Detection and treatment of akathisia in advanced cancer patients during adjuvant analgesic therapy with tricyclic antidepressants: Case reports and review of the literature

2007 ◽  
Vol 5 (4) ◽  
pp. 411-414 ◽  
Author(s):  
Hideki Onishi ◽  
Wataru Yamamoto ◽  
Makoto Wada ◽  
Tomomi Nishida ◽  
Mei Wada ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Cancer Patients ◽  
Tricyclic Antidepressants ◽  
Case Reports ◽  
The Body ◽  
Advanced Cancer Patients ◽  
Substantial Evidence ◽  
Analgesic Therapy ◽  
Appropriate Treatment ◽  
Inflammatory Drugs

ABSTRACTObjective:There is substantial evidence that tricyclic antidepressants are effective in the management of chronic pain, including cancer pain. In oncological settings, these agents are used as adjuvant analgesic drugs. However, cases of akathisia due to tricyclic antidepressants used as adjuvant analgesic therapy have not previously been reported.Case reports:Two cancer patients experiencing chronic pain who were refractory to nonsteroidal anti-inflammatory drugs and opioids were prescribed amoxapine as an adjuvant analgesic therapy for neuropathic pain. These patients developed inner restlessness and restless physical movements after amoxapine was prescribed. Although symptoms were atypical, akathisia was suspected and discontinuation of amoxapine resolved the symptoms.Results and significance of results:Akathisia should be considered in patients receiving adjuvant analgesic therapy with tricyclic antidepressants. Early detection and appropriate treatment will relieve this distressing symptom. Restless movements involving parts of the body other than the legs may be the clue to the diagnosis.

scholarly journals Hyperprogressive disease in advanced cancer patients with liver metastasis treated with PD-1 inhibitors: two case reports

2020 ◽  
Vol 8 (17) ◽  
pp. 1100-1100 ◽  
Author(s):  
Zhuangbin Lin ◽  
Qing Liu ◽  
Qiongyin Wei ◽  
Lan Lin ◽  
Xiangqi Chen ◽  
...  
Keyword(s):  
Liver Metastasis ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Case Reports ◽  
Advanced Cancer Patients ◽  
Hyperprogressive Disease

scholarly journals “Ow, doc, it hurts”

2016 ◽  
Vol 85 (1) ◽  
pp. 14-16
Author(s):  
Brandon Chau ◽  
Robert Bobotsis
Keyword(s):  
Chronic Pain ◽  
Multidisciplinary Approach ◽  
Tricyclic Antidepressants ◽  
Long Term Results ◽  
First Line ◽  
Second Line Therapy ◽  
Line Therapy ◽  
Topical Lidocaine ◽  
Inflammatory Drugs

In a world where medical conditions are increasingly understood, chronic pain remains among the most difficult to diagnose and treat. Current first-line treatment of nonmalignant chronic pain include tricyclic antidepressants and physiotherapy, while topical lidocaine, nonsteroidal anti-inflammatory drugs and other antidepressants serve as appropriate second-line therapy. Opioids, though highly effective analgesics, remain medical options of last resort due to their highly addictive properties. Surgical implantation of nerve stimulators and/or spinal decompression may also be considered for treatment of chronic pain. As a parallel course of treatment, complementary and alternative medicine such as acupuncture may also be considered. Unfortunately, people with pain are among the least anticipated patients that doctors will see, and lack of both patience and expertise often result in cookie-cutter prescriptions and standardized healthcare that do not benefit individual patients. In the ever-evolving field of pain management, recent evidence has shown that a multidisciplinary approach, rather than traditional physician-based management, offers the best long-term results to patients.

KUALITAS HIDUP PASIEN KANKER YANG MENJALANI KEMOTERAPI DI RUMAH SAKIT AWAL BROS BATAM TAHUN 2019

Ners Journal ◽  
2021 ◽  
Vol 1 (2) ◽  
Author(s):  
Tivanny
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Physical Condition ◽  
Health Workers ◽  
Human Life ◽  
The Body ◽  
Whole Body ◽  
Advanced Cancer Patients ◽  
Depth Interviews

Cancer patients who undergo chemotherapy will experience many changes in their lives. Changes that will change their lives due to cancer and the effects of chemotherapy that will affect aspects of human life holistically and will also affect the quality of life. This study aims to analyze the quality of life of cancer patients undergoing chemotherapy by describing their physical, psychological, and social conditions. The type of research used is qualitative with in-depth interviews (in dept interview) and observation. Participants in this study were 8 cancer patients undergoing chemotherapy at Awal Bros Hospital in Batam according to the inclusion and exclusion criteria. The research was conducted in May 2020- July 2020. Qualitative   data analysis with content analysis. From the results of the research, the physical condition of the patient after undergoing chemotherapy, the body feels weak, cannot walk long distances, has pain in the whole body, it is difficult to rest, has decreased in activity and the ability to concentrate is decreased. The patient's psychological condition while undergoing chemotherapy, the patient experiences emotions that make the patient think negatively about his physical condition, such as a patient who wants to give up on chemotherapy. Social support for cancer patients undergoing chemotherapy receives emotional support, motivation from family and health workers and becomes financially dependent. Nurses can further improve the quality of providing multi-dimensional nursing care according to the problems experienced by advanced cancer patients undergoing chemotherapy and can provide new insights in the science of oncology.

scholarly journals Sativex oromucosal spray as adjunctive therapy in advanced cancer patients with chronic pain unalleviated by optimized opioid therapy: two double-blind, randomized, placebo-controlled phase 3 studies

2017 ◽  
Vol 11 (3) ◽  
pp. 119-133 ◽  
Author(s):  
Marie T Fallon ◽  
Eberhard Albert Lux ◽  
Robert McQuade ◽  
Sandro Rossetti ◽  
Raymond Sanchez ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Cancer Patients ◽  
Treatment Period ◽  
Advanced Cancer ◽  
Treatment Effect ◽  
Opioid Therapy ◽  
Advanced Cancer Patients ◽  
Phase 3 ◽  
Double Blind ◽  
The World

Background: Opioids are critical for managing cancer pain, but may provide inadequate relief and/or unacceptable side effects in some cases. Objective: To assess the analgesic efficacy of adjunctive Sativex (Δ9-tetrahydrocannabinol (27 mg/mL): cannabidiol (25 mg/mL)) in advanced cancer patients with chronic pain unalleviated by optimized opioid therapy. Methods: This report describes two phase 3, double-blind, randomized, placebo-controlled trials. Eligible patients had advanced cancer and average pain numerical rating scale (NRS) scores ≥4 and ≤8 at baseline, despite optimized opioid therapy. In Study-1, patients were randomized to Sativex or placebo, and then self-titrated study medications over a 2-week period per effect and tolerability, followed by a 3-week treatment period. In Study-2, all patients self-titrated Sativex over a 2-week period. Patients with a ≥15% improvement from baseline in pain score were then randomized 1:1 to Sativex or placebo, followed by 5-week treatment period (randomized withdrawal design). Results: The primary efficacy endpoint (percent improvement (Study-1) and mean change (Study-2) in average daily pain NRS scores) was not met in either study. Post hoc analyses of the primary endpoints identified statistically favourable treatment effect for Sativex in US patients <65 years (median treatment difference: 8.8; 95% confidence interval (CI): 0.00–17.95; p = 0.040) that was not observed in patients <65 years from the rest of the world (median treatment difference: 0.2; 95% CI: −5.00 to 7.74; p = 0.794). Treatment effect in favour of Sativex was observed on quality-of-life questionnaires, despite the fact that similar effects were not observed on NRS score. The safety profile of Sativex was consistent with earlier studies, and no evidence of abuse or misuse was identified. Conclusions: Sativex did not demonstrate superiority to placebo in reducing self-reported pain NRS scores in advanced cancer patients with chronic pain unalleviated by optimized opioid therapy, although further exploration of differences between United States and patients from the rest of the world is warranted.

scholarly journals Long-lasting severe knee pain in a SLE patient after renal transplantation: what is the reason? A case report and literature review

2021 ◽  
Author(s):  
Anna Masiak ◽  
Iga Kościńska ◽  
Beata Rutkowska ◽  
Zbigniew Zdrojewski
Keyword(s):  
Kidney Transplantation ◽  
Case Report ◽  
Knee Pain ◽  
Case Reports ◽  
Immunosuppressive Treatment ◽  
The Body ◽  
Review Of The Literature ◽  
Letters To The Editor ◽  
Appropriate Treatment ◽  
The Right

AbstractMusculo-skeletal complaints in a patient suffering from systemic lupus, with co-existing chronic renal failure, undergoing immunosuppressive treatment after kidney transplantation, can have a varied etiology. The aim of this work was to present a case based review of differential diagnosis of knee pain in such a patient. A literature search was carried out using MEDLINE/PubMed, Google Scholar and EBSCO, with no time limit. We undertook a systematic review of the literature published in English, limited to full-text publications of original articles, letters to the editor, and case reports in peer-reviewed journals, for a discussion and analysis of studies reporting arthralgia in patients with lupus after kidney transplantation. We present a case report of a 45-year-old woman with lupus nephritis, after kidney transplantation, who started to complain of increasing pain in the knees, most pronounced at night and after physical activity approximately 2 years after transplantation. Extensive causal diagnostics were carried out, which revealed bilateral extensive regions of bone infarction in the femur and tibia, chondropathy, degenerative changes of medial meniscuses in the body and posterior horn as well as chondromalacia of the patella. Establishing the right diagnosis is crucial for implementing appropriate treatment.

Control of chronic pain in very advanced cancer patients with morphine hydrochloride administered by oral, rectal and sublingual route

Pain ◽  
1982 ◽  
Vol 14 (2) ◽  
pp. 196
Author(s):  
F. Pannuti ◽  
A. P. Rossi ◽  
G. Iafelice ◽  
D. Marraro ◽  
P. Camera ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Advanced Cancer Patients ◽  
Morphine Hydrochloride

scholarly journals Are there any gender differences in pain perception? Clinical and experimental studies in oncology

2021 ◽  
Vol 67 (6) ◽  
pp. 755-760
Author(s):  
Elena Frantsiyants ◽  
Inga Kotieva ◽  
Elena Sheiko ◽  
Iurii Sidorenko
Keyword(s):  
Gender Differences ◽  
Chronic Pain ◽  
Cancer Patients ◽  
Pain Perception ◽  
Experimental Studies ◽  
Pain Syndrome ◽  
Living Organism ◽  
The Body ◽  
Protective Function ◽  
Mechanisms Of Development

The review considers and analyzes scientific literature on gender differences in the incidence of pain syndromes, perception of clinical pain, including that in cancer patients and in experimental oncology. The literature highlights theoretical basis, some biological mechanisms and practical results associated with gender differences. Chronic pain no longer performs a protective function and is not biologically appropriate. The review presents results of experimental studies demonstrating the important role of sex hormones and regulatory systems of a living organism in the mechanisms of development, distribution and perception of pain. Some aspects of sexual dimorphism in the processes of nociception and antinociception are covered. We present the data on the causes of chronic pain syndrome and its perception in cancer patients of both sexes indicating genetically determined sexual reactivity of the body which causes an imbalance in the function of peripheral nervous system and CNS under the influence of prolonged permanent pain in a living organism. Various pain effects have been shown to cause changes in the main types of metabolism, mobilization of adaptive metabolic mechanisms, and tissue damage. Conclusions. The high prevalence of chronic pain in both women and men with cancer, heavy humanitarian and social and economic burden explains a significant increase in fundamental and clinical research in this direction.      

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