Successful management of a difficult cancer pain patient by appropriate adjuvant and morphine titration

Rana, Shiv Ps; Ahmed, Arif; Kumar, V.; Chaudhary, Prakash; Khurana, Deepa; Mishra, Seema

doi:10.4103/0973-1075.84541

Cited by 8 publications

(9 citation statements)

References 7 publications

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“…Thus we had a final list of 90 articles for our analysis. [1112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960616263646566676869707172737475767778798081828384858687888990919293949596979899100]…”

Section: Resultsmentioning

confidence: 99%

An exploratory analysis of levels of evidence for articles published in Indian journal of palliative care in the years 2010-2011

Kumar¹,

Sisodia²

2013

Indian J Palliat Care

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Context:Indian Journal of Palliative Care (IJPC) provides a comprehensive multidisciplinary evidence base for an evidence-informed clinical decision making.Aims:To analyze the levels of evidence of articles published in IJPC in the years 2010-2011.Settings and Design:Systematic review of palliative care journals.Materials and Methods:Systematic review of articles was done and was scored according to Center for Evidence-Based Medicine levels of evidence into any of the five grades. The articles were categorized based upon article type, number of authors, study approach, age focus, population focus, disease focus, goals of care, domains of care, models of care, and year of publication.Statistical Analysis Used:All descriptive analysis was done using frequencies and percentiles, and association between all categorical variables was done using Chi-square test at 95% confidence interval (CI) using Statistical Package for Social Sciences (SPSS) version 16 for Windows (SPSS Inc, Chicago, IL).Results:There was a greater prevalence of low level evidence (level 4: n = 46, 51%; level 5: n = 35, 39%) among the 90 selected articles, and article type (original articles with higher level of evidence, P = 0.000), article approach (analytical studies with higher level of evidence, P = 0.000), domains of palliative care (practice-related studies with higher level of evidence, P = 0.000) and models of care (biological or psychosocial model with higher level of evidence, P = 0.044) had a significant association with the grade of levels of evidence. Association with other factors was not statistically significant (P < 0.05).Conclusions:The levels of research evidence for palliative care provided by articles published in IJPC were predominantly level 4 and level 5, and there is scope for more high quality evidence to inform palliative care decisions in the developing countries.

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Section: Resultsmentioning

confidence: 99%

An exploratory analysis of levels of evidence for articles published in Indian journal of palliative care in the years 2010-2011

Kumar¹,

Sisodia²

2013

Indian J Palliat Care

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“…[22] The goal of morphine therapy has been suggested to yield a favorable balance between pain control and side effects. [23] The side effect profile of oxycodone has been reported to be similar to that of morphine. However, other studies also indicated that patients prescribed with oxycodone had less adverse effects.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of sustained-release oxycodone compared with immediate-release morphine for pain titration in cancer patients

et al. 2019

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Background: The study aims to investigate the effect and safety of sustained-release oxycodone hydrochloride as background dose on pain titration in patients with moderate-to-severe cancer pain. Material and methods: Adult patients scheduled with a regular strong opioid for cancer-related pain were recruited and randomly assigned to sustained-release oxycodone group (tablets, 12 hourly) and immediate-release morphine group (5 mg initially, hourly). All patients were hourly reassessed for efficacy and dose titration. Results: The primary end point was the number of titration cycles required to achieve adequate pain relief (numerical rating scale, NRS ≤ 3). Secondary end points included the proportion of patients achieving adequate pain relief during each cycle, potential predictive factors for titration performance, and side effects. Ninety (94.7%) patients in oxycodone group and 78 (86.7%) patients in morphine group achieved adequate pain control during 1 to 4 cycles of titration. Patients in oxycodone group reached adequate pain control within the first 2 cycles of titration, which was significantly shorter than morphine group wherein the number of titration cycles ranged from 1 to 4 ( P = .034). Oxycodone prescription significantly increased the response rate of patients to morphine titration during the first cycle of titration ( P = .010). The initial NRS score and oxycodone administration were significantly associated with titration performance. The mild or moderate adverse effects were similar in 2 groups, while severe adverse effects were only identified in morphine group ( P = .001). Conclusion: Use of background sustained-release oxycodone is more efficient and better tolerated on dose titration than immediate-release morphine.

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“…We found 11 drugs with logIC50 =< -2 in at least five cell lines out of 12 (Table 3). Of these 11 drugs, six were known anti-cancer drugs, three were antimicrobial that have been shown to have an antineoplastic effect , and two drugs i.e., viomycin (anti-microbial agent) and diamorphine (analgesic) have yet not been experimentally validated as anti-cancer drugs [46][47][48].…”

Section: Fda-approved Drugs Analysismentioning

confidence: 99%

Support Vector Machine based prediction models for drug repurposing and designing novel drugs for colorectal cancer

Sengupta,

Kumar

2023

Preprint

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Colorectal cancer (CRC) has witnessed a concerning increase in incidence and poses a significant therapeutic challenge due to its poor prognosis. There is a pressing demand to identify novel drug therapies to combat CRC. In this study, we addressed this need by utilizing the library of CRC pharmacological profiles of anticancer drugs and developed QSAR models for prediction of alternative and promiscuous anti-cancer compounds for CRC treatment. Our QSAR models demonstrated their robustness by achieving high correlation of determination (R2) after 10-fold cross validation. For 12 CRC cell lines, R2ranges from 0.609-0.827. Highest performance was achieved for SW1417 and GP5d cell lines with R2, 0.827 and 0.786, respectively. Further, we listed the most common descriptors in the drug profiles of the CRC cell lines and we also checked the correlation of the descriptors with the drug activity. The KRFP314 fingerprint was the predominantly occurring descriptor, with the KRFPC314 fingerprint following closely in prevalence within the drug profiles of the CRC cell lines. Beyond predictive modeling, we also successfully validated drug-to-oncogene relationship via in-silico methods and identified FDA- approved drugs which could be used as potential anti-CRC drugs, paving the way for subsequent in vitro or in vivo experiments to validate their efficacy. To provide easy accessibility and utility of our research findings, we have incorporated these models into a free-to-use user-friendly prediction webserver named, ColoRecPred hosted on project.iith.ac.in/cgntlab/colorecpred. This web-based tool can be used to screen for potential anti-cancer compounds for CRC.

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Successful management of a difficult cancer pain patient by appropriate adjuvant and morphine titration

Cited by 8 publications

References 7 publications

An exploratory analysis of levels of evidence for articles published in Indian journal of palliative care in the years 2010-2011

An exploratory analysis of levels of evidence for articles published in Indian journal of palliative care in the years 2010-2011

Efficacy and safety of sustained-release oxycodone compared with immediate-release morphine for pain titration in cancer patients

Support Vector Machine based prediction models for drug repurposing and designing novel drugs for colorectal cancer

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