Links to Exploration step
Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Ethical and practical issues with opioids in life-limiting illness</title><author><name sortKey="Fine, Robert L" sort="Fine, Robert L" uniqKey="Fine R" first="Robert L." last="Fine">Robert L. Fine</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">17256034</idno><idno type="pmc">1769525</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1769525</idno><idno type="RBID">PMC:1769525</idno><date when="2007">2007</date><idno type="wicri:Area/Pmc/Corpus">003159</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">003159</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Ethical and practical issues with opioids in life-limiting illness</title><author><name sortKey="Fine, Robert L" sort="Fine, Robert L" uniqKey="Fine R" first="Robert L." last="Fine">Robert L. Fine</name></author></analytic><series><title level="j">Proceedings (Baylor University. Medical Center)</title><idno type="ISSN">0899-8280</idno><imprint><date when="2007">2007</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Effective pain relief, especially at the end of life, is a primary ethical obligation based upon the principles of beneficence, nonmaleficence, patient autonomy, and particularly the concept of double effect. The pragmatic foundation of pain management begins with a complete assessment, which incorporates “WILDA” (words, intensity, location, duration, aggravating/alleviating factors) and considers the components of total pain: physical, emotional, social, and spiritual pain. Opioids are the pharmacologic <italic>sine qua non</italic> of pain management in life-limiting illness and should be prescribed based on the severity of pain, considering the functional and psychological significance of that severity. Numerous misunderstandings present a barrier to effective pain management. These misconceptions include the idea that opioids are highly addictive, that dependence or tolerance are forms of addiction, that respiratory depression is common with opioids, that opioids have a narrow therapeutic range, and that opioids are ineffective by mouth and cause too much nausea. In reality, opioids are the safest and most effective pain medicine for most moderate to severe pain in most patients. Aspects of basic opioid pharmacology, such as dosage, route of administration, rotation of drugs, and the avoidance of toxicity and complications, should be considered when initiating and maintaining therapy. Failure to pay attention to the basic rules can lead to errors in opioid management.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Proc (Bayl Univ Med Cent)</journal-id><journal-id journal-id-type="publisher-id">bumc</journal-id><journal-title>Proceedings (Baylor University. Medical Center)</journal-title><issn pub-type="ppub">0899-8280</issn><publisher><publisher-name>Baylor Health Care System</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">17256034</article-id><article-id pub-id-type="pmc">1769525</article-id><article-id pub-id-type="publisher-id">bumc0020-0005</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group></article-categories><title-group><article-title>Ethical and practical issues with opioids in life-limiting illness</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Fine</surname><given-names>Robert L.</given-names></name><degrees>MD</degrees></contrib></contrib-group><aff>From the Office of Clinical Ethics, Baylor Health Care System, and Palliative Care Consultation Service, Baylor University Medical Center, Dallas, Texas.</aff><author-notes><corresp><bold>Corresponding author:</bold> Robert L. Fine, MD, 3434 Swiss Avenue, Suite 205, Dallas, Texas 75204 (e-mail: <email>rl.fine@BaylorHealth.edu</email>).</corresp><fn><p>Presented at internal medicine grand rounds, Baylor University Medical Center, September 26, 2006.</p></fn></author-notes><pub-date pub-type="ppub"><month>1</month><year>2007</year></pub-date><volume>20</volume><issue>1</issue><fpage>5</fpage><lpage>12</lpage><ext-link ext-link-type="uri" xlink:href="http://www.BaylorHealth.com/Proceedings">http://www.BaylorHealth.com/Proceedings</ext-link><copyright-statement>Copyright © 2007, Baylor University Medical Center</copyright-statement><copyright-year>2007</copyright-year><abstract><p>Effective pain relief, especially at the end of life, is a primary ethical obligation based upon the principles of beneficence, nonmaleficence, patient autonomy, and particularly the concept of double effect. The pragmatic foundation of pain management begins with a complete assessment, which incorporates “WILDA” (words, intensity, location, duration, aggravating/alleviating factors) and considers the components of total pain: physical, emotional, social, and spiritual pain. Opioids are the pharmacologic <italic>sine qua non</italic> of pain management in life-limiting illness and should be prescribed based on the severity of pain, considering the functional and psychological significance of that severity. Numerous misunderstandings present a barrier to effective pain management. These misconceptions include the idea that opioids are highly addictive, that dependence or tolerance are forms of addiction, that respiratory depression is common with opioids, that opioids have a narrow therapeutic range, and that opioids are ineffective by mouth and cause too much nausea. In reality, opioids are the safest and most effective pain medicine for most moderate to severe pain in most patients. Aspects of basic opioid pharmacology, such as dosage, route of administration, rotation of drugs, and the avoidance of toxicity and complications, should be considered when initiating and maintaining therapy. Failure to pay attention to the basic rules can lead to errors in opioid management.</p></abstract></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/LymphedemaV1/Data/Pmc/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 003159 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd -nk 003159 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= LymphedemaV1
|flux= Pmc
|étape= Corpus
|type= RBID
|clé=
|texte=
}}
| This area was generated with Dilib version V0.6.31. |  |