Pain in terminally ill patients: Guidelines for pharmacological management
Successful pharmacological treatment of pain in terminally ill patients is possible most of the time. It requires a determination of the type of pain syndrome (i.e. nociceptive, neuropathic or mixed). Complete pain assessment also requires an understanding of other dimensions of suffering that a pat...
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| Veröffentlicht in: | CNS drugs 2003-01, Vol.17 (9), p.621-631 |
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| container_title | CNS drugs |
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| creator | THOMAS, Jay R VON GUNTEN, Charles F |
| description | Successful pharmacological treatment of pain in terminally ill patients is possible most of the time. It requires a determination of the type of pain syndrome (i.e. nociceptive, neuropathic or mixed). Complete pain assessment also requires an understanding of other dimensions of suffering that a patient may be experiencing on psychological, social and spiritual/existential levels. The World Health Organization has introduced a three-step approach to treating pain. Opioids are the mainstay of therapy for moderate to severe pain at the end of life. Familiarity with the pharmacokinetics, equianalgesic dose and adverse effects of opioids is necessary for their safe and effective use. In addition, adjuvant analgesics such as antiepileptic drugs, antidepressants and local anaesthetics are often needed to optimise pain control, especially in patients with neuropathic pain. Given the complex aetiology of pain states, combinations of classes of adjuvants may sometimes be needed for effective treatment. |
| doi_str_mv | 10.2165/00023210-200317090-00002 |
| format | Article |
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It requires a determination of the type of pain syndrome (i.e. nociceptive, neuropathic or mixed). Complete pain assessment also requires an understanding of other dimensions of suffering that a patient may be experiencing on psychological, social and spiritual/existential levels. The World Health Organization has introduced a three-step approach to treating pain. Opioids are the mainstay of therapy for moderate to severe pain at the end of life. Familiarity with the pharmacokinetics, equianalgesic dose and adverse effects of opioids is necessary for their safe and effective use. In addition, adjuvant analgesics such as antiepileptic drugs, antidepressants and local anaesthetics are often needed to optimise pain control, especially in patients with neuropathic pain. 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Drug treatments</topic><topic>Practice Guidelines as Topic</topic><topic>Receptors, N-Methyl-D-Aspartate - antagonists & inhibitors</topic><topic>Receptors, N-Methyl-D-Aspartate - therapeutic use</topic><topic>Terminally Ill</topic><topic>Therapeutic Equivalency</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>THOMAS, Jay R</creatorcontrib><creatorcontrib>VON GUNTEN, Charles F</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>CNS drugs</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>THOMAS, Jay R</au><au>VON GUNTEN, Charles F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pain in terminally ill patients: Guidelines for pharmacological management</atitle><jtitle>CNS drugs</jtitle><addtitle>CNS Drugs</addtitle><date>2003-01-01</date><risdate>2003</risdate><volume>17</volume><issue>9</issue><spage>621</spage><epage>631</epage><pages>621-631</pages><issn>1172-7047</issn><eissn>1179-1934</eissn><abstract>Successful pharmacological treatment of pain in terminally ill patients is possible most of the time. 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| fulltext | fulltext |
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| ispartof | CNS drugs, 2003-01, Vol.17 (9), p.621-631 |
| issn | 1172-7047 1179-1934 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adrenergic alpha-Agonists - therapeutic use Analgesics Analgesics - pharmacology Anesthetics, Local - therapeutic use Anti-Inflammatory Agents - therapeutic use Anticonvulsants - therapeutic use Antidepressive Agents, Tricyclic - therapeutic use Biological and medical sciences Drug Administration Routes Drug Therapy, Combination Humans Medical sciences Neoplasms - drug therapy Neuropharmacology Pain - drug therapy Palliative Care - standards Pharmacology. Drug treatments Practice Guidelines as Topic Receptors, N-Methyl-D-Aspartate - antagonists & inhibitors Receptors, N-Methyl-D-Aspartate - therapeutic use Terminally Ill Therapeutic Equivalency |
| title | Pain in terminally ill patients: Guidelines for pharmacological management |
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