Onco P.R.N. Has Been Linked!
A great list of various Palliative Medicine blogs...Onco P.R.N. included!
http://www.pallimed.org/2009/09/updated-list-of-hospice-palliative.html
Tuesday, September 15, 2009
Why You Should Comment On Blogs And How To
From an excellent Palliative Medicine blog, this article discusses why uou should post comments and is applicable to this blog as well:
http://www.pallimed.org/2009/08/why-you-should-comment-on-blogs-and-how.html
Pain And Symptom Medication Info - Ketamine For Mucositis Pain
From MDLinx:
Ketamine mouthwash for mucositis pain
Journal of Palliative Medicine, 09/01/09
Ryan AJ et al. – Ketamine swish and expectorate may be a viable treatment option in refractory mucositis pain.
Methods
A retrospective chart audit was preformed on eight patients who received ketamine mouthwash (20mg/5mL) for refractory mucositis pain.
Results
All eight patients had mucositis pain refractory to a mucositis mixture (lidocaine, magnesium/aluminum hydroxide, and diphenhydramine) and opioids.
An improvement in mucositis pain was seen in over half (5/8) of the patients.
Four of eight patients had adverse effects that could have been associated with the ketamine mouthwash; all side effects were transient and subsided when the ketamine mouthwash was stopped.
The following articles discuss management of oral mucositis:
http://www.supportiveoncology.net/journal/articles/0502s113.pdf
http://www3.interscience.wiley.com/cgi-bin/fulltext/114078093/PDFSTART
If you have any other articles or information, please share below in the comments or email me at: chrisral@cancerboard.ab.ca
Pain And Symptom Control Medication Highlights - Intranasal Fentanyl
Clinical Therapeutics, 08/26/09
Kress HG et al. – Intranasal fentanyl spray (INFS), at 50, 100, and 200 micrograms, was associated with an onset of activity at 10 min and effective tx of breakthrough pain compared with placebo.
Methods
Phase III, double-blind, randomized, placebo-controlled, crossover trial 120 adults with cancer receiving a stable dose of long-term opioid tx for the control of background pain. Patients were treated at home with 50, 100, or 200 micrograms of INFS or placebo for 3 weeks, followed by a 10-month, phase when they received their effective dose of INFS.
Results
The pain intensity difference at 10 minutes (PID10) with INFS was 2-fold that with placebo.
The mean response rate with all 3 doses of INFS was 51.1% vs. 20.9% with placebo.
The prevalence of AEs was 19.8% (nausea [4.5%] and vertigo [1.8%]).
Of course, Onsolis (Fentanyl Buccal Film) was approved by the FDA back in July “for the management of breakthrough pain in patients with cancer aged 18 years and older who receive around-the-clock opioid therapy and are able to safely use high doses of additional opioid agents.”
"Onsolis can provide strong pain relief to patients who are opioid tolerant. But for patients who are not opioid tolerant, it can lead to overdose, sudden serious breathing difficulties and death," said Bob Rappaport, MD, director, Division of Anesthesia, Analgesia and Rheumatology Products in the FDA's Center for Drug Evaluation and Research, in an agency news release. "For this reason, Onsolis should be prescribed only under the safeguards provided by the FDA-required [risk evaluation and mitigation strategy] and by health care professionals knowledgeable about Onsolis and the use of potent opioid medications."
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