Medication-focused approach to total pain: Poor symptom control, polypharmacy, and adverse reactions

American Journal of Hospice and Palliative Medicine

Volumn 20, Issue 4, 2003, Pages 307-310

  Al Shahri, Mohammad Zafir ^a   Molina, Emilio Herrera ^b   Oneschuk, Doreen ^c  

^a KING FAISAL SPECIALIST HOSPITAL AND RESEARCH CENTER   (Saudi Arabia)

^b Regional Palliative Care Program   (Spain)

^c UNIVERSITY OF ALBERTA   (Canada)

Author keywords

Adverse reaction; Cancer; Medication; Opioid; Pain; Polypharmacy; Symptom control

Indexed keywords

ANALGESIC AGENT; DEXAMETHASONE; GABAPENTIN; HYDROMORPHONE; KETAMINE; LEVOMEPROMAZINE; METHADONE; MIDAZOLAM; MORPHINE; NORTRIPTYLINE; OPIATE; PAROXETINE; ROFECOXIB; ANTINEOPLASTIC HORMONE AGONISTS AND ANTAGONISTS; NARCOTIC AGENT; NARCOTIC ANALGESIC AGENT;

ADULT; AGITATION; ANAMNESIS; ARTICLE; CASE REPORT; CAUDA EQUINA SYNDROME; CONFUSION; DROWSINESS; DRUG MEGADOSE; EWING SARCOMA; HUMAN; INTENSIVE CARE; MALE; MYOCLONUS; NEUROPATHIC PAIN; NEUROTOXICITY; PALLIATIVE THERAPY; POLYPHARMACY; RESTLESSNESS; SEIZURE; SIDE EFFECT; SYMPTOM; VIVID DREAM; BONE TUMOR; INTRACTABLE PAIN; LUNG TUMOR; METASTASIS; METHODOLOGY; PATHOLOGY; PSYCHOLOGICAL ASPECT; TERMINALLY ILL PATIENT; TIME;

ADULT; ANALGESICS, OPIOID; ANTINEOPLASTIC AGENTS, HORMONAL; BONE NEOPLASMS; HUMANS; LUNG NEOPLASMS; MALE; NARCOTICS; PAIN, INTRACTABLE; PALLIATIVE CARE; SARCOMA, EWING'S; TERMINALLY ILL; TIME FACTORS;

EID: 0141447222     PISSN: 10499091     EISSN: None     Source Type: Journal    
DOI: 10.1177/104990910302000414     Document Type: Article

References (21)

1. Dickenson AH: Neurophysiology of opioid poorly responsive pain. Cancer Surv. 1994; 21: 5-16.
2. Martin LA, Hagen NA: Neuropathic pain in cancer patients: Mechanisms, syndromes, and clinical controversies. J Pain Symptom Manage. 1997; 14(2): 99-117.
3. Mercadante S, Portenoy RK: Opioid poorly responsive cancer pain. Part 2: Basic mechanisms that could shift dose response for analgesia. J Pain Symptom Manage. 2001; 21(3): 255-264.
4. Chandler A, Williams JE: Gabapentin, an adjuvant treatment for neuropathic pain in a cancer hospital. J Pain Symptom Manage. 2000; 20(2): 82-86.
5. Sloan P, Basta M, Storey P, et al.: Mexilitine as an adjuvant analgesic for the management of neuropathic cancer pain. Anesth Analg. 1999; 89(3): 760-761.
6. Caraceni A, Zecca E, Martini C, et al.: Gabapentin as an adjuvant to opioid analgesia for neuropathic cancer pain. J Pain Symptom Manage. 1999; 17(6): 441-445.
7. McQuay HJ, Moore RA: Antidepressants and chronic pain. Brit Med J. 1997; 314(7083): 763-764.
8. Strang P: Existential consequences of unrelieved cancer pain. Palliat Med. 1997; 11(4): 299-305.
9. Greenstreet W: The concept of total pain: A focused patient care study. Br J Nurs. 2001; 10(19): 1248-1255.
10. Clark D: "Total pain," disciplinary power, and the body in the work of Cicely Saunders, 1958-1967. Soc Sci Med. 1999; 49(6): 727-736.
11. Fiellin DA, Reid MC, O'Connor PG: Screening for alcohol problems in primary care: A systematic review. Arch Intern Med. 2000; 160(13): 1977-1989.
12. Indelicato RA, Portenoy RK: Opioid rotation in the management of refractory cancer pain. J Clin Oncol. 2002; 20(1): 348-352.
13. Ripamonti C, Zecca E, Bruera E: An update on the clinical use of methadone for cancer pain. Pain. 1997; 70: 109-115.
14. Benitez del Rosario MA, Martin AS, Ortega JJ, et al.: Temporary sedation with midazolam for control of severe incident pain. J Pain Symptom Manage. 2001; 21(5): 439-42.
15. Fainsinger RL, Waller A, Bercovici M, et al.: A multicenter international study of sedation for uncontrolled symptoms in terminally ill patients. Palliat Med. 2000; 14(4): 257-265.
16. Reich DL, Silvay G: Ketamine: An update on the first 25 years of clinical experience. Can J Anesth. 1989; 36(2): 186-197.
17. White PF, Way WL, Trevor AJ: Ketamine: Its pharmacology and therapeutic uses. Anesthesiology. 1982; 56: 119-136.
18. Pender JW: Dissociative anesthesia. JAMA. 1971; 215: 1126-1130.
19. Mitchell AC: Generalized hyperalgesia and allodynia following abrupt cessation of subcutaneous ketamine infusion. Palliat Med 1999; 13: 427-428.
20. Watanabe S, Carmody D, Bruera E: Successful multidimensional intervention in a patient with intractable neuropathic cancer pain. J Palliat Care. 1997; 13(2): 52-54.
21. Robinson K, Bruera E: The management of pain in patients with advanced cancer: The importance of multidimensional assessment. J Palliat Care. 1995; 11(4): 51-53.