Palliative Care: Comprehensive Assessment and Control of Pain — Treatise on Palliative Medicine and Oncological Support

Palliative Care · Clinical Specialties

How it begins

Un compendio exhaustivo y de nivel de maestría clínica sobre los fundamentos moleculares del dolor, las estrategias de rotación de opioides de alta complejidad, la neurobiología de la sensibilización central y las directrices ético-farmacológicas en el paciente al final de la vida.

What it covers

1. Comprehensive Assessment and Pain Control
2. Care Models and Transition Criteria
3. · Early Integration Models vs. Terminality
4. · Objective Clinical Prognostic Tools
5. Multidimensional and Comprehensive Assessment of the Patient
6. · The Construct of "Total Pain" by Cicely Saunders
7. · Systematization of Multidimensional Evaluation
8. Neurobiological Pathophysiology of Pain
9. · Inflammatory Soup and Transduction Receptors
10. · Central Sensitization and "Wind-up" Phenomenon
11. · Glial and Immunological Activation in the Dorsal Horn
12. · Singular Pathophysiology of Bone Oncological Pain
13. Clinical Assessment and Pain Measurement Scales
14. · Semiological Taxonomy of Palliative Pain
15. · Breakthrough Oncological Pain
16. · Evaluation in Patients with Cognitive Impairment or Non-Communicative
17. Pain Pharmacotherapy — Non-Opioid Analgesics
18. · Paracetamol (Acetaminophen): Central Mechanism and Limits in Cachexia
19. · Non-Steroidal Anti-Inflammatories (NSAIDs): Selectivity and Systemic Risk
20. · Metamizole (Dipyrone): Safety Profile and Agranulocytosis
21. Pain Pharmacotherapy — Weak Opioids
22. · Tramadol: A Dual Action Drug
23. · The Critical Impact of CYP2D6 Polymorphisms
24. · Codeine: Metabolization Limits and Ceiling Effect
25. Pain Pharmacotherapy — Classic Potent Opioids
26. · Morphine: The Reference Standard and its Active Metabolites
27. · Fentanyl: Extreme Lipophilicity and Transdermal Kinetics
28. · Oxycodone: Balanced Semisynthetic Profile
29. · Hydromorphone: Alternative in Extreme Frailty
30. · Buprenorphine: Partial Agonist Dynamics
31. Methadone — Advanced Pharmacology and Rotation
32. · Polymodal Subreceptor Mechanism of Methadone
33. · Metabolism and Elimination Variability
34. · Cardiotoxicity: QTc Interval Prolongation
35. · Rotation Strategies from Opioids to Methadone
36. Opioid Rotation and Equianalgesia Calculation
37. · Equianalgesia Calculation Algorithm Step by Step
38. · Practical Cases of Opioid Interconversion
39. Analgesic Adjuvants and Supportive Drugs
40. · Gabapentinoids: Blockade of the Alpha-2-Delta Subunit ($\alpha_2\delta$)
41. · Tricyclic Antidepressants (TCA) and Dual Inhibitors (SNRI)
42. · Systemic Corticosteroids in Palliative Support
43. · Ketamine: The NMDA Antagonist in Refractory Pain
44. Breakthrough Oncological Pain (IOP) and its Management
45. · Limitations of Oral Opioids in DIO
46. · Transmucosal Fentanyl: Immediate Absorption
47. · The Golden Rule of Rapid Fentanyl Titration
48. Management of Adverse Effects of Opioids
49. · Constipation Induced by Opioids (EIO) and Peripherally Acting Antagonists
50. · Nausea and Vomiting due to Opioids: Induction Routes
51. · Opioid-Induced Neurotoxicity Syndrome (OIN)
52. · Reversal of Respiratory Depression through Microdosed Naloxone
53. Interventional Techniques in Refractory Pain
54. · Celiac Plexus Neurolysis in Pancreatic Cancer
55. · Superior Hypogastric Plexus Block in Pelvic Pain
56. · Continuous Intrathecal Drug Infusion Systems
57. Palliative Sedation and Ethical Implications
58. · The Clinical Concept of Refractory Symptoms
59. · Pharmacological Palliative Sedation Protocol
60. · Ethical Justification: The Principle of Double Effect