Treatise on Oncological Pain Medicine and Palliative Care

Pain Medicine · Clinical Specialties

How it begins

Un tratado clínico exhaustivo sobre el abordaje fisiopatológico del dolor inducido por el cáncer y el manejo avanzado al final de la vida. Desde la inmunobiología del microambiente tumoral y el acoplamiento a receptores opioides con sus correspondientes vías de señalización sesgada, hasta la rotación de metadona guiada por cinética, bloqueos neurolíticos intervencionistas, neuroplasticidad y protocolos de sedación…

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