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Continuing Education Information

Physicians' Education Resource is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Physicians' Education Resource designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

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It is the policy of Physicians’ Education Resource to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. As an organization accredited by the Accreditation Council for Continuing Medical Education (ACCME), Physicians’ Education Resource requires everyone who is in a position to control the content of an educational activity, including spouses/partners, to disclose all relevant financial relationships with any commercial interest. The ACCME defines “relevant financial relationships” as financial relationships in any amount occurring within the past 12 months that create a conflict of interest. Physicians’ Education Resource has implemented a mechanism to identify and resolve all conflicts of interest prior to the activity.

Russell K. Portenoy, MD
Research Funding – Alpharma, Inc.; Archimedes Pharma Limited; BioDelivery Sciences International, Inc.; Cephalon, Inc.; CIMA Labs, Inc.; Endo Pharmaceuticals; GlaxoSmithKline; GW Pharmaceuticals; Ligand Pharmaceuticals, Inc.; Organon USA; Pfizer Inc.; Progenics Pharmaceuticals, Inc.; ZARS Pharma, Inc.
Paid Consultant – Alpharma Inc.; Fralex Therapeutics Inc.; Insys Therapeutics, Inc.; King Pharmaceuticals, Inc.; Nektar; Neuromed Pharmaceuticals Ltd.; Shire; Transcept Pharmaceuticals, Inc.; WEX Pharmaceuticals Inc.; Wyeth Pharmaceuticals

PER Editorial Staff
No relevant relationships to disclose

This CME activity might include discussion of investigational and/or unlabeled uses of drugs. If the activity includes discussion of investigational and/or unlabeled uses of a drug, specific information is located on the title page. Please refer to the full prescribing information for each drug discussed in this newsletter for FDA-approved dosing, indications, and warnings.

Commercial Support
An educational grant for this activity was provided by Elan Pharmaceuticals, Inc.

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Illustration

Neuropathic pain results from damage to or inflammation of the nervous system; in patients with cancer, peripheral neuropathic pain can be caused by direct or indirect mechanisms, including malignant infiltration, compression of the nerve, and radiation therapy or chemotherapy. Peripheral nerve injury might reduce inhibitory control over dorsal horn neurons, resulting in the spontaneous firing of those neurons or an exaggerated response to stimuli. Peripheral nerve injury can also induce sympathetic sprouting whereby nerve fibers grow into regions that normally receive only nociceptive information. As a result, sensations that are normally perceived as touch might be misinterpreted by the nervous system as pain. Chemical mediators that are usually involved in nociceptive pain transmission, such as substance P, can also be released in response to peripheral nerve injury, which generates a state of hyperexcitability in the dorsal horn, a phenomenon normally produced only by nociceptive input. Neuropathic information, like nociceptive information, is transmitted from the dorsal root ganglion to higher centers in the brain by the spinothalamic tract.

Disclaimer

The views and opinions expressed in this activity are those of the authors and do not necessarily reflect the views of the sponsor, supporter, or publisher. Although great care has been taken in compiling and checking the information given in this activity to ensure accuracy, the authors, and Physicians’ Education Resource and its servants or agents shall not be responsible or in any way liable for the continued currency of the information or for any errors, omissions, or inaccuracies in this activity, whether arising from negligence or otherwise howsoever or for any consequences arising therefrom.

Please consult full prescribing information for any drugs or procedures discussed within.

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©Copyright 2008 by Physicians’ Education Resource. No material may be reproduced in whole or in part, in any form, without written permission from the publisher.

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Editor, Case Studies in Pain Management
Physicians’ Education Resource
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About the Illustration About the Illustration:

Neuropathic pain results from damage to or inflammation of the nervous system; in patients with cancer, peripheral neuropathic pain can be caused by direct or indirect mechanisms, including malignant infiltration, compression of the nerve, and radiation therapy or chemotherapy. Peripheral nerve injury might reduce inhibitory control over dorsal horn neurons, resulting in the spontaneous firing of those neurons or an exaggerated response to stimuli. Peripheral nerve injury can also induce sympathetic sprouting whereby nerve fibers grow into regions that normally receive only nociceptive information. As a result, sensations that are normally perceived as touch might be misinterpreted by the nervous system as pain. Chemical mediators that are usually involved in nociceptive pain transmission, such as substance P, can also be released in response to peripheral nerve injury, which generates a state of hyperexcitability in the dorsal horn, a phenomenon normally produced only by nociceptive input. Neuropathic information, like nociceptive information, is transmitted from the dorsal root ganglion to higher centers in the brain by the spinothalamic tract.

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Educational Grants

An educational grant for this activity was provided by:

1. Elan Pharmaceuticals, Inc.