oalib
Search Results: 1 - 10 of 100 matches for " "
All listed articles are free for downloading (OA Articles)
Page 1 /100
Display every page Item
Editorial
Kannan A
Reports in Electrochemistry , 2012, DOI: http://dx.doi.org/10.2147/RIE.S30246
Abstract: Editorial Editorial (1862) Total Article Views Authors: Kannan A Published Date June 2012 Volume 2012:2 Pages 1 - 2 DOI: http://dx.doi.org/10.2147/RIE.S30246 Received: 03 April 2012 Accepted: 20 April 2012 Published: 15 June 2012 Arunachalanadar Kannan Department of Engineering Technology, Arizona State University, Mesa, AZ, USA Post to: Cannotea Citeulike Del.icio.us Facebook LinkedIn Twitter Readers of this article also read: Local anesthetic failure associated with inflammation: verification of the acidosis mechanism and the hypothetic participation of inflammatory peroxynitrite Imaging of peripheral vascular disease Intercellular cancer collisions generate an ejected crystal comet tail effect with fractal interface embryoid body reassembly transformation Improved understanding and satisfaction with a modified informed consent document: a randomized study Antifungal cyclic peptides from the marine sponge Microscleroderma herdmani Conjugation of quantum dots on carbon nanotubes for medical diagnosis and treatment Considerations in selecting rapid-onset opioids for the management of breakthrough pain Copy number variation in sulfotransferase isoform 1A1 (SULT1A1) is significantly associated with enzymatic activity in Japanese subjects In vitro determination of the antibiotic susceptibility of biofilm-forming Pseudomonas aeruginosa and Staphylococcus aureus: possible role of proteolytic activity and membrane lipopolysaccharide Maternal stress and childhood migraine: a new perspective on management
Intranasal Fentanyl for Breakthrough Pain Control
Claudia F. Clavijo, Rachael Rzasa Lynn, Uwe Christians and Jeffrey L. Galinkin
Clinical Medicine Insights: Therapeutics , 2012, DOI: 10.4137/CMT.S7298
Abstract: Breakthrough pain (BTP) is experienced by approximately 65% of children and adults with chronic pain. Undiagnosed or untreated BTP produces negative emotional, physical, and economic consequences. BTP episodes have a rapid onset and short duration. Short acting oral opioids are the cornerstone of BTP management. Oral medications available to treat BTP episodes like immediate-release morphine or oxycodone have a delayed onset of action so that there is a mismatch between the episode of BTP and the effect of the oral opioids. Novel fentanyl delivery systems for BTP offer pharmacokinetic properties that match the time profile of BTP. Among the transmucosal routes, intranasal fentanyl has gained popularity due to its high bioavailability, rapid onset of action, high potency, short duration, and ease of administration. Its efficacy and safety have been demonstrated in adults who are opioid tolerant. Although children with chronic cancer pain also experience BTP, there is paucity of data on the use of intranasal fentanyl for BTP in this age group.
Fentanyl transmucosal tablets: current status in the management of cancer-related breakthrough pain
Prommer E, Ficek B
Patient Preference and Adherence , 2012, DOI: http://dx.doi.org/10.2147/PPA.S20655
Abstract: tanyl transmucosal tablets: current status in the management of cancer-related breakthrough pain Review (1595) Total Article Views Authors: Prommer E, Ficek B Published Date June 2012 Volume 2012:6 Pages 465 - 475 DOI: http://dx.doi.org/10.2147/PPA.S20655 Received: 19 March 2012 Accepted: 04 May 2012 Published: 25 June 2012 Eric Prommer, Brandy Ficek Division of Hematology/Oncology, Mayo Clinic College of Medicine, Mayo Clinic Hospital, Scottsdale, AZ, USA Abstract: Breakthrough pain is a newly recognized pain category that was first described by Portenoy and Hagen in 1990. The term describes pain that increases in intensity to “break through” chronic pain that is being controlled by a scheduled opioid regimen. The development of fluctuations in pain intensity is challenging due to their unpredictable nature, rapid onset, and need for rapid treatment intervention. Breakthrough pain has been treated by using an extra opioid dose in addition to the scheduled opioid being used for pain. Recommendations for dose and frequency are based on expert opinion only, and have included dosing based on a percentage of the total opioid dose. Other recommendations include increasing the regularly scheduled opioid dose. Clinical trials have now focused on delivery of opioids that have both potency and a rapid onset of action. Lipophilic opioids have received a substantial amount of study due to their quick absorption and rapid onset of analgesia. Lipophilic opioids that have been studied to date include transmucosal fentanyl, sublingual fentanyl, intranasal sufentanil, and oral and sublingual methadone. Initial clinical trials have established the superiority of transmucosal fentanyl as a breakthrough analgesic when compared with immediate-release oral opioid formulations. Problems with bioavailability have led to a search for newer formulations of transmucosal delivery. Newer formulations, such as fentanyl transmucosal tablets, have been developed to ensure superior delivery for the patient suffering from breakthrough pain. The purpose of this paper is to discuss the current status of transmucosal tablet formulations for cancer breakthrough pain.
Fentanyl transmucosal tablets: current status in the management of cancer-related breakthrough pain  [cached]
Prommer E,Ficek B
Patient Preference and Adherence , 2012,
Abstract: Eric Prommer, Brandy FicekDivision of Hematology/Oncology, Mayo Clinic College of Medicine, Mayo Clinic Hospital, Scottsdale, AZ, USAAbstract: Breakthrough pain is a newly recognized pain category that was first described by Portenoy and Hagen in 1990. The term describes pain that increases in intensity to “break through” chronic pain that is being controlled by a scheduled opioid regimen. The development of fluctuations in pain intensity is challenging due to their unpredictable nature, rapid onset, and need for rapid treatment intervention. Breakthrough pain has been treated by using an extra opioid dose in addition to the scheduled opioid being used for pain. Recommendations for dose and frequency are based on expert opinion only, and have included dosing based on a percentage of the total opioid dose. Other recommendations include increasing the regularly scheduled opioid dose. Clinical trials have now focused on delivery of opioids that have both potency and a rapid onset of action. Lipophilic opioids have received a substantial amount of study due to their quick absorption and rapid onset of analgesia. Lipophilic opioids that have been studied to date include transmucosal fentanyl, sublingual fentanyl, intranasal sufentanil, and oral and sublingual methadone. Initial clinical trials have established the superiority of transmucosal fentanyl as a breakthrough analgesic when compared with immediate-release oral opioid formulations. Problems with bioavailability have led to a search for newer formulations of transmucosal delivery. Newer formulations, such as fentanyl transmucosal tablets, have been developed to ensure superior delivery for the patient suffering from breakthrough pain. The purpose of this paper is to discuss the current status of transmucosal tablet formulations for cancer breakthrough pain.Keywords: fentanyl, transmucosal, tablets, pain, breakthrough, cancer
Intranasal fentanyl for pain control: current status with a focus on patient considerations
Eric Prommer,Lisa Thompson
Patient Preference and Adherence , 2011,
Abstract: Eric Prommer, Lisa ThompsonDivision of Hematology/Oncology, Mayo Clinic College of Medicine, Mayo Clinic Hospital, Scottsdale, AZ, USAAbstract: Of several newer delivery systems under development and investigation for the administration of opioids, the intranasal route has received a substantial amount of attention. Intranasal administration is a convenient form of delivery that is applicable to several opioids. It has the potential for self-administration, combined with a rapid onset of action, allowing for patient-controlled analgesia. In clinical practice, intranasal administration has been found to be a reliable drug delivery method that is familiar to patients. Intranasal opioids have proven to be useful in both in-hospital and out-of-hospital pain management settings. Fentanyl, a highly lipophilic step 3 opioid, has been evaluated for intranasal administration. The purpose of this review is to examine the role of the nasal route of opioid administration and examine the evidence base for the use of fentanyl intranasally.Keywords: fentanyl, intranasal, pain, breakthrough pain
Recent advances in the use of opioids for cancer pain  [cached]
Joanne Droney,Julia Riley
Journal of Pain Research , 2009,
Abstract: Joanne Droney, Julia RileyPalliative Medicine Department, Royal Marsden Hospital, London, UKAbstract: Opioids are the mainstay of treatment for moderate to severe cancer pain. In recent years there have been many advances in the use of opioids for cancer pain. Availability and consumption of opioids have increased and opioids other than morphine (including methadone, fentanyl, oxycodone) have become more widely used. Inter-individual variation in response to opioids has been identified as a significant challenge in the management of cancer pain. Many studies have been published demonstrating the benefits of opioid switching as a clinical maneuver to improve tolerability. Constipation has been recognized as a significant burden in cancer patients on opioids. Peripherally restricted opioid antagonists have been developed for the prevention and management of opioid induced constipation. The phenomenon of breakthrough pain has been characterized and novel modes of opioid administration (transmucosal, intranasal, sublingual) have been explored to facilitate improved management of breakthrough cancer pain. Advances have also been made in the realm of molecular biology. Pharmacogenetic studies have explored associations between clinical response to opioids and genetic variation at a DNA level. To date these studies have been small but future research may facilitate prospective prediction of response to individual drugs.Keywords: opioids, cancer, pain, pharmacogenetics, constipation, breakthrough pain
Tratamiento del dolor irruptivo Treatment of breakthrough pain  [cached]
L. Cánovas Martínez,A. B. Rodríguez Rodríguez,M. Castro Bande,L. Pérez Arviza
Revista de la Sociedad Espa?ola del Dolor , 2012,
Abstract: La Sociedad Espa ola de Oncología Médica (SEOM), la Sociedad Espa ola de Cuidados Paliativos (SECPAL) y la Sociedad Espa ola de Dolor (SED), establecieron un documento de consenso en el que asumieron el término "dolor irruptivo", para definir una exacerbación del dolor de forma súbita y transitoria, de gran intensidad (EVA > 7) y de corta duración (usualmente inferior a 20-30 minutos), que aparece sobre la base de un dolor persistente estable, cuando este se encuentra reducido a un nivel tolerable (EVA < 5) mediante el uso fundamental de opioides mayores. La clasificación del dolor irruptivo más utilizada es la que distingue entre dolor irruptivo incidental (predecible o impredecible), idiopático y relacionado con el final de dosis. El manejo adecuado del dolor irruptivo se basa en tres aspectos: prevención, anticipación y uso de la medicación adecuada. Existen formulaciones de opioides de inicio de acción rápida y duración de acción corta (ROOs) que se ajustan mucho mejor al perfil y al tratamiento de este tipo de dolor. Todas ellas contienen citrato de fentanilo y se administran a través de la mucosa oral (transmucosa oral, bucal o sublingual) o nasal. Todos tienen un inicio precoz del efecto, entre 5-15 minutos tras la administración y un tiempo de duración entre 2-4 h y una biodisponibilidad que puede variar según la presentación. Fentanilo sublingual, bucal e intranasal tienen un inicio de acción más rápido y una mayor biodisponibilidad que fentanilo transmucosa oral. Aunque la mayoría de los estudios controlados publicados al respecto, sobre la utilización de ROOs en el dolor irruptivo, recomiendan la necesidad de titulación de dosis (sobre todo los que incluyen CFOT y fentanilo bucal), la elección de una dosis eficaz sigue siendo dificultosa. Breakthrough pain is defined as an exacerbation of the pain of sudden and transient, high intensity (VAS > 7) and short duration (usually less than 20-30 minutes), which appears on the basis of a stable persistent pain, when this is reduced to a tolerable level (VAS < 5) by using strong opioids. The classification most used is the classification based on the following: Incident (predictable, unpredictable), idiopathic and end-of-dose. Proper management of breakthrough pain is based on three aspects: prevention, early and appropriate medication use. There are formulations of opioids rapid onset and short duration of action (ROOS) that better fit the profile and treatment of this type of pain. Everyone has an early onset of effect, between 5-15 minutes after dosing and a duration of 2-4 h and a bioavailability
Fentanyl Buccal Tablet for the Treatment of Breakthrough Pain: Pharmacokinetics of Buccal Mucosa Delivery and Clinical Efficacy
Mona Darwish, Ehab Hamed and John Messina
Perspectives in Medicinal Chemistry , 2012, DOI: 10.4137/PMC.S3928
Abstract: The treatment of breakthrough pain (BTP), a transitory exacerbation of pain that occurs on a background of otherwise-controlled, persistent pain, requires an opioid formulation and/or method of administration that can provide rapid and extensive systemic exposure. Fentanyl buccal tablet (FBT; FENTORA , Cephalon, Inc.) employs OraVescent drug delivery technology, which enhances the rate and extent of fentanyl absorption. OraVescent technology enhances the oral dissolution and buccal absorption of fentanyl, which facilitates rapid uptake of fentanyl into the bloodstream, reducing gastrointestinal absorption and minimizing extensive first-pass metabolism. The resulting pharmacokinetic profile of FBT is characterized by greater bioavailability and a higher early systemic exposure compared with the earlier oral transmucosal fentanyl citrate formulation. In clinical studies of opioid-tolerant patients with cancer-related and noncancer- related BTP, FBT has provided consistent and clinically relevant improvements in pain intensity and pain relief relative to placebo, with a safety and tolerability profile that is generally typical of that observed with other potent opioids. The pharmacokinetic properties of FBT allow for meaningful clinical efficacy, with an onset of action that closely matches the onset of BTP.
Fentanyl Buccal Tablet for the Treatment of Breakthrough Pain: Pharmacokinetics of Buccal Mucosa Delivery and Clinical Efficacy
Mona Darwish,Ehab Hamed,John Messina
Perspectives in Medicinal Chemistry , 2010,
Abstract: The treatment of breakthrough pain (BTP), a transitory exacerbation of pain that occurs on a background of otherwise-controlled, persistent pain, requires an opioid formulation and/or method of administration that can provide rapid and extensive systemic exposure. Fentanyl buccal tablet (FBT; FENTORA , Cephalon, Inc.) employs OraVescent drug delivery technology, which enhances the rate and extent of fentanyl absorption. OraVescent technology enhances the oral dissolution and buccal absorption of fentanyl, which facilitates rapid uptake of fentanyl into the bloodstream, reducing gastrointestinal absorption and minimizing extensive first-pass metabolism. The resulting pharmacokinetic profile of FBT is characterized by greater bioavailability and a higher early systemic exposure compared with the earlier oral transmucosal fentanyl citrate formulation. In clinical studies of opioid-tolerant patients with cancer-related and noncancer- related BTP, FBT has provided consistent and clinically relevant improvements in pain intensity and pain relief relative to placebo, with a safety and tolerability profile that is generally typical of that observed with other potent opioids. The pharmacokinetic properties of FBT allow for meaningful clinical efficacy, with an onset of action that closely matches the onset of BTP.
Recent advances in the use of opioids for cancer pain
Joanne Droney, Julia Riley
Journal of Pain Research , 2009, DOI: http://dx.doi.org/10.2147/JPR.S6905
Abstract: ent advances in the use of opioids for cancer pain Review (8317) Total Article Views Authors: Joanne Droney, Julia Riley Published Date September 2009 Volume 2009:2 Pages 135 - 155 DOI: http://dx.doi.org/10.2147/JPR.S6905 Joanne Droney, Julia Riley Palliative Medicine Department, Royal Marsden Hospital, London, UK Abstract: Opioids are the mainstay of treatment for moderate to severe cancer pain. In recent years there have been many advances in the use of opioids for cancer pain. Availability and consumption of opioids have increased and opioids other than morphine (including methadone, fentanyl, oxycodone) have become more widely used. Inter-individual variation in response to opioids has been identified as a significant challenge in the management of cancer pain. Many studies have been published demonstrating the benefits of opioid switching as a clinical maneuver to improve tolerability. Constipation has been recognized as a significant burden in cancer patients on opioids. Peripherally restricted opioid antagonists have been developed for the prevention and management of opioid induced constipation. The phenomenon of breakthrough pain has been characterized and novel modes of opioid administration (transmucosal, intranasal, sublingual) have been explored to facilitate improved management of breakthrough cancer pain. Advances have also been made in the realm of molecular biology. Pharmacogenetic studies have explored associations between clinical response to opioids and genetic variation at a DNA level. To date these studies have been small but future research may facilitate prospective prediction of response to individual drugs.
Page 1 /100
Display every page Item


Home
Copyright © 2008-2017 Open Access Library. All rights reserved.