PURPOSE: The use, safety, and efficacy of intrathecal medication administration with implantable pumps for @entity5 and @entity1118 management are reviewed. SUMMARY: Implanted intrathecal drug-delivery systems (IDDSs) are used for long-term management of persistent, severe @entity158 despite a multimodal approach with conventional @entity158 treatment options. Currently, consensus papers published in the literature are used as guidelines for determining @entity1 selection and medication administration, because there is a lack of supporting evidence from randomized, controlled, clinical trials. Pharmacists have a critical role in the safe use of intrathecal medication. Most of the medication concentrations and combinations administered through IDDSs are not commercially available and therefore must be compounded in a pharmacy. Medications commonly administered through IDDSs include opioids, local anesthetics, @entity1338 , @entity1772 , and ziconotide. It is important for pharmacists who prepare products for IDDSs to understand the pharmacology, adverse effects, and concentration limitations of each medication in order to prevent adverse events related to postoperative @entity510 , @entity281 , catheter-tip inflammatory masses, withdrawal, and @entity1445 . Pharmacists play an important role in maintaining quality assurance of intrathecal drug use, including the use of standard procedures for ordering and compounding medications, documentation of @entity1 education, and monitoring of @entity1 outcomes. CONCLUSION: The use of long-term intrathecal drug delivery for the treatment of intractable @entity158 or intolerable medication adverse effects has expanded to include the treatment of @entity1 with chronic or @entity5 -related @entity158 . Important considerations for the use of intrathecal drug therapy include the appropriate selection of @entity1 , delivery systems, and medications, as well as potential complications of therapy and quality-assurance measures necessary to ensure @entity1 safety.

Intrathecal drug therapy for long-term XXXX management.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity510 :: ('MESH:D013345', 'Disease') :: ['subarachnoid hemorrhage'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer'] @entity1445 :: ('MESH:D062787', 'Disease') :: ['overdose'] @entity281 :: ('MESH:D007239', 'Disease') :: ['infection'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain'] @entity1338 :: ('MESH:D003000', 'Chemical') :: ['clonidine'] @entity1772 :: ('MESH:D001418', 'Chemical') :: ['baclofen'] @entity1118 :: ('MESH:D059350', 'Disease') :: ['chronic pain']
@entity158 :: (MESH:D010146,Disease) :: ['pain']
