To identify potential areas for intervention and gain insight on current practice in patients who are tapered to zero morphine equivalent daily doses (MEDD) through the Pharmacy Pain E-Consult at […]» Read more
Addressing “total pain” is a concept commonly practiced in palliative care. Spiritual healing in a Navy Veteran led to a significant improvement in pain allowing a voluntary taper of opioid […]» Read more
A Quality Improvement Pilot of Pharmacist-Led Identification of an Inpatient Population for Opioid Stewardship and Pain Management.
The Joint Commission standards now include identification and monitoring patients at high-risk for adverse outcomes of opioid use. Our institution does not have a method to identify at-risk patients. This […]» Read more
While mirtazapine is primarily prescribed for major depressive disorder, it is less commonly prescribed for anorexia related to various disease states. Mirtazapine is associated with few adverse events but potential […]» Read more
Single Subcutaneous Ketamine Dose Followed by Oral Ketamine for Depression Symptoms in Hospice Patients: A Case Series.
Management of depression symptoms in hospice patients is complicated by the fact that an appropriate trial of antidepressant therapy requires 4-6 weeks and most hospice patients receive hospice services for less […]» Read more
Over the past two decades, opioid use and overdose have increased substantially. Naloxone, an opioid overdose reversal agent, has been one of many risk mitigation strategies for preventing mortality due […]» Read more
Lidocaine Continuous Subcutaneous Infusion for Neuropathic Pain in Hospice Patients: Safety and Efficacy.
Lidocaine continuous subcutaneous infusion (L-CSCI) for neuropathic pain in hospice patients has limited evidence for its safety and efficacy, and guidelines are lacking. This study assesses a series of patients […]» Read more
Recent studies in pediatric patients have suggested that ketamine, an N-methyl-D-aspartate receptor (NMDA) antagonist, given at sub-anesthetic doses can effectively decrease pain scores, provide analgesic effects, and in some cases, […]» Read more
There are currently limited published case reports and clinical studies looking at octreotide as a potential therapeutic agent for treating surgery- and malignancy-related chylothorax in adult patients. Few case reports […]» Read more
Guidance and evidence to support best practices in rotating between gabapentinoids is lacking. This retrospective cohort study was performed to describe and evaluate strategies for rotation. Patients rotated while admitted […]» Read more
Opioid induced constipation (OIC) is a predictable and preventable adverse effect of opioid use. Docusate is often utilized for OIC prophylaxis and treatment because of its low cost, easy accessibility […]» Read more
What People Search for When Browsing “Doctor Google.” An Analysis of Search Trends in Italy after the Law on Pain.
Italy adopted a law on chronic pain in March 2010, which focused on detection and management of this symptom, that affects approximately 25% of the population. The aim of this […]» Read more
Approximately 30% of patients experience nausea after initiation of opioid therapy, which can lead to poor quality of life. We aimed to identify risk factors for opioid-induced nausea at the […]» Read more
Erenumab and OnabotulinumtoxinA Combination Therapy for the Prevention of Intractable Chronic Migraine without Aura: A Retrospective Analysis.
Erenumab is a monoclonal antibody that mediates calcitonin-gene-related peptide (CGRP), a pro-inflammatory polypeptide implicated in migraine pathology, by targeting its receptor. To date, no clinical trial has evaluated combination therapy […]» Read more
Defining an Opioid Sparing Treatment Pathway for Chronic Abdominal Pain of Somatic and Visceral Origin: A Case Series.
Chronic non-malignant abdominal pain presents a treatment challenge for pain physicians. Treatment algorithms are often defined by single specialty and are unimodal with a dependence on opioids. We present a […]» Read more
Tramadol is a schedule IV, monoaminergic and μ-opioid-receptor analgesic with unique pharmacology properties. Though it is well established and widely utilized, there is little guidance on tramadol’s place in therapy, […]» Read more
Palliative and Supportive Care Prescribing Considerations Around QT Prolongation Risk in the Context of COVID-19 (Coronavirus Disease 2019) Management.
COVID-19 brings with it unprecedented challenges in clinical management. An important component of care is the provision of safe and effective symptom control. Given the emerging literature reporting on the […]» Read more
Intravenous Ketamine Administered as Patient Controlled Analgesia and Continuous Infusion for Central Pain Syndrome.
Treatment of Central Pain Syndrome (CPS) is known to be extremely challenging. Current therapies are unsatisfactory as patients report only mild to moderate pain relief. We report a case of […]» Read more
Population Pharmacokinetics of Methadone after Oral Administration in Japanese Patients with Cancer-Related Pain.
Methadone tablets were approved for use in Japan in March 2013. The metabolism of methadone is complex and executed mainly by the cytochromes, CYP3A4 and CYP2B6. The aim of this […]» Read more
The mainstay of treatment in advanced cancer pain is opioids; however, non-opioid medications such as acetaminophen continue to be included in guidelines despite a lack of clear, convincing evidence for […]» Read more
Effect of Antipsychotics and Non-Pharmacotherapy for the Management of Delirium in People Receiving Palliative Care.
Evidence to support the use of antipsychotic medications for the management of delirium symptoms remains limited. The primary objective of this study was to compare the effect of antipsychotic and […]» Read more
Changes in Pain Medication Profile among Patients Admitted to Specialized Home Palliative Care in Relation to Referral Source: An Exploratory Study.
Pain is a common symptom leading to referrals to specialized home palliative care (SHPC) services and is known to affect patients’ quality of life. To date, little is known about […]» Read more
Peripheral Neuropathy Associated with Hypereosinophilic Syndrome: A Clinical Therapeutic Success with Capsaicin 8% Patch.
Neuropathic pain is defined as a direct consequence of an injury or disease that affects the somatosensory system, which may affect 7 to 10% of the world population. Regardless of […]» Read more
Tailoring an individual patient’s pain treatment is paramount to decreasing patient suffering and diminishing morbidity. Performing pharmacogenomic (PGx) testing can help guide prescribing decisions for current and future medication therapy […]» Read more
Healthcare Expenditures Associated with Persistent Opioid use Among Adults with Chronic Non-Cancer Pain Conditions: A Retrospective Cohort Study.
Persistent opioid use in adults with chronic non-cancer pain (CNCP) conditions may lead to high economic burden due to adverse events associated with opioids. The objective of our study was […]» Read more
Attitudes toward and Barriers to Acetaminophen Use in the Chronic Pain Population: A Cross-Sectional Study.
The use of acetaminophen is recommended in pain management, particularly acute pain management, to reduce opioid utilization and opioid related adverse drug events. Acetaminophen’s role in chronic pain conditions is […]» Read more
The purpose of this quality improvement initiative was to demonstrate the value of having a clinical pain pharmacist in transitional perioperative pain management. Patients were referred to the pain pharmacist […]» Read more
Topical pain therapy offers several potential advantages as an alternative or adjunct to oral analgesic therapy, including decrease in concurrent oral drug use, lower abuse potential, lower side effects and […]» Read more
Chemotherapy-Induced Peripheral Neuropathy: Causative Agents, Preventative Strategies, and Treatment Approaches.
Chemotherapy-induced peripheral neuropathy (CIPN) is a chronic symptom associated with chemotherapy treatment. Symptoms and severity vary based on chemotherapeutic agent used and dose. At present, effective options for the prevention […]» Read more
Pruritic Manifestation of Peripheral T Cell Lymphoma Effectively Managed with Mirtazapine: A Case Report.
Chronic pruritus associated with underlying malignancy can greatly hinder a patient’s quality of life. The severity is variable and patients frequently fail traditional first line therapies. We report a patient […]» Read more