RESUMEN
Pharmaceutical care of the hospice patient offers unique challenges in the management of pain and other symptoms. Lessons learned in providing hospice care can be used in the care of nonterminal patients as well to optimize patient-specific care, regardless of care setting or life expectancy.
Asunto(s)
Monitoreo de Drogas , Servicios de Salud para Ancianos , Cuidados Paliativos al Final de la Vida , Anciano , Anciano de 80 o más Años , Amitriptilina/administración & dosificación , Amitriptilina/efectos adversos , Amitriptilina/uso terapéutico , Analgésicos Opioides/administración & dosificación , Analgésicos Opioides/efectos adversos , Analgésicos Opioides/farmacocinética , Analgésicos Opioides/uso terapéutico , Monitoreo de Drogas/métodos , Monitoreo de Drogas/normas , Fentanilo/administración & dosificación , Fentanilo/efectos adversos , Fentanilo/farmacocinética , Fentanilo/uso terapéutico , Servicios de Salud para Ancianos/organización & administración , Servicios de Salud para Ancianos/normas , Servicios de Salud para Ancianos/tendencias , Cuidados Paliativos al Final de la Vida/organización & administración , Cuidados Paliativos al Final de la Vida/normas , Cuidados Paliativos al Final de la Vida/tendencias , Humanos , Náusea/tratamiento farmacológico , Prurito/tratamiento farmacológico , Parche Transdérmico , Vómitos/tratamiento farmacológicoRESUMEN
With the prevalence of diabetes mellitus (DM) increasing, pathologic complications such as diabetic peripheral neuropathy (DPN) are also becoming more common. Of those diagnosed with DM, 10% to 20% of patients suffer from painful DPN. Until recently, only pregabalin and duloxetine possessed Food and Drug Administration (FDA) approval for this condition. However, FDA recently approved tapentadol-ER [extended release] (Nucynta ER) for painful DPN. Tapentadol-ER is an opioid analgesic commonly used for the treatment of moderate-to-severe chronic pain that contains a unique dual mechanism acting as both a weak mu-opiod receptor agonist and norepinephine-reuptake inhibitor. It is by way of this unique dual mechanism that allows for effective analgesic effects with increased tolerability. This new FDA approval provides an additional therapeutic option to treat DPN in symptomatic patients.