Tuesday, January 18, 2011

Pain from Vinorelbine Infusion

  • Pain in tumour-containing tissue (rare) as per BCCA.  
  • It has been hypothesized that it is caused by a ‘‘two-step’’ pathogenetic mechanism.
  • First, surgery, radiotherapy, or the tumor itself causes a neural lesion.
  • Vinorelbine administration then induces production of pain modulators at the site of the lesion.
  • It could be classified and treated as an incident pain.
  • Patients in treatment with opioids could receive one-sixth of the daily dose 15 minutes before vinorelbine administration.
  • Opioid-naïve patients could be treated with low doses of morphine. Ketorolac alone does not allow effective control of pain and we do not recommend it to treat, or to prevent, vinorelbine associated pain.
  • Finally, PO administration (?compounded) does not seem to induce vinorelbine-related pain and a switch from IV to PO vinorelbine could be proposed as a method for opioid-resistant patients.



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Pharmacy History

"The earliest known compilation of medicinal substances was ARIANA the Sushruta Samhita, an Indian Ayurvedic treatise attributed to Sushruta in the 6th century BC. However, the earliest text as preserved dates to the 3rd or 4th century AD.
Many Sumerian (late 6th millennium BC - early 2nd millennium BC) cuneiform clay tablets record prescriptions for medicine.[3]

Ancient Egyptian pharmacological knowledge was recorded in various papyri such as the Ebers Papyrus of 1550 BC, and the Edwin Smith Papyrus of the 16th century BC.

The earliest known Chinese manual on materia medica is the Shennong Bencao Jing (The Divine Farmer's Herb-Root Classic), dating back to the 1st century AD. It was compiled during the Han dynasty and was attributed to the mythical Shennong. Earlier literature included lists of prescriptions for specific ailments, exemplified by a manuscript "Recipes for 52 Ailments", found in the Mawangdui tomb, sealed in 168 BC. Further details on Chinese pharmacy can be found in the Pharmacy in China article."

From Wikipedia:

Journal of Palliative Medicine - Table of Contents

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