Subcutaneous Morphine for Dyspnea in Cancer Patients

Bruera, Éduardo; MacEachern, Tara; Ripamonti, Carla; Hanson, John

doi:10.7326/0003-4819-119-9-199311010-00007

Cited by 191 publications

(111 citation statements)

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“…have not yet defined the minimum effective dose; [1,7,8] furthermore since the study by Abernethy et al which evaluated the efficacy of 20mg oral morphine daily, a 10mg per 24 hour preparation has become available.…”

Section: Introductionmentioning

confidence: 99%

Once-Daily Opioids for Chronic Dyspnea: A Dose Increment and Pharmacovigilance Study

Currow

McDonald

Oaten

et al. 2011

Journal of Pain and Symptom Management

256

242

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Please note that any alterations made during the publishing process may not appear in this version."NOTICE: this is the authors' version of a work that was accepted for publication in the Journal of Pain and Symptom Management. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Cities. Published Journal Articles (PJAs) Definition: A published journal article (PJA) is the definitive final record of published research that appears or will appear in the journal and embodies all value-adding publisher activities including copy-editing, formatting and (if relevant) pagination. Policy: Elsevier guarantees each PJA's authenticity, we work with others (e.g. national libraries) to preserve them for posterity and in perpetuity, and we invest to drive their usage. We strictly apply an absolute guideline regarding their location: every PJA will reside only on a completely controlled site because this is the only way that we as the publisher can guarantee each PJA's permanence, authenticity and that it is not altered. The continued viability of scholarly journals and their PJAs is also important to the research community. Publishers invest significant time, money and resources to create, maintain and develop both journals' reputations and the publishing process. The distribution of PJAs is therefore also subject to strict guidelines so that journals' ability to recoup the investments required to create them are not compromised. An author may use the PJA for personal use and internal institutional use (see above for definitions of these terms). In the interest of safeguarding the correct scientific record, however, Elsevier does not permit the posting of PJAs (Elsevier-provided PDF or HTML files) on any open websites. This is to ensure that the final published version of an article, which has been edited and peer-reviewed according to the publishing standards of an Elsevier journal, is always recognized as such only via the journal itself, whether in print or electronic format. PJAs may not be used for commercial use or for systematic distribution (see above for definitions of these terms). Tables: 6 References: 25Funding : This study was generously funded by National Health and Medical Research Council grant #480459. 2Archived at Flinders University: dspace.flinders.edu.au Abstract ContextRandomised controlled trials (RCTs) can answer questions of efficacy, but rarely generate a complete safety profile. Long term pharmacovigilance studies complement RCTs. ObjectivesLevel I evidence supports short term efficacy of opioids in reducing refractory dyspnoea. This study aims to determine: the minimum effective daily dose of sustained release morphine to reduce refractory breathlessness; and whether net clinical benefits are sustained safely. MethodsIn a phase II d...

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Section: Introductionmentioning

confidence: 99%

Once-Daily Opioids for Chronic Dyspnea: A Dose Increment and Pharmacovigilance Study

Currow

McDonald

Oaten

et al. 2011

Journal of Pain and Symptom Management

256

242

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“…Opioids have been the most widely studied agent in the treatment of dyspnea (204,230,235). Short-term administration reduces breathlessness in patients with a variety of conditions, including advanced COPD (236,237), interstitial lung disease (238), cancer (239), and chronic heart failure (240). However, evidence of long-term efficacy is limited and conflicting (241,242).…”

Section: Treatmentmentioning

confidence: 99%

An Official American Thoracic Society Statement: Update on the Mechanisms, Assessment, and Management of Dyspnea

Parshall¹,

Schwartzstein²,

Adams³

et al. 2012

Am J Respir Crit Care Med

1,477

1,328

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“…She could have also obtained significant relief from dyspnea with optimal opioid use. [8][9][10] In the absence of delirium, psychosis, or severe depression, as assessed by both the psychiatry and palliative care teams, Ms. AB was considered to be competent to make these decisions on the basis of the following principles, as previously described by other authors: [11][12][13] -Ability to understand the relevant information pertaining to the diagnosis and treatment and the associated benefits and risks with and without the treatment. Our patient had a very clear understanding of the diagnosis of end-stage acute myeloid leukemia, stem cell transplantation, BK virus-associated hemorrhagic cystitis, and pain as a result of the primary mediastinal mass and the passage of clots from the urethra.…”

Section: Discussionmentioning

confidence: 99%

“Whatever My Mother Wants”: Barriers to Adequate Pain Management

Reddy

Yennurajalingam²,

Bruera³

2013

Journal of Palliative Medicine

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Opioids are the preferred medications to treat cancer pain; however, several barriers to cancer pain management exist, including those related to the patient, health care provider, and family caregiver. We describe one such situation in which a family member prevents the patient from receiving adequate pain management at the end of life despite interdepartmental and interdisciplinary efforts. This case highlights the importance of understanding and addressing fears regarding opioid use and implementing an integrated approach including oncologists and palliative care physicians, along with early referrals to palliative care.

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Subcutaneous Morphine for Dyspnea in Cancer Patients

Cited by 191 publications

References 0 publications

Once-Daily Opioids for Chronic Dyspnea: A Dose Increment and Pharmacovigilance Study

Once-Daily Opioids for Chronic Dyspnea: A Dose Increment and Pharmacovigilance Study

An Official American Thoracic Society Statement: Update on the Mechanisms, Assessment, and Management of Dyspnea

“Whatever My Mother Wants”: Barriers to Adequate Pain Management

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