Treatise on Oncological Pain Medicine and Palliative Care

Pain Medicine · Clinical Specialties

How it begins

A comprehensive clinical treatise on the pathophysiological approach to cancer-induced pain and advanced management at the end of life. From the immunobiology of the tumor microenvironment and the coupling to opioid receptors with their corresponding biased signaling pathways, to kinetic-guided methadone rotation, interventional neurolytic blocks, neuroplasticity and sedation protocols...

What it covers

1. Oncological Pain Palliative Care
2. Pathophysiology of Oncological Pain: Routes of Transmission and Tumor Immunobiology
3. · 1.1 · The Chemical Flavor of the Tumor: The Tumor "Inflammatory Soup"
4. · 1.2 · Glial Activation and Spinal Neuroinflammation
5. Multidimensional Evaluation of Oncological Pain and Genetic Profiles
6. · 2.1 · Pathophysiological Classification of Breakthrough Pain
7. · 2.2 · Multidimensional Scales and Questionnaires
8. · 2.3 · Pharmacogenomics of Nociception and Response to Opioids
9. Pharmacology of Major Opioids: Morphine, Fentanyl, Oxycodone and Hydromorphone
10. · 3.1 · Biased Signaling Dynamics
11. · 3.2 · Pharmacokinetic Profile and Comparative Metabolism
12. · 3.3 · WHO Analgesic Ladder vs. The Analgesic Elevator
13. Methadone: Unique Pharmacology, Opioid Rotation and QTc Monitoring
14. · 4.1 · Exceptional Pharmacokinetics and the Half-Life Paradox
15. · 4.2 · Methadone Rotation Protocol: The Nonlinear Algorithm
16. Tolerance, Dependence and Opioid-Induced Hyperalgesia (OIH)
17. · 5.1 · Molecular Mechanisms of Analgesic Tolerance
18. · 5.2 · Opioid-Induced Hyperalgesia (OIH): The Pain Paradox
19. · 5.3 · Differential Diagnosis and Approach to OIH
20. Analgesic Adjuvants: Gabapentinoids, Antidepressants and Corticosteroids
21. · 6.1 · Gabapentinoids: Calcium Channel Modulators
22. · 6.2 · Antidepressants in Cancer Pain: Reinforcement of Descending Inhibition
23. · 6.3 · Corticosteroids: Control of the Membrane and Edema
24. Interventional Techniques: Celiac, Hypogastric and Odd Neurolytic Blocks
25. · 7.1 · Neurolytic Celiac Plexus Blockade (CPB)
26. · 7.2 · Neurolysis of the Superior Hypogastric Plexus and Impar Ganglion
27. Spinal Analgesic Infusion Systems: Intrathecal Continuous Infusion Devices
28. · 8.1 · Relative Analgesic Potency by Route of Administration
29. · 8.2 · Structural Components of Programmable Pumps
30. · 8.3 · Authorized Drugs and Clinical Combinations
31. Pain from Bone Metastasis: Immunobiology of Destruction and Targeted Therapy
32. · 9.1 · The Vicious Circle of Metastatic Bone Destruction
33. · 9.2 · Activation of Nociceptors by Bone Acidosis
34. · 9.3 · Therapeutics Targeted at the Bone Microenvironment
35. Neuropathic Pain Induced by Chemotherapy and Radiotherapy
36. · 10.1 · Pathophysiology of Neurotoxicity due to Chemotherapeutic Drugs
37. · 10.2 · Actinic Plexopathy: Pain from Radiotherapy
38. Advanced Palliative Care: Multidimensional Approach and Advance Planning
39. · 11.1 · Early Integration vs. Traditional Transition Model
40. · 11.2 · Advance Care Decision Planning (PADA)
41. Management of Non-Painful Refractory Symptoms in Advanced Disease
42. · 12.1 · Refractory Dyspnea: Pathophysiology and Therapeutics
43. · 12.2 · Malignant Intestinal Obstruction (MIO)
44. · 12.3 · Delirium at the End of Life: Agitation and Confusion Syndrome
45. Oncological Cachexia-Anorexia and Artificial Nutrition Support
46. · 13.1 · Pathophysiology of Oncological Cachexia: The Cytokine Storm
47. · 13.2 · Ethical Dilemmas of Artificial Nutrition and Hydration at the End of Life
48. Palliative Sedation: Pharmacology of Midazolam and Levomepromazine
49. · 14.1 · Essential Clinical Criteria for Sedation
50. · 14.2 · Pharmacology of Palliative Sedation
51. · 14.3 · Objective Monitoring using the RASS-PAL Scale
52. Ethical and Legal Aspects at the End of Life
53. · 15.1 · The Ethical Principle of Double Effect
54. · 15.2 · Clinical Differentiation and Ethics of Medical Decisions
55. Total Pain, Grief and Humanization of Palliative Medicine
56. · 16.1 · Interconnected Dimensions of Total Pain
57. · 16.2 · Physiology of Grief: From Adaptation to Pathology
58. · 16.3 · Key Principles of Palliative Medicine