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Ketorolac vs Morphine for Severe Vaso-Occlusive Crisis in Sickle Cell Disease: An Open-Label Randomized Controlled Trial (KISS Study).
Indian Pediatr
January 2025
Department of Pediatrics, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India. Correspondence to: Dr Anil Kumar Goel, Department of Pediatrics, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.
Objectives: To compare the efficacy and safety of intravenous (IV) ketorolac and IV morphine in the management of severe vaso-occlusive crisis (VOC) in children with sickle cell disease (SCD).
Method: An open-label, randomized controlled trial was conducted from January 2021 to July 2022 wherein children with SCD aged 3 to 15 years, presenting with severe VOC (score > 6 on the Wong-Baker Faces Pain scale) were included. Block randomization with minimization was done and participants received either IV ketorolac (intervention) or IV morphine infusion (standard).
Background: Bone marrow transplant (BMT) offers potential cure for cancer and a spectrum of otherwise incur- able diseases. The BMT process can cause multi-systemic pain in patients with sickle cell disease (SCD) refractory to high-dose opioid analgesics during BMT because of their pre-existing opioid-tolerance. Because of frequent pain resulting in hyperalgesia and chronic opioid use, SCD patients undergoing BMT often experience excruciating pain uncontrolled by exceedingly high-dose opioids with severe and intolerable adverse effects.
View Article and Find Full Text PDFReal-world implementation of the David-Carroll buprenorphine protocol for pain management in sickle cell disease.
Am J Hematol
September 2024
Heersink School of Medicine, Department of Medicine, Division of Hematology and Oncology, The University of Alabama at Birmingham, Birmingham, Alabama, USA.
Increasing Naloxone Access and Prescribing for Patients on High-Dose Opioids From a Managed Care Pharmacy Health Plan Perspective.
J Pharm Pract
December 2024
Pharmacy Services, Baylor Scott & White Health Plan, Temple, TX, USA.
Opioid overdoses decrease when communities have access to naloxone. Clinicians play a key role in offering naloxone to high-risk chronic opioid patients. Managed care pharmacists within our health plan noted disproportionate processing for claims of opioid utilizers compared to claims of naloxone prescriptions.
View Article and Find Full Text PDFLong-Term Opiate Therapy-Induced Secondary Adrenal Insufficiency: A Distinct Differential Diagnosis That Should Be Considered.
Cureus
December 2023
Internal Medicine, Jazan University, Jazan, SAU.
Pain management with opioid medication is associated with several side effects. Opioid-induced adrenal insufficiency by suppression of the hypothalamic-pituitary-adrenal (HPA) axis is one of them that needs to be considered. The possible effects of opioid use on adrenal function are addressed in this case report.
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