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THERAPEUTIQUE MEDICAMENTEUSE

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Top ten tips palliative care clinicians should know when caring for patients with endometrial cancer

DAVIDSON, Brittany A. ; MOSS, Haley A. ; ARQUIETTE, Jaclyn ; KAMAL, Arif H.
JOURNAL OF PALLIATIVE MEDICINE, 06/2018, vol.21, n°6, p. 857-861

Treating tobacco use in patients with incurable malignancies - should we even start the conversation?

TROUT, Susan ; GOLDSTEIN, Adam O. ; MARKS, Lawrence ; RIPLEY-MOFFITT, Carol
JOURNAL OF PALLIATIVE MEDICINE, 06/2018, vol.21, n°6, p. 746-750

Deprescribing in end-of-life care

GARDNER, Emma
British journal of community nursing, 02/10/2019, vol.24, n°10, p. 474-477

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Pharmacology update - low-dose naltrexone as a possible nonopioid modality for some chronic, nonmalignant pain syndromes

TROFIMOVITCH, Diana ; BAUMRUCKER, Steven J.
American journal of hospice and palliative medicine, 10/2019, vol.36, n°10, p. 907-912

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Thème : Médicaments - Pharmacie. Cote : 00.07AME

CONTROLE DOULEUR ; THERAPEUTIQUE MEDICAMENTEUSE ; QUALITE VIE

Pain can have a devastating effect on the quality of life of patients in palliative medicine. Thus far, majority of research has been centered on opioid-based pain management, with a limited empirical evidence for the use of nonopioid medications in palliative care. However, opioid and nonopioid medications such as nonsteroidal anti-inflammatory drugs have their limitations in the clinical use due to risk of adverse effects, therefore, there is a need for more research to be directed to finding an alternative approach to pain management in comfort care setting. The purpose of this article is to discuss a potential new drug that would adequately alleviate pain and enhance quality of life without significant risks of adverse effects that would limit its use. Naltrexone is a reversible competitive antagonist at µ-opioid and -opioid receptors, which when used at standard doses of 50 to 150 mg was initially intended for use in opioid and alcohol use disorders. However, it was discovered that its use in low doses follows alternate pharmacodynamic pathways with various effects. When used in doses of 1 to 5 mg it acts as a glial modulator with a neuroprotective effect via inhibition of microglial activation. It binds to Toll-like receptor 4 and acts as an antagonist, therefore inhibiting the downstream cellular signaling pathways that ultimately lead to pro-inflammatory cytokines, therefore reducing inflammatory response. Its other mode of action involves transient opioid receptor blockade ensuing from low-dose use which upregulates opioid signaling resulting in increased levels of endogenous opioid production, known as opioid rebound effect. Low dose naltrexone has gained popularity as an off-label treatment of several autoimmune diseases including multiple sclerosis and inflammatory bowel disease, as well as chronic pain disorders including fibromyalgia, complex regional pain syndrome, and diabetic neuropathy. Low-dose naltrexone (LDN) may also have utility in improving mood disorders and the potential to enhance the quality of life. This article will therefore propose the potential off-label use of LDN in management of nonmalignant pain in the palliative medicine setting.

Origine : SAGE Journals

The combination of levomepromazine (methotrimeprazine) and rotigotine enables the safe and effective management of refractory nausea and vomiting in a patient with idiopathic Parkinson’s disease

HINDMARSH, Jonathan ; HINDMARSH, Sharlene ; LEE, Mark A. ; TELFORD, Richard
PALLIATIVE MEDICINE, 01/2019, vol.33, n°1, p. 109-113

Polypharmacy increases risk of dyspnea among adults with serious, life-limiting diseases

AKGUN, Kathleen M. ; KRISHNAN, Supriya ; FEDER, Shelli L. ; TATE, Janet ; KUTNER, Jean S. ; CROTHERS, Kristina
The American journal of hospice and palliative care, 24/09/2019, Pagination inconnue

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Thème : Médicaments - Pharmacie.

THERAPEUTIQUE MEDICAMENTEUSE ; DYSPNEE ; MALADIE LETALE

Background: Polypharmacy is associated with dyspnea in cross-sectional studies, but associations have not been determined in longitudinal analyses. Statins are commonly prescribed but their contribution to dyspnea is unknown. We determined whether polypharmacy was associated with dyspnea trajectory over time in adults with advanced illness enrolled in a statin discontinuation trial, overall, and in models stratified by statin discontinuation.
Methods: Using data from a parallel-group unblinded pragmatic clinical trial (patients on statins =3 months with life expectancy of 1 month to 1 year, enrolled in the parent study between June 3, 2011, and May 2, 2013, n = 308/381 [81%]), we restricted analyses to patients with available baseline medication count and =1 dyspnea score. Polypharmacy was assessed by self-reported chronic medication count. Dyspnea trajectory group, our primary outcome, was determined over 24 weeks using the Edmonton Symptom Assessment System.
Results: The mean age of the patients was 73.8 years (standard deviation [SD]: ±11.0) and the mean medication count was 11.6 (SD: ±5.0). We identified 3 dyspnea trajectory groups: none (n = 108), mild (n = 130), and moderate–severe (n = 70). Statins were discontinued in 51.8%, 48.5%, and 42.9% of patients, respectively. In multivariable models adjusting for age, sex, diagnosis, and statin discontinuation, each additional medication was associated with 8% (odds ratio [OR] = 1.08 [1.01-1.14]) and 16% (OR = 1.16 [1.08-1.25]) increased risk for mild and moderate–severe dyspnea, respectively. In stratified models, polypharmacy was associated with dyspnea in the statin continuation group only (mild OR = 1.12 [1.01-1.24], moderate–severe OR = 1.24 [1.11-1.39]) versus statin discontinuation (mild OR = 1.03 [0.95-1.12], and moderate–severe OR = 1.09 [0.98-1.22]).
Conclusion: Polypharmacy was strongly associated with dyspnea. Prospective interventions to decrease polypharmacy may impact dyspnea symptoms, especially for statins.

Origine : PubMed

An ethical exploration of the narratives surrounding substance use and pain management at the end of life - a discussion paper

WITHAM, Gary ; YARWOOD, Gemma ; WRIGHT, Sam ; GALVANI, Sarah
Nursing ethics, 16/09/2019, p. 1-11

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Evaluating the pharmacological management of terminal delirium in imminently dying patients with and without the comfort measure order set

SUTHERLAND, Megan ; STILOS, Kalli Kalliopi
JOURNAL OF HOSPICE AND PALLIATIVE NURSING, 10/2019, vol.21, n°5, p. 430-437

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Nonprescription medication use in hospice patients

BALTZ, Alan P. ; GRESSLER, Laura E. ; COSTANTINO, Ryan C. ; McPHERSON, Mary Lynn
The American journal of hospice and palliative care, 17/09/2019, Pagination inconnue

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Evaluating the effects of the pharmacological and nonpharmacological interventions to manage delirium symptoms in palliative care patients - systematic review

SKELTON, Luke ; GUO, Ping
Current opinion in supportive and palliative care, 03/09/2019, Pagination inconnue

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Polypharmacy and medication errors on palliative care admission

GRADALSKI, Tomasz
Polish archives of internal medicine, 10/09/2019, p. 1-27

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Subcutaneous pantoprazole in an elderly, palliative care patient

MICHELON, Hugues ; SOUCHU, Hélène ; CHAUVRON-DEFILIPPI, Bénédicte ; LECOEUR, Anne ; VILLART, Maryvonne ; DENIS, Michel
BMJ supportive and palliative care, 28/08/2019, Pagination inconnue

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Administering neostigmine as a subcutaneous infusion - a case report of a patient dying with myasthenia gravis

HINDMARSH, Jonathan ; WOODS, Elizabeth ; LEE, Mark A. ; PICKARD, Jonathan
JOURNAL OF PALLIATIVE CARE, 14/08/2019, Pagination inconnue

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Polémique douleur - mises en boîtes

BEAU, Dominique
ASP LIAISONS, 06/2019, n°58, p. 43-44

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Nurses’ perspectives on family caregiver medication management support and deprescribing

TJIA, Jennifer ; DESANTO-MADEYA, Susan ; MAZOR, Kathleen M. ; HAN, Paul ; NGUYEN, Bryan ; CURRAN, Tess ; GALLAGHER, Julia ; CLAYTON, Margaret F.
JOURNAL OF HOSPICE AND PALLIATIVE NURSING, 08/2019, vol.21, n°4, p. 312-318

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Propofol-based palliative sedation to treat antipsychotic-resistant agitated delirium

COVARRUBIAS-GÓMEZ, Alfredo ; LÓPEZ COLLADA-ESTRADA, Maria
Journal of pain and palliative care pharmacotherapy, 02/10/2017, vol.31, n°3-4, p. 190-194

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Gabapentin for cough in cancer

RAZZAK, Rab ; WALDFOGEL, Julie M. ; DOBERMAN, Danielle J. ; FELICIANO, Josephine L. ; SMITH, Thomas J.
Journal of pain and palliative care pharmacotherapy, 02/10/2017, vol.31, n°3-4, p. 195-197

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Nurses’ perspectives on family caregiver medication management support and deprescribing

TJIA, Jennifer ; DESANTO-MADEYA, Susan ; MAZOR, Kathleen ; HAN, Paul ; NGUYEN, Bryan ; CURRAN, Tess ; GALLAGHER, Julia
JOURNAL OF HOSPICE AND PALLIATIVE NURSING, /08/2019, vol.21, n°4, p. 312-318

A nationwide survey of hospital pharmacist interventions to improve polypharmacy for patients with cancer in palliative care in Japan

UCHIDA, Mayako ; SUZUKI, Shinya ; SUGAWARA, Hideki ; SUGA, Yukio ; KOKUBUN, Hideya ; UESAWA, Yoshihiro ; NAKAGAWA, Takayuki ; TAKASE, Hisamitsu
Journal of pharmaceutical health care and sciences, 2019, vol.5, p. 1-13

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Palliative use of nitroglycerin to improve microvascular circulation

MCGAHAN, Rose K. ; GAFFORD, Ellin F. ; WHITSON, Bryan A. ; PAPADIMOS, Thomas J. ; TRIPATHI, Ravi S.
JOURNAL OF PALLIATIVE CARE, 23/06/2019, Pagination inconnue

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