Thursday, October 13, 2005
September's J of Pain & Symptom Management has a couple of letters I wanted to highlight. The edition as a whole has, as usual, a bunch of interesting articles (including one examining a switch from reservoir to matrix fentanyl patches) but 2 letters struck me. One is about nicotine withdrawal in the palliative care setting. It introduced to me the small body of literature about nicotine withdrawal & delirium. As a relucatant ex-smoker I was somewhat disappointed in reading this letter & the problems patients have smoking due to physical disability or facility restrictions--I had always planned on lighting up again the moment I checked myself into the hospice but it looks like this may not happen. The other letter is a case report on a young woman with cancer who ended up on 10 lidocaine patches at a time for 24hrs a day for many months & had no problems with this & still had systemic lidocaine levels that were far from cardiotoxic.