title: Steroids as pain relief adjuvants.
abstract: Mr. C. is a married, 80-year-old man with a straight posture and a sharp wit. Ten years ago he was diagnosed with a pancreatic carcinoid tumour and underwent a Whipple procedure. Since then, his symptoms have been well controlled with intermittent chemotherapy despite his known liver and multiple spinal metastases.One year ago, Mr. C. developed bony pain from his cervical spine disease and was started on hydromorphone. Despite escalating doses, he presents to your office with increasing pain. The pain is moderate in severity and described as aching and constant in his neck, with intermittent, sharp, shooting pain through his left upper back and shoulder. You consider adding a corticosteroid as an adjuvant analgesic to Mr. C.'s hydromorphone regimen.
authors.affiliation: Department of Family Medicine, University of Ottawa, Ontario.
authors.forename: Melissa
authors.initials: M
authors.lastname: Vyvey
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects* / Q000627:therapeutic use*; D000369:Aged, 80 and over; D000700:Analgesics / Q000009:adverse effects* / Q000627:therapeutic use*; D002276:Carcinoid Tumor / Q000188:drug therapy / Q000556:secondary / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D006801:Humans; D008297:Male; D010146:Pain / Q000188:drug therapy*; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000601:surgery; D007319:Sleep Initiation and Maintenance Disorders / Q000139:chemically induced; D013125:Spinal Neoplasms / Q000188:drug therapy / Q000556:secondary; D013375:Substance Withdrawal Syndrome / Q000209:etiology / Q000517:prevention & control
chemical_list: D000305:Adrenal Cortex Hormones; D000700:Analgesics