Provided by the Meniscus Educational Institute  

Highlights No.2

Agenda and Faculty | Intended Audience | Rationale and Purpose | Learning Objectives

Continuing Education | Registration Information | Educational Grant

A Breakfast Symposium to be held at the
33rd Annual Congress of the Oncology Nursing Society

Pennsylvania Convention Center
Grand Ballrooms, Salons A, B, and F
1201 Market Street
Philadelphia, PA 19107
Friday, May 16, 2008
6:00
AM to 8:00AM  

Supported by an educational grant from Wyeth Pharmaceuticals. 


Intended Audience

These activities are intended for practicing oncology, palliative care, hospice, and pain management nurses caring for oncology patients with advanced disease.
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Rationale and Purpose
Cancer-related pain afflicts approximately 9 million people worldwide annually, and 55% to 95% of patients with advanced disease have severe pain. Opioids are the mainstay of treatment for cancer-related pain and provide relief to improve patients’ quality of life, but opioids’ adverse effects have potential limitations and can negatively impact quality of life. Most of the side effects are easily managed with relatively simple remedies, and they improve or resolve shortly after therapy begins.

Unlike adverse effects that improve and often resolve with continued therapy, constipation resolves very slowly, if at all, and can actually worsen as opioid doses increase. Constipation, which affects over 50% of cancer patients admitted to palliative care units, needs to be addressed when opioid therapy is initiated. If constipation is not avoided, further aspects of obstructive bowel disease (OBD) can surface, including lower abdominal discomfort, fecal impaction with overflow diarrhea and incontinence, urinary retention, nausea, vomiting, and inadequate absorption of oral drugs.

Current guidelines and treatment approaches to prevent constipation recommend starting the patient on a prophylactic regimen containing both a laxative and a stool softener, as well as dietary modifications as tolerated. The mechanism of OBD is becoming better understood and appears to be linked to both the central and peripheral effects of opioids. A new class of agents, peripherally acting µ-opioid receptor (PAM-OR) antagonists, are being developed to specifically target µ-opioid receptor–mediated activity in the gastrointestinal (GI) tract. These agents effectively inhibit the adverse side effects of opiates on the GI tract while maintaining the opiates’ beneficial analgesic effects. The inclusion of PAM-OR agents in the management and treatment of patients with OBD may have a significant effect on their quality of life and activities of daily living.

The purpose of this activity is to enhance the quality of care provided by oncology, palliative care, pain management, and hospice nurses by supplying them with information and tools to manage opioid-induced side effects in patients with chronic pain and advanced disease.


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Learning Objectives

After participating in this activity, nurses should be able to
  • Explain the prevalence, etiology, and pathophysiology of select opioid-induced side effects
  • Recognize the clinical presentation of opioid-induced side effects and current strategies to prevent and manage them
  • Incorporate currently available management options into the care of the patient with constipation
  • Assess the impact of constipation on a patient’s quality of life and activities of daily living
  • Explain the role of µ-opioid receptors in pain perception and GI function
  • Describe new therapies that directly target the underlying symptoms of OBD and integrate them into a multimodal therapeutic regimen designed to alleviate symptoms of OBD and, ultimately, to improve patient outcomes with better pain relief management

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Continuing Education

Statement of Credit—Participants who successfully complete this activity (including completion and submission of the evaluation form) will be issued a statement of credit via e-mail or US mail within 4 weeks.


Nurses.
This activity for 1.8 contact hours is provided by the Meniscus Educational Institute.

The Meniscus Educational Institute is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Accreditation refers to recognition of educational activities only and does not imply approval or endorsement by the Meniscus Educational Institute or the American Nurses Credentialing Center’s Commission on Accreditation of any product mentioned.

Provider approved by the California Board of Registered Nursing, Provider No. 13164, for 1.8 contact hours.


Meeting space has been assigned to provide a satellite symposium funded by Wyeth Pharmaceuticals via an educational grant during the Oncology Nursing Society’s (ONS) 33rd Annual Congress, May 15–18, 2008 in Philadelphia, Pennsylvania. The Oncology Nursing Society’s assignment of meeting space does not imply product endorsement nor does the Oncology Nursing Society assume any responsibility for the educational content.

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