1
|
Rai DK, Sharma P. Palliative Care in Drug Resistance Tuberculosis: An Overlooked Component in Management. Indian J Palliat Care 2023; 29:388-393. [PMID: 38058485 PMCID: PMC10696341 DOI: 10.25259/ijpc_141_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 10/10/2023] [Indexed: 12/08/2023] Open
Abstract
Palliative care should be an important component in the management of drug resistant tuberculosis (DRTB); however, it is not given much importance. Even in the current scenario, many patients and their caregivers consider multidrug-resistant and extensively drug-resistant tuberculosis (TB) as a terminal illness and considering it almost as a death sentence, this group of patients also require palliative care. There is a misconception about considering palliative care as a treatment component in the terminal stage of an illness where curative treatment has no role in improving the survival of the patient. However, the real meaning of palliative care is to relieve suffering in all stages of the disease and is not limited to end-of-life care only. Palliative care in DRTB aims to improve the quality of life, intractable symptoms and physical, psychosocial and spiritual suffering of patients as well as their caregivers. There is an imminent need to train all TB healthcare workers regarding basic palliative care and integrate palliative care into the TB healthcare system.
Collapse
Affiliation(s)
- Deependra Kumar Rai
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Priya Sharma
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| |
Collapse
|
2
|
Najam F, Jafri N, Khan MN, Daraz U. Reduction of Acute Postoperative Pain With Pre-Emptive Pregabalin Following Laparoscopic Cholecystectomy. Cureus 2022; 14:e27783. [PMID: 36106290 PMCID: PMC9450992 DOI: 10.7759/cureus.27783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2022] [Indexed: 11/05/2022] Open
Abstract
Abstract Pregabalin has been considered to be a safe treatment for neuropathic pain. Owing to the lack of research regarding the use of pregabalin in the management of pain in under-resourced settings, our study aimed to deduce the effectiveness of a pre-emptive single dose of pregabalin pre-operatively to provide pain relief after laparoscopic cholecystectomy. Treating acute pain is essential to avoid an increased hospital stay. There is a need for non-opioid drugs with lower risks to avoid using opioids, which lead to many side effects. Methodology Patients diagnosed with cholelithiasis and scheduled to undergo laparoscopic cholecystectomy at the Abbasi Shaheed Hospital were included in this study. The study aimed to determine whether the effect of pregabalin in combination with patient-controlled analgesia can decrease pain scores. This was a double-blind study where patients, caregivers, and analysts were blinded to group allocation and drugs administered until the data was recorded and sealed. The patients were divided into pregabalin and placebo groups through a web-based model; blocks of four were used and stratification was employed at the center. A confidence interval of 95% was considered significant. Results In our study, a total number of 60 patients were included. They were randomly divided by a computer-based model into two groups, the pregabalin group, and the control group. The placebo group had 33 patients while the pregabalin group had 27 patients. The pregabalin group was given a pregabalin tablet of 150 mg before surgery while the placebo group was given an identical-looking placebo. Patient-controlled analgesia was started in both groups and the visual analog scale (VAS) scoring was observed postoperatively. The pregabalin group had a decreased incidence of pain as compared to the placebo group. There were no significant side effects during the trial; episodes of vomiting were managed using intravenous ondansetron. Conclusion Pregabalin is effective in reducing pain in an acute postoperative period when compared with a placebo. Patients who were pre-emptively administered pregabalin reported decreased VAS as compared to the placebo. However, both were inefficient in reducing postoperative nausea and vomiting.
Collapse
|
3
|
Williams J, Gingras MA, Dubé R, Lee TC, McDonald EG. Patient empowerment brochures to increase gabapentinoid deprescribing: protocol for the prospective, controlled before-and-after GABA-WHY trial. CMAJ Open 2022; 10:E652-E656. [PMID: 35820684 PMCID: PMC9473286 DOI: 10.9778/cmajo.20210302] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Off-label use of gabapentinoids is common among patients admitted to hospital medical wards, who are at risk of adverse drug events. In this study, we will assess if educational brochures can increase rates of gabapentinoid deprescription among medical inpatients, compared with usual care. METHODS We describe the protocol for a prospective before-and-after trial that will take place on 5 medical wards of 2 tertiary care hospitals in Montréal, Canada. The study intervention will include distribution of educational brochures to users of gabapentinoids during hospital admission, as well as short educational sessions for medical staff on safe gabapentinoid prescribing practices. We will include patients with a gabapentinoid prescription before admission who are aged 60 years or older. Exclusion criteria are known seizure disorder, severe cognitive impairment, expected prognosis less than 3 months and inability to read English or French. The primary outcome is the rate of gabapentinoid deprescription at 8 weeks postdischarge. We aim to recruit 160 participants, with a 1:1 distribution between intervention and control groups. INTERPRETATION If successful, the use of educational brochures and staff education represents a scalable intervention to reduce gabapentinoid overuse by encouraging deprescription conversations between patients and their health care providers. Results of the study will be disseminated through publication in peer-reviewed journals and presentations at conferences. TRIAL REGISTRATION ClinicalTrials.gov, no. NCT04855578.
Collapse
Affiliation(s)
- Jerome Williams
- Department of Medicine (Williams, Gingras, Dubé, Lee, McDonald), McGill University; Clinical Practice Assessment Unit (Lee, McDonald), Department of Medicine, McGill University Health Centre, Montréal, Que
| | - Marc-Alexandre Gingras
- Department of Medicine (Williams, Gingras, Dubé, Lee, McDonald), McGill University; Clinical Practice Assessment Unit (Lee, McDonald), Department of Medicine, McGill University Health Centre, Montréal, Que
| | - Robert Dubé
- Department of Medicine (Williams, Gingras, Dubé, Lee, McDonald), McGill University; Clinical Practice Assessment Unit (Lee, McDonald), Department of Medicine, McGill University Health Centre, Montréal, Que
| | - Todd C Lee
- Department of Medicine (Williams, Gingras, Dubé, Lee, McDonald), McGill University; Clinical Practice Assessment Unit (Lee, McDonald), Department of Medicine, McGill University Health Centre, Montréal, Que
| | - Emily G McDonald
- Department of Medicine (Williams, Gingras, Dubé, Lee, McDonald), McGill University; Clinical Practice Assessment Unit (Lee, McDonald), Department of Medicine, McGill University Health Centre, Montréal, Que.
| |
Collapse
|
4
|
Shkodra M, Caraceni A. Treatment of Neuropathic Pain Directly Due to Cancer: An Update. Cancers (Basel) 2022; 14:cancers14081992. [PMID: 35454894 PMCID: PMC9031615 DOI: 10.3390/cancers14081992] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/10/2022] [Accepted: 04/12/2022] [Indexed: 02/06/2023] Open
Abstract
Simple Summary This review discusses treatment approaches for providing pain relief to oncological patients affected by pain caused by nerve damage due to the tumor, also known as neuropathic cancer pain. Although being encountered often and causing a relevant burden to these patients, neuropathic cancer pain remains still difficult to diagnose and treat. Strong evidence about the best drugs to be used remain limited, as do therapeutic choices. Abstract Neuropathic pain can be defined as pain related to abnormal somatosensory processing in either the peripheral or central nervous system. In this review article, with neuropathic cancer pain (NCP), we refer to pain due to nervous tissue lesions caused by the tumor or its metastases. Nervous tissue damage is the cause of cancer pain in approximately 40% of those experiencing cancer pain. Recognizing a neuropathic pathophysiology in these cases may be difficult and requires specific criteria that are not homogenously applied in clinical practice. The management of this type of pain can be challenging, requiring the use of specific non-opioid adjuvant drugs. The majority of the criteria for NCP diagnosis and management have been based mainly on results from the noncancer population, risking the failure of addressing the specific needs of this population of patients. In this review, we summarize current management options available for NCP and provide some insights on new promising treatments.
Collapse
Affiliation(s)
- Morena Shkodra
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milano, Italy;
- Institute of Clinical Medicine, University of Oslo, 0318 Oslo, Norway
- Correspondence:
| | - Augusto Caraceni
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milano, Italy;
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milano, Italy
| |
Collapse
|
5
|
Ni SF, Huang G, Chen Y, Wright JS, Li M, Dang L. Recent advances in γ-C(sp3)–H bond activation of amides, aliphatic amines, sulfanilamides and amino acids. Coord Chem Rev 2022. [DOI: 10.1016/j.ccr.2021.214255] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
6
|
Tagami K, Matsuoka H, Ariyoshi K, Oyamada S, Hiratsuka Y, Kizawa Y, Koyama A, Inoue A. The current clinical use of adjuvant analgesics for refractory cancer pain in Japan: a nationwide cross-sectional survey. Jpn J Clin Oncol 2021; 50:1434-1441. [PMID: 32869060 DOI: 10.1093/jjco/hyaa147] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 07/22/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Although adjuvant analgesics are used to treat opioid-refractory cancer pain, there is insufficient evidence to support this practice and limited data to guide the choice depending on cancer pain pathophysiology, dose titration and starting dose. This survey aimed to clarify the current use of adjuvant analgesics for treating opioid-refractory cancer pain. METHODS In this cross-sectional study, we sent an online survey questionnaire to 208 certified palliative care specialists. Primary outcomes were (i) effective pathophysiological mechanism of cancer pain and (ii) initiating doses and time period to the first response to each adjuvant analgesic therapy. RESULTS In total, 87 (42%) palliative care specialists responded. Of all patients with cancer pain, 40% of patients (median) with refractory cancer pain were prescribed adjuvant analgesics. Additionally, 94.3, 93.1 and 86.2% of palliative care specialists found dexamethasone/betamethasone effective for neuropathic pain caused by tumor-related spinal cord compression, pregabalin effective for malignant painful radiculopathy and dexamethasone/betamethasone effective for brain tumor or leptomeningeal metastases-related headache, respectively. The median starting dose of pregabalin, dexamethasone/betamethasone, lidocaine and ketamine were 75, 4, 200, and 50 mg/day, respectively, and the median time to the first response of those medications were 5, 3, 2 and 3 days, respectively. CONCLUSIONS Many palliative care specialists select adjuvant analgesics depending on the pathophysiological mechanism of cancer pain in each case. They used such adjuvant analgesics in low doses for cancer pain with short first-response periods.
Collapse
Affiliation(s)
- Keita Tagami
- Department of Palliative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiromichi Matsuoka
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osakasayama, Japan.,Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | | | | | - Yusuke Hiratsuka
- Department of Palliative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoshiyuki Kizawa
- Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Atsuko Koyama
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Akira Inoue
- Department of Palliative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| |
Collapse
|
7
|
Madden K, Haider A, Rozman De Moraes A, Naqvi SM, Enriquez PA, Wu J, Williams J, Liu D, Bruera E. Frequency of Concomitant Use of Gabapentinoids and Opioids among Patients with Cancer-Related Pain at an Outpatient Palliative Care Clinic. J Palliat Med 2020; 24:91-96. [PMID: 32486874 DOI: 10.1089/jpm.2019.0614] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Patients with cancer-related pain use opioids for nociceptive pain, while gabapentinoids are common to treat neuropathic pain. The simultaneous use of opioids with gabapentinoids has been associated with an increased risk of opioid-related death. Objectives: Determine the frequency of combined use of gabapentinoids among patients receiving opioids for cancer-related pain. We also examined if concomitant use of opioids and gabapentinoids together was associated with increased scores of fatigue and drowsiness on the Edmonton Symptom Assessment Scale (ESAS) compared to patients on opioids. Design: Retrospective study of patients on opioids and opioids plus gabapentinoids at their third visit to the outpatient Supportive Care Center. Results: We found that 48% (508/1059) of patients were on opioids. Of these patients, 51% (257/508) were on opioids only, and 49% (251/508) were on opioids plus gabapentinoids. The median (interquartile range [IQR]) morphine equivalent daily dose for patients on opioids was 75 (45, 138) mg, and opioids plus gabapentinoids was 68 (38, 150) mg (p = 0.94). The median (IQR) gabapentinoid equivalent daily dose was 900 (300, 1200) mg. The median (IQR) for ESAS-fatigue in patients on opioids was 5 (3, 7), and opioids plus gabapentinoids was 5 (3, 7) (p = 0.27). The median (IQR) for ESAS-drowsiness in patients on opioids was 3 (0, 5), and opioids plus gabapentinoids was 3 (0, 6) (p = 0.11). Conclusion: Almost 50% of advanced cancer patients receiving opioids for pain were exposed to gabapentinoids. Maximal efforts should be made to minimize potential complications from the concomitant use of opioids with gabapentinoids.
Collapse
Affiliation(s)
- Kevin Madden
- M.D. Anderson Cancer Center, University of Texas, Houston, Texas, USA.,Department of Palliative, Rehabilitation and Integrative Medicine, Houston, Texas, USA
| | - Ali Haider
- M.D. Anderson Cancer Center, University of Texas, Houston, Texas, USA.,Department of Palliative, Rehabilitation and Integrative Medicine, Houston, Texas, USA
| | - Aline Rozman De Moraes
- M.D. Anderson Cancer Center, University of Texas, Houston, Texas, USA.,Department of Palliative, Rehabilitation and Integrative Medicine, Houston, Texas, USA
| | - Syed Mujtaba Naqvi
- M.D. Anderson Cancer Center, University of Texas, Houston, Texas, USA.,Department of Palliative, Rehabilitation and Integrative Medicine, Houston, Texas, USA
| | - Parema Alizadeh Enriquez
- M.D. Anderson Cancer Center, University of Texas, Houston, Texas, USA.,Department of Palliative, Rehabilitation and Integrative Medicine, Houston, Texas, USA
| | - Jimin Wu
- M.D. Anderson Cancer Center, University of Texas, Houston, Texas, USA.,Department of Biostatistics, Houston, Texas, USA
| | - Janet Williams
- M.D. Anderson Cancer Center, University of Texas, Houston, Texas, USA.,Department of Palliative, Rehabilitation and Integrative Medicine, Houston, Texas, USA
| | - Diane Liu
- M.D. Anderson Cancer Center, University of Texas, Houston, Texas, USA.,Department of Biostatistics, Houston, Texas, USA
| | - Eduardo Bruera
- M.D. Anderson Cancer Center, University of Texas, Houston, Texas, USA.,Department of Palliative, Rehabilitation and Integrative Medicine, Houston, Texas, USA
| |
Collapse
|
8
|
Selvy M, Cuménal M, Kerckhove N, Courteix C, Busserolles J, Balayssac D. The safety of medications used to treat peripheral neuropathic pain, part 1 (antidepressants and antiepileptics): review of double-blind, placebo-controlled, randomized clinical trials. Expert Opin Drug Saf 2020; 19:707-733. [PMID: 32363948 DOI: 10.1080/14740338.2020.1764934] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Peripheral neuropathic pain is a highly disabling condition for patients and a challenge for neurologists and pain physicians. Although many drugs have been assessed in scientific studies, few have demonstrated a clear clinical efficacy against neuropathic pain. Moreover, the paucity of data regarding their safety raised the question on the benefit-risk ratio when used in patients experiencing peripheral neuropathies. AREAS COVERED The authors conducted a review of double-blind, placebo-controlled, randomized clinical trials to assess the safety of medications used to treat neuropathic pain. This first review was focused on antidepressant and antiepileptic medications. The aim was to provide an overview of the treatment-emergent adverse events (≥10%) and the serious adverse effects described in clinical trials. EXPERT OPINION Among antiepileptics and antidepressants, duloxetine appeared to have the most detailed safety for the treatment of peripheral neuropathic pain. Over all studies, the most commonly reported adverse effects were dizziness, drowsiness, nausea, and constipation. Only 20.0% of the included studies (N = 90) presented a good description of adverse effects that included a statistical comparison vers usa placebo group. Important methodological improvements must be made to improve the assessment of medication safety in future clinical trials.
Collapse
Affiliation(s)
- Marie Selvy
- Université Clermont Auvergne, CHU Clermont-Ferrand, Service de chirurgie digestive, INSERM, NEURO-DOL , Clermont-Ferrand, France
| | - Mélissa Cuménal
- Université Clermont Auvergne, INSERM NEURO-DOL , Clermont-Ferrand, France
| | - Nicolas Kerckhove
- Université Clermont Auvergne, CHU Clermont-Ferrand, Service de pharmacologie médicale, INSERMNEURO-DOL, Institut Analgesia , Clermont-Ferrand, France
| | - Christine Courteix
- Université Clermont Auvergne, INSERM NEURO-DOL , Clermont-Ferrand, France
| | - Jérôme Busserolles
- Université Clermont Auvergne, INSERM NEURO-DOL , Clermont-Ferrand, France
| | - David Balayssac
- Université Clermont Auvergne, CHU Clermont-Ferrand, Délégation à la recherche clinique et à l'innovation, INSERM, NEURO-DOL , Clermont-Ferrand, France
| |
Collapse
|
9
|
Abstract
PURPOSE OF REVIEW This paper aims to give the specialist and non-specialist alike an overview of the considerations involved in the management of cancer-related pain in the older population. RECENT FINDINGS Comprehensive guidelines on cancer pain management have been published recently by expert bodies. Cancer pain differs in many respects to other pain conditions and we are likely to encounter it more frequently in older patients in the future. The elderly are more sensitive to the effects of many analgesic medications. The elderly patient with cancer pain presents a unique challenge to the treating physician. The biological effects of ageing impact on the efficacy of many pain management strategies as well as its diagnosis and assessment. Treatment options can be broadly divided into pharmacological, non-pharmacological and interventional. A multidisciplinary approach and frequent re-assessment are essential in achieving favourable outcomes in this patient group.
Collapse
Affiliation(s)
- Dylan Finnerty
- Department of Anaesthesia, Mater Misericordiae University Hospital, Level 4, Whitty Building, Eccles Street, Dublin, D07 R2WY, Ireland.
| | - Áine O'Gara
- Department of Anaesthesia, Mater Misericordiae University Hospital, Level 4, Whitty Building, Eccles Street, Dublin, D07 R2WY, Ireland
| | - Donal J Buggy
- Department of Anaesthesia, Mater Misericordiae University Hospital, Level 4, Whitty Building, Eccles Street, Dublin, D07 R2WY, Ireland
| |
Collapse
|
10
|
Abstract
PURPOSE OF REVIEW Gabapentinoids are frequently used in the management of cancer pain. In recent Cochrane systematic reviews, although there was an abundance of evidence relating to non-cancer pain, only a few studies related to cancer pain. This review summarizes recent randomised controlled trials (RCTs) evaluating the use of gabapentinoids for tumour-related (as monotherapy or part of combination therapy) and treatment-related pain. RECENT FINDINGS For tumour-related pain, ten out of thirteen studies showed statistically significant benefits in favour of gabapentinoids. When used, as part of monotherapy or combination therapy, benefits were observed in five out of six studies evaluating gabapentin, and in six out of eight studies evaluating pregabalin. For treatment-related pain, none of the four studies (two gabapentin, two pregabalin) showed statistically significant benefits in favour of gabapentinoids. Unfortunately, many of the studies included were limited by small sample size, lack of blinding, and inadequate follow-up. SUMMARY More and better quality studies are required, although it may be challenging to accomplish in this patient population. Gabapentinoids may offer benefits to cancer patients with pain, but careful titration and monitoring of adverse effects is necessary.
Collapse
|
11
|
Matsuoka H, Tagami K, Ariyoshi K, Oyamada S, Kizawa Y, Inoue A, Koyama A. Attitude of Japanese palliative care specialists towards adjuvant analgesics cancer-related neuropathic pain refractory to opioid therapy: a nationwide cross-sectional survey. Jpn J Clin Oncol 2019; 49:486-490. [PMID: 30793161 DOI: 10.1093/jjco/hyz002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 12/27/2018] [Accepted: 01/04/2019] [Indexed: 11/13/2022] Open
Abstract
Cancer-related neuropathic pain (CNP) requires therapy involving multiple pharmaceuticals, including anticonvulsants and antidepressants; however, strong evidence to support this practice is limited. This study is a cross-sectional questionnaire-based survey. As the standard dose of adjuvant analgesics for CNP refractory to opioid therapy is not clear, the purpose of this study is to clarify the opinions of specialists about the usage of duloxetine and pregabalin for patients with CNP refractory to opioid therapy. Two hundred and eight certified palliative care specialists were surveyed and a total of 87 (42%) responses were analyzed. Twenty-five percent of specialists had considered increasing duloxetine doses up to 60 mg/day and 58% had considered increasing pregabalin doses up to 300 mg/day for CNP refractory to opioid therapy. However, 23% of the specialists succeeded in increasing duloxetine doses up to 60 mg/day and 17% in increasing pregabalin doses up to 300 mg/day, respectively.
Collapse
Affiliation(s)
- Hiromichi Matsuoka
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osakasayama City, Osaka, Japan.,Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Keita Tagami
- Department of Palliative Medicine, Tohoku University School of Medicine, Japan
| | | | | | - Yoshiyuki Kizawa
- Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akira Inoue
- Department of Palliative Medicine, Tohoku University School of Medicine, Japan
| | - Atsuko Koyama
- Department of Psychosomatic Medicine, Kindai University Faculty of Medicine, Osakasayama City, Osaka, Japan
| |
Collapse
|
12
|
Streckmann F, Hess V, Bloch W, Décard BF, Ritzmann R, Lehmann HC, Balke M, Koliamitra C, Oschwald V, Elter T, Zahner L, Donath L, Roth R, Faude O. Individually tailored whole-body vibration training to reduce symptoms of chemotherapy-induced peripheral neuropathy: study protocol of a randomised controlled trial-VANISH. BMJ Open 2019; 9:e024467. [PMID: 31023750 PMCID: PMC6501973 DOI: 10.1136/bmjopen-2018-024467] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 11/02/2018] [Accepted: 12/19/2018] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Chemotherapy-induced peripheral neuropathy (CIPN) is a prevalent and clinically meaningful side effect of cancer treatment. CIPN is induced by neurotoxic agents, causing severe sensory and/or motor deficits, resulting in disability and poor recovery, reducing patients' quality of life and limiting medical therapy. To date, effective treatment options are lacking. Whole-body vibration (WBV) training can attenuate motor and sensory deficits. We are conducting a two-armed, multicentre, assessor-blinded, randomised controlled trial, to investigate the effects of WBV on relevant symptoms of CIPN and determine the training characteristics. METHODS AND ANALYSIS In this ongoing study, 44 patients who have completed therapy in the past 3 months, with a neurologically confirmed CIPN are assessed before and after a 12-week intervention and follow-up. The intervention group receives WBV twice a week. Exercises are individually tailored according to the initially determined optimal neuromuscular response. The control group receives care as usual.Primary endpoint is the patient reported reduction of CIPN-related symptoms (Functional Assessment of Cancer Therapy/Gynaecology Oncology Group-Neurotoxicity). Secondary endpoints are compound muscle action potentials, distal motor latency, conduction velocity, F-waves from the tibial and peroneal nerve, antidromic sensory nerve conduction studies of the sural nerve, normalised electromyographic activity, peripheral deep sensitivity, proprioception, balance, pain, the feasibility of training settings, quality of life and the level of physical activity. AIM, ETHICS AND DISSEMINATION The study was approved by both responsible ethics committees. (1) Our results may contribute to a better understanding of the effects of WBV on motor and sensory functions and (2) may provide information whether WBV at the most effective setting, is feasible for neuropathic patients. (3) Our results may also contribute to improve supportive care in oncology, thereby enhancing quality of life and enabling the optimal medical therapy. All results will be published in international peer-reviewed journals as well as a manual for clinical practice. TRIAL REGISTRATION NUMBER NCT03032718.
Collapse
Affiliation(s)
- Fiona Streckmann
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
- Institute of Cardiovascular Research and Sport Medicine, German Sport University, Cologne, Germany
- Department of Oncology, University Hospital, Basel, Switzerland
| | - Viviane Hess
- Department of Oncology, University Hospital, Basel, Switzerland
| | - Wilhelm Bloch
- Institute of Cardiovascular Research and Sport Medicine, German Sport University, Cologne, Germany
| | | | - Ramona Ritzmann
- Department of Sport and Sport Science, University of Freiburg, Freiburg i.Br., Germany
| | | | - Maryam Balke
- Neurological Day Clinic (NTC) and Department of Early Neurological and Interdisciplinary Rehabilitation, St. Marien-Hospital, Cologne, Germany
| | - Christina Koliamitra
- Institute of Cardiovascular Research and Sport Medicine, German Sport University, Cologne, Germany
| | - Vanessa Oschwald
- Institute of Cardiovascular Research and Sport Medicine, German Sport University, Cologne, Germany
| | - Thomas Elter
- Department of Oncology, University Hospital, Cologne, Germany
| | - Lukas Zahner
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Lars Donath
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
- Department of Intervention Research in Exercise Training, German Sports University, Cologne, Germany
| | - Ralf Roth
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| |
Collapse
|
13
|
Moghimi MH, Hosseini SN, Salehi V, Kamali K. The effects of oral pregabalin on post-Lichtenstein herniorrhaphic pain: a randomized clinical trial. J Basic Clin Physiol Pharmacol 2018; 29:321-327. [PMID: 30007057 DOI: 10.1515/jbcpp-2016-0196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 01/24/2018] [Indexed: 11/15/2022]
Abstract
Background Pregabalin is a gamma-aminobutyric acid analog which seems to be effective in different neuropathic pains, as well as in incisional and inflammatory injuries. This study evaluated the effectiveness and safety of pregabalin on pain relief post herniorrhaphy. Methods In this randomized clinical trial, 60 men were chosen for unilateral inguinal herniorrhaphy under spinal anesthesia. The participants were randomly divided into two groups. The investigation (pregabalin) group received 300 mg of oral pregabalin 2 h before and 150 mg of pregabalin 12 and 24 h after surgery in addition to routine postoperative medication and 1 mg/kg of pethidine as needed. The control (placebo) group received placebo capsules similar to the investigation group, as well as routine medication and 1 mg/kg of pethidine as needed. All surgeries were done with the same technique. Post-surgery pain was evaluated in the walking and lying positions with a visual analog scale at 12 and 24 h and at 3 and 7 days after the surgery. Pethidine consumption and adverse effects of pregabalin were also assessed. Results The investigation group had less pain and lower visual analog scale scores at 12 and 24 h and also at 3 days after surgery and consumed less pethidine compared to the control group (p<0.05). Conclusions Pregabalin reduces pain and opioid consumption in the first 3 days after surgery. The adverse effects of pregabalin are limited to the first 12 h after surgery. Pregabalin can be suggested for pain relief, but it should be used with caution in the elderly.
Collapse
Affiliation(s)
- Mohammad Hossein Moghimi
- Department of Surgery, Ayatollah Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Seyed Nejat Hosseini
- Faculty of Medicine and Department of Surgery, Ayatollah Mousavi Hospital, Zanjan University of Medical Sciences, Mahdavi Boulevard, Zanjan 4513956111, Iran
| | - Vahid Salehi
- Department of Surgery, Ayatollah Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Kourosh Kamali
- Department of Epidemiology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| |
Collapse
|
14
|
Reich M, Bondenet X. Place des psychotropes en oncologie. PSYCHO-ONCOLOGIE 2018. [DOI: 10.3166/pson-2018-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
15
|
Fallon M, Giusti R, Aielli F, Hoskin P, Rolke R, Sharma M, Ripamonti CI. Management of cancer pain in adult patients: ESMO Clinical Practice Guidelines. Ann Oncol 2018; 29:iv166-iv191. [PMID: 30052758 DOI: 10.1093/annonc/mdy152] [Citation(s) in RCA: 423] [Impact Index Per Article: 70.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Affiliation(s)
- M Fallon
- Edinburgh Cancer Research Centre, IGMM, University of Edinburgh, Edinburgh, UK
| | - R Giusti
- Medical Oncology Unit, Sant'Andrea Hospital of Rome, Rome
| | - F Aielli
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - P Hoskin
- Mount Vernon Cancer Centre, Northwood, Hertfordshire, UK
| | - R Rolke
- Department of Palliative Medicine, Medical Faculty RWTH Aachen University, Aachen, Germany
| | - M Sharma
- The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - C I Ripamonti
- Department of Onco-Haematology, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milano, Italy
| |
Collapse
|
16
|
|
17
|
Wood H, Dickman A, Star A, Boland JW. Updates in palliative care - overview and recent advancements in the pharmacological management of cancer pain. Clin Med (Lond) 2018; 18:17-22. [PMID: 29436434 PMCID: PMC6330928 DOI: 10.7861/clinmedicine.18-1-17] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Pain is a common symptom in many types of cancer. Interdisciplinary team management, including pain assessment, explanation to the patient/family, treating the reversible, non-pharmacological treatments and reassessment are essential. This article focuses on the pharmacological management of cancer pain, and overviews and updates on the recent advances in this field. Both non-opioid and opioid analgesia as well as coanalgesics (adjuvants) are reviewed. Within non-opioid analgesia the risks of non-steroidal anti-inflammatory drugs (NSAIDs) are considered and recommendations for NSAIDs in patients at risk of gastrointestinal and cardiovascular toxicity are made. For opioid analgesics, side effects of opioids are discussed alongside practical guidance on opioid prescribing and converting between opioids. Newer drugs such as tapentadol are considered in this update. Amitriptyline, duloxetine, gabapentin and pregabalin, and the guidance for their use are reviewed in the coanalgesics (adjuvants) section.
Collapse
Affiliation(s)
- Helen Wood
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Andrew Dickman
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | | | - Jason W Boland
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
| |
Collapse
|
18
|
A Validated Fluorometric Method for the Rapid Determination of Pregabalin in Human Plasma Applied to Patients With Pain. Ther Drug Monit 2017; 38:628-33. [PMID: 27465975 DOI: 10.1097/ftd.0000000000000325] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Pregabalin has been used for the treatment of pain. A clinically accepted method applied to patients with pain has not been published for the determination of pregabalin in human plasma. This study developed a fluorometric ultrahigh-performance liquid chromatography (UHPLC) method to measure pregabalin concentration in patients with pain. METHODS After plasma pretreatment involving protein precipitation, pregabalin and gabapentin as an internal standard were derivatized with 4-fluoro-7-nitrobenzofurazan (NBD-F) under the following reaction conditions: 1 minute, pH 10, and 60°C. The UHPLC separation was performed using a 2.3-μm particle size octadecylsilyl column. The fluorescence detector was set at excitation and emission wavelengths of 470 and 530 nm, respectively. The predose blood samples were collected from 40 patients with pain who have been treated with 75 mg of pregabalin twice daily. RESULTS The chromatographic run time was 1.25 minutes. No interfering peaks were observed in the blank plasma at the retention times of NBD derivatives. The calibration curve of pregabalin was linear at a range of 0.05-10 mcg/mL (r > 0.999). The lower limit of quantification was 0.05 mcg/mL. The intra-assay accuracy and precision were 98.3%-99.8% and within 4.3%, respectively. The inter-assay accuracy and precision were 103.2%-107.1% and within 4.1%, respectively. The predose plasma concentration of pregabalin in patients with pain ranged from 0.14 to 8.5 mcg/mL. CONCLUSIONS This study provides a validated fluorometric UHPLC method with fast analytical performance for the determination of pregabalin in human plasma. The present method could be applied to patients with pain and be used for the clinical research or therapeutic drug monitoring of pregabalin.
Collapse
|
19
|
SEOM clinical guideline for treatment of cancer pain (2017). Clin Transl Oncol 2017; 20:97-107. [PMID: 29127593 PMCID: PMC5785609 DOI: 10.1007/s12094-017-1791-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 10/26/2017] [Indexed: 11/23/2022]
Abstract
Pain is a highly prevalent symptom in patients with cancer. Despite therapeutic advances and well-accepted treatment guidelines, a percentage of patients with pain are under-treated.
Currently, it has been recognized that several barriers in pain management still exist and, in addition, there are new challenges surrounding complex subtypes of pain, such as breakthrough and neuropathic pain, requiring further reviews and recommendations. This is an update of the guide our society previously published and represents the continued commitment of SEOM to move forward and improve supportive care of cancer patients.
Collapse
|
20
|
Dong J, Li W, Wang Y. The effect of pregabalin on acute postoperative pain in patients undergoing total knee arthroplasty: A meta-analysis. Int J Surg 2016; 34:148-160. [PMID: 27573693 DOI: 10.1016/j.ijsu.2016.08.521] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 08/21/2016] [Accepted: 08/24/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The purpose of this systematic review and meta-analysis of randomised controlled trials (RCTs) was to evaluate the effect of pain control of pregabalin versus placebo after a total knee arthroplasty (TKA). METHODS The electronic databases: Medline, Embase, PubMed, CENTRAL (Cochrane Controlled Trials Register), Web of Science and Google were searched from inception to February 2016. This systematic review and meta-analysis were performed according to the PRISMA statement criteria. The primary endpoint was the visual analogue scale (VAS) after a TKA with rest or mobilization at 24 h and 48 h, which represents the effect of pain control after TKA. The cumulative morphine consumption is also assessed to the morphine-sparing effect. The complications of nausea, vomiting, dizziness and sedation were also compiled to assess the safety of pregabalin. Software Stata 12.0 was used for the meta-analysis. After testing for publication bias and heterogeneity across studies, data were aggregated for random-effects modelling when necessary. RESULTS Six clinical trials with 769 patients were used for the meta-analysis. The meta-analysis indicated that pregabalin can decrease the VAS with rest at 24 h (MD = -8.14; 95% CI -12.57 to -3.71; P < 0.001) and 48 h (MD = -7.34; 95% CI -11.65 to -3.02; P < 0.001). Pregabalin can decrease the VAS with mobilization at 24 h (MD = -6.56; 95% CI -10.45 to -2.66; P = 0.001) and 48 h (MD = -9.62; 95% CI -12.80 to -6.44; P < 0.001). The results indicated that perioperative pregabalin can decrease the cumulative morphine consumption at 24 h (SMD = -0.97; 95% CI -1.17 to -0.78; P < 0.001) and 48 h (MD = -2.23; 95% CI -2.48 to -1.97; P < 0.001). Moreover, pregabalin can decrease the occurrence of nausea and vomiting but increase the occurrence of dizziness and sedation. CONCLUSION Based on the current meta-analysis, pregabalin has an analgesic and opioid-sparing effect in acute postoperative pain management without increasing the rate of nausea, vomiting.
Collapse
Affiliation(s)
- Jian Dong
- Department of Orthopedics, Linyi People's Hospital, Linyi, 276003, PR China
| | - Wenmin Li
- Department of Pharmacy, Linyi Cancer Hospital, Linyi, 276001, PR China
| | - Yuling Wang
- Department of Rheumatology and Immunology, Linyi People's Hospital, Linyi, 276003, PR China.
| |
Collapse
|
21
|
van den Beuken-van Everdingen MH, de Graeff A, Jongen JL, Dijkstra D, Mostovaya I, Vissers KC. Pharmacological Treatment of Pain in Cancer Patients: The Role of Adjuvant Analgesics, a Systematic Review. Pain Pract 2016; 17:409-419. [DOI: 10.1111/papr.12459] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 02/23/2016] [Accepted: 03/14/2016] [Indexed: 12/13/2022]
Affiliation(s)
- Marieke H.J. van den Beuken-van Everdingen
- Centre of Expertise for Palliative Care; Maastricht University Medical Centre; Maastricht the Netherlands
- Department of Anaesthesiology and Pain Management; Maastricht University Medical Centre; Maastricht the Netherlands
| | - Alexander de Graeff
- Department of Internal Medicine; University Medical Centre; Utrecht the Netherlands
| | - Joost L.M. Jongen
- Department of Neurology; Erasmus Medical Centre; Rotterdam the Netherlands
| | | | - Irina Mostovaya
- Knowledge Institute of Medical Specialists; Federation of Medical Specialists; Utrecht the Netherlands
| | - Kris C. Vissers
- Department of Anaesthesiology, Pain and Palliative Medicine; Radboud University Medical Centre; Nijmegen the Netherlands
| | | |
Collapse
|
22
|
Marras F, Leali PT. The role of drugs in bone pain. CLINICAL CASES IN MINERAL AND BONE METABOLISM : THE OFFICIAL JOURNAL OF THE ITALIAN SOCIETY OF OSTEOPOROSIS, MINERAL METABOLISM, AND SKELETAL DISEASES 2016; 13:93-96. [PMID: 27920802 PMCID: PMC5119721 DOI: 10.11138/ccmbm/2016.13.2.093] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Painful symptomatology in the skeletal system can be found in various pathological conditions and can be either localised or diffused. Bone tenderness is common in those who are of an elderly age. TREATMENT STRATEGY Patients should be informed of the possible causes of their pain and the different therapies that could alleviate it; furthermore they should be encouraged to have an active role in their therapy. It is necessary to prevent the onset of the pain (by the clock) by considering the biological half-life, the bioavailability and the duration of action of the therapy. According to the World Health Organization (WHO), pain treatment is based on a three-step ladder. ADJUVANT THERAPIES Adjuvant therapies are often associated with the drugs in the WHO three step ladder. This heterogeneous group of non-analgesic drugs is used in the treatment of bone pain by bettering the analgesia or reducing the side effects brought on by analgesics. CONCLUSION In the daily struggle that doctors face to treat their patients, pain management should not be disregarded. Among the various types of pain, bone pain, must not be underestimated but be fought against by using all means available. Patients need to be treated depending on the severity of their pain, NSAIDs should be the preferred choice of treatment for acute pain but not for that of chronic pain. In the case of chronic pain opioids should be used in their most recent fomulations as they can guarantee fewer side effects. Patients should also be prescribed adjuvant drugs as well as being given psychological support in order to ensure successful treatment.
Collapse
|
23
|
Sanderson C, Quinn SJ, Agar M, Chye R, Clark K, Doogue M, Fazekas B, Lee J, Lovell MR, Rowett D, Spruyt O, Currow DC. Pharmacovigilance in hospice/palliative care: net effect of pregabalin for neuropathic pain. BMJ Support Palliat Care 2016; 6:323-30. [PMID: 26908535 DOI: 10.1136/bmjspcare-2014-000825] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 02/02/2016] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Real-world effectiveness of many medications has been poorly researched, including in hospice/palliative care. Directly extrapolating findings from other clinical settings may not yield robust clinical advice. Pharmacovigilance studies provide an opportunity to understand better the net impact of medications. The study aimed to examine immediate and short-term benefits and harms of pregabalin in routine practice for neuropathic pain in hospice/palliative care. METHODS A consecutive cohort of 155 patients from 62 centres in 5 countries was started on pregabalin and studied prospectively. Data were collected at three time points: baseline; day 7 (immediate, short-term harms); ad hoc reports of any harms ≤21 days; and day 21 (short-term benefits). RESULTS Median dose for 155 patients at day 21 was 150 mg/24 h. Benefits were reported by 61 patients (39%), of whom 11 (7%) experienced complete pain resolution. Harms were reported by 51 (35%) patients at or before 7 days, the most frequent of which were somnolence, fatigue, cognitive disturbance and dizziness. 10 patients (6%) ceased pregabalin due to harms, but 82 patients (53%) were being treated at 21 days. In regression modelling, people with worse baseline pain derived more benefit (OR=8.5 (95% CI 2.5 to 28.68). CONCLUSIONS Pregabalin delivered benefit to many patients, with 4 of 10 experiencing pain reductions by 21 days. Harms, occurring in 1 in 3 patients, may be difficult to detect in clinical practice, as they mostly involve worsening of symptoms prevalent at baseline.
Collapse
Affiliation(s)
- Christine Sanderson
- Department of Palliative Medicine, Calvary Health Care Sydney, Sydney, New South Wales, Australia CareSearch, Flinders University, Adelaide, South Australia, Australia
| | - Stephen J Quinn
- Flinders Clinical Effectiveness, Flinders University, Adelaide, South Australia, Australia
| | - Meera Agar
- CareSearch, Flinders University, Adelaide, South Australia, Australia Department of Palliative Care, Braeside Hospital, HammondCare, Sydney, New South Wales, Australia
| | - Richard Chye
- Sacred Heart Palliative Care Services, Darlinghurst, New South Wales, Australia
| | - Katherine Clark
- Department of Palliative Care, Calvary Mater Hospital, Newcastle, New South Wales, Australia
| | - Matthew Doogue
- Clinical Pharmacologist & Endocrinologist University of Otago Christchurch & Canterbury District Health Board, Christchurch, New Zealand
| | - Belinda Fazekas
- Discipline, Palliative and Supportive Services, Flinders University, Adelaide, South Australia, Australia
| | - Jessica Lee
- Department of Palliative Medicine, Concord Hospital, Sydney, New South Wales, Australia
| | - Melanie R Lovell
- Department of Palliative Care, Braeside Hospital, HammondCare, Sydney, New South Wales, Australia
| | - Debra Rowett
- Drug and Therapeutic Information Services, Repatriation General Hospital, Daw Park, Adelaide, South Australia, Australia
| | - Odette Spruyt
- Pain and Palliative Care, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Victoria, Australia
| | - David C Currow
- CareSearch, Flinders University, Adelaide, South Australia, Australia Discipline, Palliative and Supportive Services, Flinders University, Adelaide, South Australia, Australia
| |
Collapse
|
24
|
Wang PL, Li Y, Wu Y, Li C, Lan Q, Wang XS. Pd-Catalyzed C(sp3)–H Carbonylation of Alkylamines: A Powerful Route to γ-Lactams and γ-Amino Acids. Org Lett 2015; 17:3698-701. [DOI: 10.1021/acs.orglett.5b01658] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Pei-Long Wang
- Department
of Chemistry, University of Science and Technology of China, Hefei 230026, China
| | - Yan Li
- Department
of Chemistry, University of Science and Technology of China, Hefei 230026, China
| | - Yun Wu
- Department
of Chemistry, University of Science and Technology of China, Hefei 230026, China
| | - Chao Li
- Department
of Chemistry, University of Science and Technology of China, Hefei 230026, China
| | - Quan Lan
- Department
of Chemistry, University of Science and Technology of China, Hefei 230026, China
| | - Xi-Sheng Wang
- Department
of Chemistry, University of Science and Technology of China, Hefei 230026, China
- Key Laboratory
of Synthetic and Self-Assembly Chemistry for Organic Functional Molecules,
Chinese Academy of Sciences, Shanghai Institute of Organic Chemistry, Shanghai, 200032, China
| |
Collapse
|
25
|
Kato H, Miyazaki M, Takeuchi M, Tsukuura H, Sugishita M, Noda Y, Yamada K. A retrospective study to identify risk factors for somnolence and dizziness in patients treated with pregabalin. J Pharm Health Care Sci 2015; 1:22. [PMID: 26819733 PMCID: PMC4728751 DOI: 10.1186/s40780-015-0022-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Accepted: 06/17/2015] [Indexed: 01/15/2023] Open
Abstract
Background Pregabalin is a therapeutic drug for neuropathic pain that is associated with somnolence and dizziness. These adverse events are often experienced shortly after initiating pregabalin, and may lead to treatment discontinuation. The purpose of this study was to explore factors that influence the incidence of somnolence and dizziness induced by pregabalin, and to identify patients at higher risk of adverse events. Methods A retrospective analysis was conducted of patient characteristics (age, gender, renal function, initial daily dose of pregabalin, co-administration of strong opioids and hypnotics) and the incidence of somnolence and dizziness during the first week of pregabalin treatment. An electronic chart was used to collect data from 204 inpatients prescribed pregabalin at Nagoya University Hospital from June 2011 to November 2012. Results Among 36 patients who regularly received strong opioids, 18 (50.0 %) reported somnolence or dizziness during the first week of pregabalin treatment. The remaining 168 patients did not regularly receive strong opioids, and 25 (14.9 %) had an adverse event. In multivariate analysis, age (≧65 years, adjusted odds ratio: 2.507, 95 % CI: 1.164-5.397, p = 0.019) and regular co-administration of strong opioids (adjusted odds ratio: 5.507, 95 % CI: 2.460-12.328, p < 0.001) correlated with somnolence or dizziness. Conclusions These data suggest that age (≧65 years) and co-administration of strong opioids are risk factors for somnolence or dizziness during pregabalin treatment for neuropathic pain. More careful dose titration is recommended for elderly patients and those receiving concomitant strong opioids.
Collapse
Affiliation(s)
- Hiroshi Kato
- Department of Neuropsychopharmacology and Hospital Pharmacy, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8560 Japan ; Division of Clinical Sciences and Neuropsychopharmacology, Meijo University Faculty of Pharmacy, Nagoya, Japan
| | - Masayuki Miyazaki
- Department of Neuropsychopharmacology and Hospital Pharmacy, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8560 Japan ; Division of Clinical Sciences and Neuropsychopharmacology, Meijo University Faculty of Pharmacy, Nagoya, Japan
| | - Mio Takeuchi
- Division of Clinical Sciences and Neuropsychopharmacology, Meijo University Faculty of Pharmacy, Nagoya, Japan
| | - Hiroaki Tsukuura
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Mihoko Sugishita
- Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan
| | - Yukihiro Noda
- Department of Neuropsychopharmacology and Hospital Pharmacy, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8560 Japan ; Division of Clinical Sciences and Neuropsychopharmacology, Meijo University Faculty of Pharmacy, Nagoya, Japan
| | - Kiyofumi Yamada
- Department of Neuropsychopharmacology and Hospital Pharmacy, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8560 Japan
| |
Collapse
|
26
|
Clark K, Quinn SJ, Doogue M, Sanderson C, Lovell M, Currow DC. Routine prescribing of gabapentin or pregabalin in supportive and palliative care: what are the comparative performances of the medications in a palliative care population? Support Care Cancer 2015; 23:2517-20. [DOI: 10.1007/s00520-015-2837-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 06/22/2015] [Indexed: 11/28/2022]
|
27
|
Pharmacological options for the management of refractory cancer pain—what is the evidence? Support Care Cancer 2015; 23:1473-81. [DOI: 10.1007/s00520-015-2678-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 02/22/2015] [Indexed: 01/30/2023]
|
28
|
Pruskowski J, Arnold RM. Pregabalin in Palliative Care #288. J Palliat Med 2015; 18:299-300. [DOI: 10.1089/jpm.2015.1015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
29
|
Abstract
Depression, anxiety, delirium, and other psychiatric symptoms are highly prevalent in the cancer setting, and pharmacological intervention is an important component in the overall psychosocial care of the patient. Psychopharmacology is also used as a primary or adjuvant treatment for the management of cancer-related symptoms stemming from the disease itself and/or its treatment, including sleep disturbance, loss of appetite, neuropathic pain, nausea, fatigue, and hot flashes. Psychiatrists, oncologists, and palliative care physicians working as members of a multidisciplinary team have the opportunity to target multiple symptoms that negatively affect a patient's quality of life with the strategic use of psychotropic medications when deemed appropriate. This article aims to review the indications for use of antidepressants, psychostimulants, anxiolytics, antipsychotics, and mood stabilizers in oncology. An updated review of the relevant literature is discussed and referenced in each section.
Collapse
Affiliation(s)
- Seema M Thekdi
- The University of Texas MD Anderson Cancer Center, P.O. Box 301402, Unit 1454, Houston, TX, 77230-1402, USA,
| | | | | |
Collapse
|
30
|
Bozkurt M, Gocmez C, Soylemez H, Daggulli M, Em S, Yildiz M, Atar M, Bozkurt Y, Ozbey I. Association Between Neuropathic Pain, Pregabalin Treatment, and Erectile Dysfunction. J Sex Med 2014; 11:1816-22. [DOI: 10.1111/jsm.12458] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|
31
|
Grassi L, Caruso R, Hammelef K, Nanni MG, Riba M. Efficacy and safety of pharmacotherapy in cancer-related psychiatric disorders across the trajectory of cancer care: a review. Int Rev Psychiatry 2014; 26:44-62. [PMID: 24716500 DOI: 10.3109/09540261.2013.842542] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
At least 25-30% of patients with cancer and an even higher percentage of patients in an advanced phase of illness meet the criteria for a psychiatric diagnosis, including depression, anxiety, stress-related syndromes, adjustment disorders, sleep disorders and delirium. A number of studies have accumulated over the last 35 years on the use of psychotropic drugs as a pillar in the treatment of psychiatric disorders. Major advances in psycho-oncology research have also shown the efficacy of psychotropic drugs as adjuvant treatment of cancer-related symptoms, such as pain, hot flushes, pruritus, nausea and vomiting, fatigue, and cognitive impairment. The knowledge about pharmacokinetics and pharmacodynamics, clinical use, safety, side effects and efficacy of psychotropic drugs in cancer care is essential for an integrated and multidimensional approach to patients treated in different settings, including community-based centres, oncology, and palliative care. A search of the major databases (MEDLINE, Embase, PsycLIT, PsycINFO, the Cochrane Library) was conducted in order to summarize relevant data concerning the efficacy and safety of pharmacotherapy for cancer-related psychiatric disorders in cancer patients across the trajectory of the disease.
Collapse
Affiliation(s)
- Luigi Grassi
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara , Ferrara , Italy
| | | | | | | | | |
Collapse
|