Journal of Health-system Pharmacy: AJHP
https://read.qxmd.com/read/37863373/routine-monitoring-of-qtc-interval-as-a-barrier-for-efficient-use-of-methadone-in-palliative-care
#3
JOURNAL ARTICLE
Varsha Pawate, Jaya Sheela Amaram Davila, Akhila Reddy, Eduardo Bruera
BACKGROUND: Methadone is a commonly prescribed opioid amongst cancer patients. It has unique pharmacological properties which can benefit in treating complex pain syndromes and neuropathic pain. However, strict guidelines have been created in a generalized manner for chronic pain and long-term survival patients. These guidelines, such as QT interval monitoring can lead to limitations for methadone use in patients with comfort associated goals. We present two cases of patients with metastatic cancer who were treated for pain with methadone and had to undergo opioid rotation due to abnormal QT interval...
October 18, 2023: Journal of Pain and Symptom Management
https://read.qxmd.com/read/37688712/opioid-induced-neurotoxicity-in-patients-with-cancer-pain
#4
REVIEW
Sebastiano Mercadante
Opioid-induced neurotoxicity (OINT) is a neuropsychiatric syndrome observed with opioid therapy. The mechanism of OINT is thought to be multifactorial, and many risk factors may facilitate its development. If symptoms of OINT are seen, the prescriber should consider hydration, discontinuation of the offending opioid drug, or switching of opioid medication, or the use of some adjuvants. Multiple factors like inter- and intraindividual differences in opioid pharmacology may influence the accuracy of dose calculations for opioid switching...
October 2023: Current Treatment Options in Oncology
https://read.qxmd.com/read/37225396/oral-ketamine-for-neuropathic-cancer-pain
#5
JOURNAL ARTICLE
Agnès Calsina-Berna, Margarita Alvaro Pardo, Marc Cucurull Salamero, Montserrat Bleda-Perez, Joaquim Julià-Torras
Optimal pain management in patients with advanced cancer often requires multiple pharmacological interventions and multimodal approach. Ketamine is an anaesthetic agent with increasing evidence supporting its use for pain. Due to its N-methyl-D-aspartate antagonism and its activity at opioid receptors, it is an adjuvant to traditional analgesics. Ketamine has a safety profile with limited experience of oral prolonged use in patients with cancer. We report a case of a 40-year-old man with refractory neuropathic cancer-related pain...
May 24, 2023: BMJ Supportive & Palliative Care
https://read.qxmd.com/read/37224674/opioid-agonist-therapy-switching-among-individuals-with-prescription-type-opioid-use-disorder-secondary-analysis-of-a-pragmatic-randomized-trial
#6
RANDOMIZED CONTROLLED TRIAL
Victor Mocanu, Nikki Bozinoff, Evan Wood, Didier Jutras-Aswad, Bernard Le Foll, Ron Lim, Jin Cheol Choi, Wing Yin Mok, M Eugenia Socias
BACKGROUND: Engagement and retention in opioid agonist therapy (OAT) remains a challenge. This study evaluated the impact of initial randomized OAT allocation on subsequent switching among people with prescription-type opioid use disorder (POUD). METHODS: Secondary analysis of a 24-week Canadian multicenter, pragmatic, randomized trial conducted between 2017 and 2020 comparing flexible take-home buprenorphine/naloxone versus supervised methadone models of care for POUD...
July 1, 2023: Drug and Alcohol Dependence
https://read.qxmd.com/read/37097772/retrospective-cohort-study-of-safety-outcomes-associated-with-opioid-rotations-to-buprenorphine
#7
JOURNAL ARTICLE
Neil K Shah, Michael W Chandler, Anne V Cetto, Lisa L Luciani, Jacob Painter, Danielle Bailey
The objective of this study was to understand the effect buprenorphine rotations have on respiratory risk and other safety outcomes. This was a retrospective observational study evaluating Veterans who underwent an opioid rotation from full-agonist opioids to buprenorphine products or to alternative opioids. The primary endpoint was change in the Risk Index for Overdose or Serious Opioid-induced Respiratory Depression (RIOSORD) score from baseline to six months post-rotation. Median baseline RIOSORD scores were 26...
April 25, 2023: Journal of Pain & Palliative Care Pharmacotherapy
https://read.qxmd.com/read/37059995/methadone-rotation-versus-other-opioid-rotation-for-refractory-cancer-induced-bone-pain-protocol-of-an-exploratory-randomised-controlled-open-label-study
#8
JOURNAL ARTICLE
Natasha Michael, Merlina Sulistio, Robert Wojnar, Alexandra Gorelik
BACKGROUND: A third of patients with advanced cancer and bone metastasis suffer from cancer induced bone pain (CIBP), impeding quality of life, psychological distress, depression and anxiety. This study will evaluate the impact of an opioid rotation, comparing methadone rotation with other opioid rotation in patients with refractory CIBP. METHODS: This open-label randomised controlled trial will recruit cancer patients with CIBP and inadequate pain control despite established baseline opioid and/or intolerable opioid side effects from cancer and palliative care services...
April 15, 2023: BMC Palliative Care
https://read.qxmd.com/read/37038067/benefits-and-risks-of-off-label-olanzapine-use-for-symptom-management-in-cancer-patients-a-case-report
#9
Rony Dev, Edgardo S Fortuno, Jaya S Amaram-Davila, Ali Haider, Eduardo Bruera
BACKGROUND: Cancer patients often experience symptoms such as anorexia, anxiety and insomnia, which can impact their quality of life. Randomized placebo-controlled trials support prophylactic use of olanzapine for the prevention of nausea and vomiting due to moderate and high-emetic risk chemotherapy. In the setting of palliative care, olanzapine is increasingly utilized as an off-label treatment of symptoms including anorexia-cachexia, anxiety, and insomnia. The following case reports will highlight the potential benefits and risks of off-label olanzapine use for symptom management in cancer patients...
May 2023: Annals of Palliative Medicine
https://read.qxmd.com/read/36720398/levorphanol-as-a-second-line-opioid-in-cancer-patients-presenting-to-an-outpatient-supportive-care-center-an-open-label-study
#10
JOURNAL ARTICLE
Akhila Reddy, Ali Haider, Joseph Arthur, David Hui, Shalini Dalal, Rony Dev, Kimberson Tanco, Jaya Amaram-Davila, Farley Hernandez, Paul Chavez, Aline Rozman De Moraes, Jimin Wu, Kristy Nguyen, Ishwaria Subbiah, Daniel Epner, Zeena Shelal, Marvin Omar Delgado Guay, Tarun Mallipeddi, Eduardo Bruera
CONTEXT: Levorphanol is a potent opioid agonist and NMDA receptor blocker with minimal drug interactions, and there are few reports of its use in cancer patients. OBJECTIVES: We aimed to determine the frequency of successful opioid rotation (OR) to levorphanol and the median opioid rotation ratio (ORR) from Morphine Equivalent Daily Dose (MEDD). METHODS: This is a prospective, single-group, interventional study. Cancer outpatients requiring an OR and receiving a MEDD of 60-300 mg were rotated to levorphanol using a ratio of 10:1 and assessed daily for 10-day...
June 2023: Journal of Pain and Symptom Management
https://read.qxmd.com/read/36520149/recurrent-persistent-hiccups-on-opioid-treatment-a-case-report-and-literature-review
#11
REVIEW
Giacomo Xausa, Monica Escher, Simon Singovski, Lisa Hentsch
Hiccups are a rare but potentially debilitating side effect of opioid treatment, with only a handful of reported cases in the medical literature. The pathophysiological mechanism linking opioids and hiccups is unknown, and a lack of evidence exists concerning the optimal management of the condition. We report on a 64-year-old man diagnosed with advanced renal cancer and painful osteolytic metastases, presenting persistent hiccups while on opioid treatment. Hiccups recurred after multiple challenges with codeine, morphine and hydromorphone on separate occasions...
March 2023: Journal of Pain & Palliative Care Pharmacotherapy
https://read.qxmd.com/read/36508032/-support-of-opioid-rotation-using-online-apps-evaluation-of-applicability-and-comparison-to-the-lonts-guidelines
#12
JOURNAL ARTICLE
Jan D Wandrey, Niklas Behnel, Sascha Tafelski
BACKGROUND: Opioid rotation can be indicated due to drug side effects, drug interactions or inadequate effect of treatment with opioids. For the determination of the oral morphine equivalence, a practice tool has been published with the long-term use of opioids in chronic nontumor-related pain (LONTS) guidelines. In contrast, several apps are available that have not yet been evaluated. MATERIAL AND METHODS: Apps and web applications for opioid conversion were searched using Google Play Store®, iOS App Store® and the Google® search engine...
December 12, 2022: Der Schmerz
https://read.qxmd.com/read/36162962/cancer-survivors-long-term-opioid-therapy-the-challenge
#13
JOURNAL ARTICLE
Sebastiano Mercadante, Yasmine Grassi, Vittorio Gebbia
The use of opioids in cancer survivors with chronic pain raises concerns as it occurs with chronic non-malignant pain .Thus, in some circumstances advanced therapeuthic strategies should be performed to allow pain control for prolonged periods of time We describe a case of a long-survivor patient receiving prolonged opioid therapy. She received multiple opioid rotations or some more complex treatments, including burst of ketamine and midazolam, which allowed to maintain an acceptable pain control for 12 years, despite her poor compliance...
September 26, 2022: BMJ Supportive & Palliative Care
https://read.qxmd.com/read/36057608/buprenorphine-naloxone-versus-methadone-opioid-rotation-in-patients-with-prescription-opioid-use-disorder-and-chronic-pain-study-protocol-for-a-randomized-controlled-trial
#14
JOURNAL ARTICLE
Hannah Ellerbroek, Sandra A S van den Heuvel, Albert Dahan, Hans Timmerman, Cornelis Kramers, Arnt F A Schellekens
BACKGROUND: Opioids are effective in pain-management, but long-term opioid users can develop prescription opioid use disorder (OUD). One treatment strategy in patients with OUD is rotating from a short-acting opioid to a long-acting opioid (buprenorphine/naloxone (BuNa) or methadone). Both BuNa and methadone have been shown to be effective strategies in patients with OUD reducing opioid misuse, however data on head-to-head comparison in patients with chronic non-malignant pain and prescription OUD are limited...
September 4, 2022: Addiction Science & Clinical Practice
https://read.qxmd.com/read/36034601/peri-operative-pain-management-education-de-escalation-poppmed-a-novel-anaesthesiologist-led-program-significantly-reduces-acute-and-long-term-postoperative-opioid-requirements-a-retrospective-cohort-study
#15
JOURNAL ARTICLE
Charlotte Heldreich, Ilonka Meyer, Esther Dube, Raymond Hu, William Howard, Natasha Holmes, Nada Maroon, Laurence Weinberg, Chong O Tan
Introduction: The opioid tolerant patient requiring surgery is highly likely to be discharged on high Oral Morphine Equivalent Daily Dosages (OMEDDs), with concomitant risk of increased morbidity and mortality. Objectives: We proposed that a single anaesthesiologist-led POPPMED (Peri-Operative Pain Management, Education & De-escalation) service could reduce both short and long-term postoperative patient OMEDDs. Methods: From April 2017, our anaesthesiologist-led POPPMED service, engaged 102 perioperative patients treated with >50mg preoperative OMEDDs...
September 2022: Pain Reports
https://read.qxmd.com/read/35930252/opioid-rotation-and-conversion-ratios-used-by-palliative-care-professionals-an-international-survey
#16
JOURNAL ARTICLE
Akhila Reddy, Christian Sinclair, Gregory B Crawford, Mary Lynn McPherson, Sebastiano Mercadante, David Hui, Ali Haider, Joseph Arthur, Kimberson Tanco, Shalini Dalal, Rony Dev, Jaya Amaram-Davila, Claudio Adile, Diane Liu, Ulrich Schuler, Sheetal Jammi, Zeena Shelal, Egidio Del Fabbro, Mellar Davis, Eduardo Bruera
Background: The opioid rotation ratios (ORRs) and conversion ratios (CRs) used worldwide among palliative care (PC) professionals to perform opioid rotations (ORs) and route conversions may have a wide variation. Methods: We surveyed PC professionals on opioid ratios used through email to the Multinational Association of Supportive Care in Cancer's PC study group and Twitter and Facebook posts between September and November 2020. Results: We received 370 responses from respondents from 53 countries: 276 (76%) were physicians, 46 (13%) advanced practice providers, 39 (11%) pharmacists, and 9 respondents did not report their profession...
October 2022: Journal of Palliative Medicine
https://read.qxmd.com/read/35647636/opioid-rotation-considerations-controversy-and-clinical-practice-440
#17
JOURNAL ARTICLE
Lauren Berninger, Corey Tapper
No abstract text is available yet for this article.
June 2022: Journal of Palliative Medicine
https://read.qxmd.com/read/35068247/role-of-ketamine-and-opioid-rotation-in-the-management-of-opioid-induced-hyperalgesia-in-a-patient-with-acute-promyelocytic-leukemia
#18
JOURNAL ARTICLE
Christopher Hino, Dan Ran-Castillo, Mojtaba Akhtari, Huynh Cao, Julio Silvestre
INTRODUCTION: Opioid analgesics are commonly used to manage moderate to severe cancer related pain. However long-term use of opioids has been known to lead to several unintended side effects, including opioid induced hyperalgesia (OIH) which is defined as the paradoxical increase in pain sensitization to pain stimulus following opioid exposure. Currently there are limited reports on the association between patients with cancer and OIH, and this phenomenon is rarely described in patients with leukemia or lymphoma...
January 24, 2022: Journal of Oncology Pharmacy Practice
https://read.qxmd.com/read/34978915/buprenorphine-microdosing-for-the-pain-and-palliative-care-clinician
#19
JOURNAL ARTICLE
Kyle Quirk, Maximillian Stevenson
Buprenorphine (BUP) can be a safe and effective alternative to traditional opioids for many patients with chronic pain. For patients on higher doses of opioids, rotation to BUP is complicated by the requirement of an opioid-free interval or withdrawal during the transition. Microdosing inductions, in which BUP is gradually titrated, while full agonist opioids are continued, are a viable alternative to traditional inductions. The objective of this article is to review the current literature on BUP microdosing induction, with a focus on patients using opioids for pain...
January 2022: Journal of Palliative Medicine
https://read.qxmd.com/read/34851186/methadone-switching-for-cancer-pain-a-new-classification-of-initiation-protocols-based-on-a-critical-literature-review
#20
REVIEW
Erwan Treillet, Olivier Giet, Stéphane Picard, Sophie Laurent, Laure Seresse
Background: The initiation of methadone, a known effective analgesic for cancer pain, is complex. The existing protocols are often inadequately described; therefore, a classification of literature is needed. We reviewed and classified the recent literature on methadone initiation protocols in cancer patients experiencing severe pain. Objective: To provide a new classification of initiation protocols, based on a critical literature review. Data Sources: The MEDLINE database was searched for articles published until March 25, 2021, using the terms "cancer pain," "methadone," "methadone introduction," or "methadone initiation...
December 2021: Journal of Palliative Medicine
keyword
keyword
35870
1
2
Fetch more papers »
Fetching more papers... Fetching...
Remove bar
Read by QxMD icon Read
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"

We want to hear from doctors like you!

Take a second to answer a survey question.