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BACKGROUND Methadone is an effective treatment for opioid dependency and chronic pain. A methadone derivative, levacetylmethadol, was withdrawn from the European market after being associated with torsade de pointes. To date, no association between methadone and this arrhythmia has been described. OBJECTIVE To evaluate a series of methadone-treated(More)
BACKGROUND The short elimination half-life of hydromorphone necessitates 4-hourly dosing to maintain optimal levels of analgesia in patients with chronic cancer pain. The purpose of this study was to compare the clinical efficacy and safety of controlled release hydromorphone administered every 12 hours and immediate release hydromorphone administered every(More)
Fentanyl has been incorporated into a transdermal therapeutic system (TTS) containing a rate-limiting membrane that provides constant release of the opioid. TTS fentanyl provides continuous opioid delivery for up to 72 hr without the need for special equipment. After Institutional Review Board approval, 53 patients with cancer pain requiring 45 mg or more(More)
Ketamine is a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist used recently for analgesia in patients with chronic pain. Twenty one patients with chronic neuropathic pain were treated with oral ketamine starting at a divided dose of 100 mg/day and titrating upwards by 40 mg/day until efficacy was reached, or until side effects became(More)
A female severe macaw (Ara severa) that was at least 11 years old was evaluated for sudden onset of exercise intolerance and dyspnea. Radiography revealed a large heart silhouette, an increase in prominence of the brachiocephalic arteries, and a diffuse increase in opacity of the lungs. Lateral nonselective angiography revealed dilatation of both chambers(More)
PROBLEM BEING ADDRESSED About 65% of patients with advanced malignancies experience cancer pain. Although oral opioids provide effective analgesia for most of these patients, alternate routes of drug delivery are often necessary as the disease progresses. PURPOSE OF PROGRAM To study use of Duragesic (fentanyl transdermal system), the only transdermal(More)