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  1. Article ; Online: Midazolam: an essential palliative care drug.

    Prommer, Eric

    Palliative care and social practice

    2020  Volume 14, Page(s) 2632352419895527

    Abstract: Midazolam is a commonly used benzodiazepine in palliative care and is considered one of the four essential drugs needed for the promotion of quality care in dying patients. Acting on the benzodiazepine receptor, it promotes the action of gamma- ... ...

    Abstract Midazolam is a commonly used benzodiazepine in palliative care and is considered one of the four essential drugs needed for the promotion of quality care in dying patients. Acting on the benzodiazepine receptor, it promotes the action of gamma-aminobutyric acid. Gamma-aminobutyric acid action promotes sedative, anxiolytic, and anticonvulsant properties. Midazolam has a faster onset and shorter duration of action than other benzodiazepines such as diazepam and lorazepam lending itself to greater flexibility in dosing than other benzodiazepines. The kidneys excrete midazolam and its active metabolite. Metabolism occurs in the liver by the P450 system. This article examines the pharmacology, pharmacodynamics, and clinical uses of midazolam in palliative care.
    Language English
    Publishing date 2020-01-13
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2632-3524
    ISSN (online) 2632-3524
    DOI 10.1177/2632352419895527
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Safety and Utility of Chloroquine/ Hydroxychloroquine in Palliative Care Patients.

    Prommer, Eric

    The American journal of hospice & palliative care

    2020  Volume 38, Issue 5, Page(s) 480–488

    Abstract: The coronavirus disease 2019 (COVID-19) pandemic represents a significant healthcare challenge for the world. Many drugs have therapeutic potential. The aminoquinolones, hydroxychloroquine, and chloroquine are undergoing evaluation as a potential therapy ...

    Abstract The coronavirus disease 2019 (COVID-19) pandemic represents a significant healthcare challenge for the world. Many drugs have therapeutic potential. The aminoquinolones, hydroxychloroquine, and chloroquine are undergoing evaluation as a potential therapy against COVID -19. In vitro and in vivo studies suggest that these drugs affect viral adherence and modify inflammatory responses, which may provide some impact on the symptoms associated with COVID. As palliative care specialists encounter more COVID positive patients, palliative care specialists need to know how these drugs work, and importantly how they interact with palliative care drugs used for symptom control. At the same time, there is a need to reduce polypharmacy in any seriously ill patient population. The goals of this paper are to identify whether or not hydroxychloroquine/chloroquine improves symptoms in palliative care patients and whether or not these drugs are safe to use in the advanced illness population who have COVID.
    MeSH term(s) Antiviral Agents/adverse effects ; Antiviral Agents/therapeutic use ; COVID-19/drug therapy ; Chloroquine/adverse effects ; Chloroquine/therapeutic use ; Humans ; Hydroxychloroquine/adverse effects ; Hydroxychloroquine/therapeutic use ; Palliative Care/methods ; Polypharmacy ; Treatment Outcome
    Chemical Substances Antiviral Agents ; Hydroxychloroquine (4QWG6N8QKH) ; Chloroquine (886U3H6UFF)
    Keywords covid19
    Language English
    Publishing date 2020-09-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1074344-3
    ISSN 1938-2715 ; 1049-9091
    ISSN (online) 1938-2715
    ISSN 1049-9091
    DOI 10.1177/1049909120952773
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Midazolam

    Eric Prommer

    Palliative Care and Social Practice, Vol

    an essential palliative care drug

    2020  Volume 14

    Abstract: Midazolam is a commonly used benzodiazepine in palliative care and is considered one of the four essential drugs needed for the promotion of quality care in dying patients. Acting on the benzodiazepine receptor, it promotes the action of gamma- ... ...

    Abstract Midazolam is a commonly used benzodiazepine in palliative care and is considered one of the four essential drugs needed for the promotion of quality care in dying patients. Acting on the benzodiazepine receptor, it promotes the action of gamma-aminobutyric acid. Gamma-aminobutyric acid action promotes sedative, anxiolytic, and anticonvulsant properties. Midazolam has a faster onset and shorter duration of action than other benzodiazepines such as diazepam and lorazepam lending itself to greater flexibility in dosing than other benzodiazepines. The kidneys excrete midazolam and its active metabolite. Metabolism occurs in the liver by the P450 system. This article examines the pharmacology, pharmacodynamics, and clinical uses of midazolam in palliative care.
    Keywords Medicine (General) ; R5-920
    Language English
    Publishing date 2020-01-01T00:00:00Z
    Publisher SAGE Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article: Safety and Utility of Chloroquine/ Hydroxychloroquine in Palliative Care Patients

    Prommer, Eric

    Am J Hosp Palliat Care

    Abstract: The coronavirus disease 2019 (COVID-19) pandemic represents a significant healthcare challenge for the world. Many drugs have therapeutic potential. The aminoquinolones, hydroxychloroquine, and chloroquine are undergoing evaluation as a potential therapy ...

    Abstract The coronavirus disease 2019 (COVID-19) pandemic represents a significant healthcare challenge for the world. Many drugs have therapeutic potential. The aminoquinolones, hydroxychloroquine, and chloroquine are undergoing evaluation as a potential therapy against COVID -19. In vitro and in vivo studies suggest that these drugs affect viral adherence and modify inflammatory responses, which may provide some impact on the symptoms associated with COVID. As palliative care specialists encounter more COVID positive patients, palliative care specialists need to know how these drugs work, and importantly how they interact with palliative care drugs used for symptom control. At the same time, there is a need to reduce polypharmacy in any seriously ill patient population. The goals of this paper are to identify whether or not hydroxychloroquine/chloroquine improves symptoms in palliative care patients and whether or not these drugs are safe to use in the advanced illness population who have COVID.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #760457
    Database COVID19

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  5. Article ; Online: Safety and Utility of Chloroquine/ Hydroxychloroquine in Palliative Care Patients

    Prommer, Eric

    American Journal of Hospice and Palliative Medicine®

    2020  , Page(s) 104990912095277

    Abstract: The coronavirus disease 2019 (COVID-19) pandemic represents a significant healthcare challenge for the world. Many drugs have therapeutic potential. The aminoquinolones, hydroxychloroquine, and chloroquine are undergoing evaluation as a potential therapy ...

    Abstract The coronavirus disease 2019 (COVID-19) pandemic represents a significant healthcare challenge for the world. Many drugs have therapeutic potential. The aminoquinolones, hydroxychloroquine, and chloroquine are undergoing evaluation as a potential therapy against COVID -19. In vitro and in vivo studies suggest that these drugs affect viral adherence and modify inflammatory responses, which may provide some impact on the symptoms associated with COVID. As palliative care specialists encounter more COVID positive patients, palliative care specialists need to know how these drugs work, and importantly how they interact with palliative care drugs used for symptom control. At the same time, there is a need to reduce polypharmacy in any seriously ill patient population. The goals of this paper are to identify whether or not hydroxychloroquine/chloroquine improves symptoms in palliative care patients and whether or not these drugs are safe to use in the advanced illness population who have COVID.
    Keywords General Medicine ; covid19
    Language English
    Publisher SAGE Publications
    Publishing country us
    Document type Article ; Online
    ZDB-ID 1074344-3
    ISSN 1938-2715 ; 1049-9091
    ISSN (online) 1938-2715
    ISSN 1049-9091
    DOI 10.1177/1049909120952773
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

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  6. Article: Oncology Update: Anamorelin.

    Prommer, Eric

    Palliative care

    2017  Volume 10, Page(s) 1178224217726336

    Abstract: Background: Cancer cachexia is a catabolic syndrome associated with uncontrolled muscle breakdown. There may be associated fat loss. Occurring in high frequency in advanced cancer, it is an indicator of poor prognosis. Besides weight loss, patients ... ...

    Abstract Background: Cancer cachexia is a catabolic syndrome associated with uncontrolled muscle breakdown. There may be associated fat loss. Occurring in high frequency in advanced cancer, it is an indicator of poor prognosis. Besides weight loss, patients experience a cluster of symptoms including anorexia, early satiety, and weakness. The 3 stages of cachexia include stages of precachexia, cachexia, and refractory cachexia. Refractory cachexia is associated with active catabolism or the presence of factors that make active management of weight loss no longer possible. Patients with refractory cachexia often receive glucocorticoids or megasterol acetate. Glucocorticoid effect is short and responses to megasterol are variable. Anamorelin is a new agent for cancer anorexia-cachexia, with trials completed in advanced lung cancer. Acting as an oral mimetic of ghrelin, it improves appetite and muscle mass. This article reviews the pharmacology, pharmacodynamics, and effect on cancer cachexia.
    Methods: A PubMed search was done using the Medical Subject Headings term anamorelin. Articles were selected to provide a pharmacologic characterization of anamorelin.
    Results: Anamorelin increases muscle mass in patients with advanced cancer in 2-phase 3 trials.
    Conclusions: Anamorelin improves anorexia-cachexia symptoms in patients with advanced non-small-cell lung cancer.
    Language English
    Publishing date 2017-08-21
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2517449-6
    ISSN 1178-2242
    ISSN 1178-2242
    DOI 10.1177/1178224217726336
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Aripiprazole.

    Prommer, Eric

    The American journal of hospice & palliative care

    2017  Volume 34, Issue 2, Page(s) 180–185

    Abstract: Delirium is a palliative care emergency where patients experience changes in perception, awareness, and behavior. Common features include changes in the sleep-wake cycle, emotional lability, delusional thinking, and language and thought disorders. ... ...

    Abstract Delirium is a palliative care emergency where patients experience changes in perception, awareness, and behavior. Common features include changes in the sleep-wake cycle, emotional lability, delusional thinking, and language and thought disorders. Delirium results from neurotransmitter imbalances involving several neurotransmitters such as dopamine, glutamate, norepinephrine, acetylcholine, gamma-aminobutyric acid, and serotonin. Untreated delirium causes significant morbidity and mortality. Nonpharmacologic and pharmacologic approaches treat delirium. Current pharmacologic management of delirium involves using agents such as haloperidol or second-generation antipsychotics. Third-generation atypical antipsychotic drugs have emerged as a potential choice for delirium management. Aripiprazole is a third-generation antipsychotic with a dopamine receptor-binding profile distinct from other second-generation antipsychotics. Aripiprazole acts as partial agonist at dopamine D
    MeSH term(s) Alzheimer Disease/drug therapy ; Antipsychotic Agents/pharmacokinetics ; Antipsychotic Agents/pharmacology ; Antipsychotic Agents/therapeutic use ; Aripiprazole/pharmacokinetics ; Aripiprazole/pharmacology ; Aripiprazole/therapeutic use ; Delirium/drug therapy ; Humans ; Psychotic Disorders/drug therapy
    Chemical Substances Antipsychotic Agents ; Aripiprazole (82VFR53I78)
    Language English
    Publishing date 2017-03
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1074344-3
    ISSN 1938-2715 ; 1049-9091
    ISSN (online) 1938-2715
    ISSN 1049-9091
    DOI 10.1177/1049909115612800
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Oncology Update

    Eric Prommer

    Palliative Care, Vol

    Anamorelin

    2017  Volume 10

    Abstract: Background: Cancer cachexia is a catabolic syndrome associated with uncontrolled muscle breakdown. There may be associated fat loss. Occurring in high frequency in advanced cancer, it is an indicator of poor prognosis. Besides weight loss, patients ... ...

    Abstract Background: Cancer cachexia is a catabolic syndrome associated with uncontrolled muscle breakdown. There may be associated fat loss. Occurring in high frequency in advanced cancer, it is an indicator of poor prognosis. Besides weight loss, patients experience a cluster of symptoms including anorexia, early satiety, and weakness. The 3 stages of cachexia include stages of precachexia, cachexia, and refractory cachexia. Refractory cachexia is associated with active catabolism or the presence of factors that make active management of weight loss no longer possible. Patients with refractory cachexia often receive glucocorticoids or megasterol acetate. Glucocorticoid effect is short and responses to megasterol are variable. Anamorelin is a new agent for cancer anorexia-cachexia, with trials completed in advanced lung cancer. Acting as an oral mimetic of ghrelin, it improves appetite and muscle mass. This article reviews the pharmacology, pharmacodynamics, and effect on cancer cachexia. Methods: A PubMed search was done using the Medical Subject Headings term anamorelin. Articles were selected to provide a pharmacologic characterization of anamorelin. Results: Anamorelin increases muscle mass in patients with advanced cancer in 2-phase 3 trials. Conclusions: Anamorelin improves anorexia-cachexia symptoms in patients with advanced non–small-cell lung cancer.
    Keywords Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2017-08-01T00:00:00Z
    Publisher SAGE Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

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  9. Article ; Online: Buprenorphine for cancer pain: is it ready for prime time?

    Prommer, Eric

    The American journal of hospice & palliative care

    2015  Volume 32, Issue 8, Page(s) 881–889

    Abstract: Buprenorphine (BUP) is a semisynthetic derivative of the opium alkaloid thebaine found in the poppy Papaver somniferum. Its chemical structure contains the morphine structure but differs by having a cyclopropylmethyl group. Buprenorphine is a potent µ ... ...

    Abstract Buprenorphine (BUP) is a semisynthetic derivative of the opium alkaloid thebaine found in the poppy Papaver somniferum. Its chemical structure contains the morphine structure but differs by having a cyclopropylmethyl group. Buprenorphine is a potent µ opioid agonist. Buprenorphine undergoes extensive first-pass metabolism in the liver and gut. The development of a transdermal BUP formulation in 2001 led to its evaluation in cancer pain. This article provides the practitioner with an update on the current role of BUP in cancer care. It highlights data suggesting effectiveness in various types of cancer pain. The article reviews pharmacology, routes of administration, adverse effects, drug interactions, and cost considerations.
    MeSH term(s) Analgesics, Opioid/metabolism ; Analgesics, Opioid/pharmacokinetics ; Analgesics, Opioid/pharmacology ; Analgesics, Opioid/therapeutic use ; Buprenorphine/metabolism ; Buprenorphine/pharmacokinetics ; Buprenorphine/pharmacology ; Buprenorphine/therapeutic use ; Cancer Pain/drug therapy ; Humans ; Palliative Care/methods
    Chemical Substances Analgesics, Opioid ; Buprenorphine (40D3SCR4GZ)
    Language English
    Publishing date 2015-12
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1074344-3
    ISSN 1938-2715 ; 1049-9091
    ISSN (online) 1938-2715
    ISSN 1049-9091
    DOI 10.1177/1049909114547227
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Palliative Oncology: Denosumab.

    Prommer, Eric

    The American journal of hospice & palliative care

    2015  Volume 32, Issue 5, Page(s) 568–572

    Abstract: Bone metastases cause devastating clinical complications leading patients to have pain, poor quality of life, loss of mobility, and autonomy. Complications from osseous metastases cause a big economic burden reflected by repeated admissions for ... ...

    Abstract Bone metastases cause devastating clinical complications leading patients to have pain, poor quality of life, loss of mobility, and autonomy. Complications from osseous metastases cause a big economic burden reflected by repeated admissions for uncontrolled symptoms. Management of symptoms associated with bone metastasis includes systemic analgesics, glucocorticoids, radiation (external beam radiation and radiopharmaceuticals), ablative techniques (radiofrequency ablation and cryoablation), chemotherapeutic agents, hormonal therapies, interventional techniques (eg, kyphoplasty), and surgical approaches. Bisphosphonates have become a standard therapy for bony metastasis. They bind to bone eventually inhibiting osteoclast action. Bisphosphonates decrease fractures when given routinely. Adverse effects of bisphosphonates include osteonecrosis of the jaw and renal insufficiency. Late last year, the Food and Drug Administration approved denosumab to prevent skeletal-related events (SREs) associated with metastatic solid tumors. This drug is a monoclonal antibody that inhibits the receptor activator of nuclear factor κB (RANK)-RANK ligand interaction. Clinical trials have shown superiority over bisphosphonates for the prevention of SREs. This article reviews the mechanism of action, pharmacology, adverse effects, and clinical trial evidence for this new drug.
    MeSH term(s) Biomarkers, Tumor ; Bone Neoplasms/drug therapy ; Bone Neoplasms/secondary ; Clinical Trials as Topic ; Denosumab/administration & dosage ; Denosumab/adverse effects ; Denosumab/pharmacology ; Denosumab/therapeutic use ; Diphosphonates/therapeutic use ; Drug Approval ; Humans ; Quality of Life ; RANK Ligand/antagonists & inhibitors ; United States ; United States Food and Drug Administration
    Chemical Substances Biomarkers, Tumor ; Diphosphonates ; RANK Ligand ; TNFSF11 protein, human ; Denosumab (4EQZ6YO2HI)
    Language English
    Publishing date 2015-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1074344-3
    ISSN 1938-2715 ; 1049-9091
    ISSN (online) 1938-2715
    ISSN 1049-9091
    DOI 10.1177/1049909114539035
    Database MEDical Literature Analysis and Retrieval System OnLINE

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