Terminal illness, pain management

Silverman HD, Croker NA. Pain management in terminally ill patients how the primary care physician can help. Postgrad Med 1988 83 181-188. 

The attractions of enabling patients to manage their own analgesics rather than be dependent on others are obvious. In mild and moderate pain it is easy to provide tablets for this purpose, but in severe chronic and acute recurrent pain, e.g. terminal illness, postsurgical, obstetric, other routes are needed to provide speedy relief just when it is needed. Drug delivery S5rstems range from inhalation devices... 

Most pharmacists possess many of the skills needed to provide pharmaceutical care to terminally ill patients. In the last few years, pharmacy curricula have placed increased emphasis on pain management and symptom control. 

As an analgesic agent, hydrocodone bitartrate is used for the symptomatic relief of temporary pain that is moderate to moderately severe, such as acute postoperative pain. It may also be appropriate for the symptomatic treatment of pain associated with acute medical disorders, particularly in the treatment of migraine headaches. For the treatment of chronic non-malignant pain, hydrocodone bitartrate preparations should only be used when non-opioid pharmacological and non-pharmacological modalities have been exhausted and fail to provide measurable symptomatic relief. In the management of severe chronic pain associated with cancer or other terminal illness, hydrocodone... 

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