• Journal of Hospice and Palliative Care
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• v.21 no.4
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• pp.152-157
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• 2018

Opioid aberrant behavior is an emerging problem as strong opioid is increasingly used to alleviate cancer pain in patients with cancer. Although the treatment of opioid addiction and physical dependence for non-cancer pain is well known, few studies have been conducted with cancer patients, particularly in the Korean population. Presented here are ten cases of cancer patients who were physically dependent on strong opioid and successfully treated with a partial mu-opioid receptor agonist, buprenorphine. This is the first report showing the efficacy of transdermal buprenorphine as a treatment for physical dependence on opioid medication in cancer patients.

• Journal of the Korean Orthopaedic Association
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• v.55 no.1
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• pp.1-8
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• 2020

The progression of aging and the increase in musculoskeletal diseases have led to an increase in invasive treatment methods, including various surgical methods, but conservative treatment should be attempted before surgical treatment in musculoskeletal diseases. Medication for pain control, such as acetaminophen, non-steroidal anti-inflammatory drugs, steroid, opioids, antidepressants, etc., is one of the most popular methods for pain control. If the pain receptors on peripheral organ are stimulated, pain is transmitted to the brain by the ascending pathway, and the brain then secretes endogenous opioids, such as endorphin, by the descending pathway for pain control. Opioids are substances that act on the opioid receptors, and there are three receptors for opioids. The affinity for each receptor varies according to the tissue and the patient's systemic status. Antidepressants work on the synapses in the central nervous system and its main mechanism is regulation of the ascending pathway. This is mainly effective in chronic pain and neuropathic pain, which is similar in effectiveness to opioids. This review focuses on the effectiveness, method of use, and side effects of opioids and antidepressants.

• Journal of Hospice and Palliative Care
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• v.19 no.4
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• pp.296-302
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• 2016

Purpose: This study examined the effectiveness of a hand massage combined with analgesics on pain control in hospice patients with terminal cancer. Methods: This study is a quasi-experimental study with a single group time series design. The study included 25 terminal cancer patients who were admitted to a hospice ward. Each patient's pain level was measured after analgesics use only (control group). When patients complained of pain again, the pain level was assessed after administering a combination of hand massage and analgesics (experimental group). As for the experimental treatment, the participants were provided with oil hand massage on each hand for 5 minutes. Results: The experimental group and the control group showed no significant differences in the changes of pain score (F=0.74, P=0.3939). Conclusion: Although the pain level of the experimental group did not significantly improve compared with the control group, their pain levels tended to be low to begin with. Thus, a complementary utility value of hand massage cannot be completely excluded in terminal cancer patients. Since the pain level significantly changed according to the dosage of analgesic, nurses need more education and research on analgesic drug therapy for terminal cancer patients.

• Journal of Hospice and Palliative Care
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• v.2 no.1
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• pp.7-15
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• 1999

This survey was designed to evaluate knowledge and attitudes of physicians and nurses toward cancer pain management in South Korea and to compare physicians' knowledge and attitudes with nurses' Ninety-nine physicians and 152 nurses working at four major institutions in South Korea were included for the study. With the 30 items of the knowledge with true and false answers about cancer pain such as pain assessment(6 items), pharmacokinetics of opioids(8 items), analgesics classification(11 items), and drug administration(5 items), total score of knowledge answered by physicians was 21.40, which was not significantly higher than 20.87 answered by nurses. Rates of the correct answer were more than 70% in both physicians and nurses. Physicians were more knowledgeable in pharmacokinetics and analgesics classification than nurses, while nurses higher only in pain assessment than physicians. Since physicians and nurses could not effectively manage the cancer pain because of inappropriate knowledge, it is important to provide intensive education to physicians and nurses about cancer pain management.

• 가정의 벗
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• v.36 no.12 s.424
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• pp.10-11
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• 2003

편두통은 머릿 속에 딱다구리가 들어와 있는 것처럼 생활을 불편하게 하는 병입니다. 특히, 20대 여성에게 많이 나타나는 편두통은 뚜렷한 원인도 없고 완치도 쉽지 않습니다. 두통이 심하면 혹시 '뇌에 종양이 생긴 게 아닐까' 두려워하는 사람도 있는데 대부분 스트레스로 인한 긴장성 두통이나 편두통입니다. 그러나 무작정 진통제로 해결하려는 것은 무모한 일이며 진통제를 남용하면 병이 만성화돼 치료가 더욱 어려울 수 있습니다.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1993.04a
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• pp.62-62
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• 1993

Morphine은 강력한 진통작용으로 약효를 나타내고 있고 이와 같은 진통작용은 대체로 크게 대별하여 두 가지 기전으로 설명이 된다. 그 첫째는 수의 opioid수용체에 작용하여 척수에서 상행으로 전달되는 통각정보를 차단하는 것이며 또 다른 하나는 뇌에 존재하는 opioid수용체에 작용하여 진통작용을 발현한다고 알려져 있다. 실지로 임상에서 morphine을 실내에 주입하여 강한 진통작용을 가진바가 많이 보고되었다. 그러나, 아직 마약성 진통제가 뇌를 통하여 진통작용을 가지는 그 기전에 대해선 잘 밝혀지지 않았다. 많은 연구가 마약성 진통제가 뇌에 주입되면 뇌에 존재하는 opioid수용체에 작용하고 이 수용체를 가진 신경세포가 하향성 억제를 함으로써 척수에서 통각정보를 차단하여 진통작용을 나타냄을 시사한다. 그러나 아직도 이의 정확한 기전이 명쾌히 밝혀지지 않고 있다. 즉, 뇌실내에 morphine을 주입하면 이것이 과연 척수세포를 억제할 것인가에 대한 답이 없기 때문이다. 그와는 반대로 뇌실내 morphine주입은 척수세포에 아무런 영향을 미치지 못한다는 보고가 있다. 이에 본 실험은 뇌실에 주입된 morphine이 척수세포를 어떤 영향을 미치는가를 확인하고자 하였다.

• Journal of the korean veterinary medical association
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• v.32 no.3
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• pp.168-171
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• 1996

• Journal of Hospice and Palliative Care
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• v.17 no.3
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• pp.113-121
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• 2014

The major symptoms of terminally ill cancer patients are fatigue, loss of energy, feeling of helplessness, poor appetite and pain as well as general weakness, which are very similar to symptoms of adrenal insufficiency. Adrenal insufficiency-induced symptoms widely vary from mild symptoms to life-threatening conditions and may be resulted from variable medical causes. For terminally ill cancer patients who are hospitalized for palliative care, opioid agents are prescribed to control moderate to severe pain. The use of acute or chronic opioid agents is believed to negatively affect adrenal gland function. In most studies of opioid effects (preclinical/clinical with animal subjects or and patients suffering non-malignant pain, adrenal insufficiency and hormonal abnormalities were observed as side effects. However, opioid-induced adrenal insufficiency has been rarely reported in studies with patients with malignant cancer pain. Relationship between the type, treatment period, dosage of opioid agents and hormonal abnormalities can be examined by measuring the functional level of the adrenal glands. We hope to improve patient's quality of life by indicating hormone substitution to treat symptoms of adrenal insufficiency.

• Journal of Veterinary Clinics
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• v.22 no.1
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• pp.6-15
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• 2005

This study was performed to investigate non-invasive behavioral pain assessment of dogs after surgery, and the analgesic effects of butorphanol after intestinal anastomosis in dogs. In this study, five dogs in the Control Group were anesthetized, but did not undergo surgery. Five dogs in the Analgesic Group were undergone intestinal anastomosis and treated with butorphanol. Five dogs in the Non-analgesic Group were also undergone intestinal anastomosis without analgesic treatment. The dogs in the Analgesic Group received butorphanol (0.4 mg/kg, IM) before and immediately after operation, while dogs in Control and Non-analgesic Groups received isovolumetric doses of sterile saline. The behavior of dogs were videotaped for 400 mins after anesthesia, during which time a researcher interacted with the dog once per each 80 mins. At each interaction, the researcher recorded behavioral pain score, using University of Melbourne Pain Scale. Interactive and non-interactive behaviors were observed and quantitated by a single observer using focal continuous sampling method. Vocalizations were obtained during 400 mins after anesthesia, and duration of call, intensity, pitch, 1-4 Formant were analyzed. Surgery affected an increasing of pain score. During interactions with researcher, greeting behaviors were decreased after surgery. Differences between Analgesic group given analgesic or that given a placebo drug were readily understood using quantitative behavioral measurements and vocalization. Significant difference between Analgesic group given butorphanol or that the given placebo drug was apparent(p< 0.05).

• Journal of Hospice and Palliative Care
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• v.17 no.4
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• pp.270-277
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• 2014

Purpose: This is a retrospective study that investigated cancer patients' complaints of moderate or severe pain to analyze pain characteristics, pain relief interventions and their effects. Methods: The participants of this study were 363 patients who were hospitalized in the cancer ward for three to 30 days and scored 4 points or higher on the pain severity assessment. Results: The most frequent region of pain was the abdomen. The most frequent factor that exacerbated pain was movement. The most frequent pain alleviating factor was administration of analgesics. The most frequent pain type was breakthrough pain, and the most frequent non-pharmaceutical intervention for pain control was heat therapy. Among all, analgesics were routinely prescribed for 52.2% of the participants. Morphine sulfate was the most frequently used analgesic while Gabapentin was the most frequently used non-narcotic analgesic. At the time of discharge, 82.5% of the participants marked their pain intensity as 3 points or lower. Conclusion: For cancer patients complaining of moderate or severe pain, it is important to actively control pain from the beginning of admission. Thus, it is necessary to educate not only cancer patients using narcotic analgesic for pain control and their families but nurses about the effects and side-effects of drugs. Moreover, patients and their families need to learn how to assess and record pain at home to collect data that can be referred for future treatment.