A new approach to the administration of opiates: TTS (fentanyl) in the management of pain in patients with cancer

Simmonds, Mary A.; Blain, C.; Richenbacher, J.; Southam, Mary; Hershey, Milton S.

doi:10.1016/0885-3924(88)90083-8

Cited by 16 publications

(5 citation statements)

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“…In patients treated with TF or parenteral morphine, the equivalent daily dose of oral morphine (ddom) was calculated first according to Simmonds et al [40] for TF and 1:3 ratio for parenteral to oral morphine, respectively. Then, starting daily dose of oral methadone (ddomet) was counted.…”

Section: Methodsmentioning

confidence: 99%

The role of methadone in opioid rotation—a Polish experience

Leppert

2008

Support Care Cancer

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Section: Methodsmentioning

confidence: 99%

The role of methadone in opioid rotation—a Polish experience

Leppert

2008

Support Care Cancer

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“…The transdermal route for the administration of fentanyl is an exciting possibility (Simmonds et al, 1988). However, because of the extremely long half-life of the drug, "rescue" doses of shortacting narcotics will be necessary at the beginning of treatment.…”

Section: Other Routes Of Administrationmentioning

confidence: 99%

Symptom Control in Patients with Cancer

Bruera¹

1990

Journal of Psychosocial Oncology

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This article reviews what is known about the etiology, assessment, and management of several symptoms chat are commonly associated with advanced cancer: pain, anorexia, nausea, and asthenia. A better awareness of cancer pain has resulted in major advances in the ability to manage the problem. The author points out that high-quality research is needed on the natural history and management of other symptoms associated with advanced cancer, some of which can be even more distressing and more difficult to manage than pain.

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“…Once applied, fentanyl is absorbed into the tissues, forming a local depot which releases the drug into the circulation by capillaries (Hill 1990). The bioavailability of fentanyl approximates a steady-state infusion similar to that delivered by continuous intravenous administration in man, once the equilibration period of 6-12h has passed (Simmonds et al 1988). In humans effectively treated with TTS fentanyl, serum concentrations are in the range of 0.5-2.0 ng/ml and can be sustained for up to 48 h after the application of a single patch (Calis et al 1992).…”

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confidence: 99%

Transdermal fentanyl compared with parenteral buprenorphine in post-surgical pain in swine: a case study

2000

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SummaryThe use of pigs as research animals in survival surgery has increased greatly in the last 15 years. Personnel conducting pig research have been hampered by a lack of proven longacting analgesics for treatment of surgical pain of longer duration, and bya lack of reliable non-subjective parameters for the assessment of pain relief. The efficacy of the mixed opioid agonist-antagonist buprenorphine hydrochloride 0.10 mg/kg pm (n = 2) in the treatment of post-thoracotomy pain was compared with that of a trans dermal therapeutic system (TTSI delivering 25 {tg/h (n = 3) or SOflg/h (n = 2) of the mu opioid agonist fentanyl hydrochloride.Food consumption, pain score, activity level and rate of movement were assessed under four conditions: normal pre-operative control (24 h), pre-operative with analgesic alone 124 hI and post-operative days I, 2, 3 (72 h). Serum concentration-time curves for fentanyl in clinical cases revealed that female Yorkshire cross pigs weighing 26.2±2.1 kg achieved serum values in the recognized human therapeutic range when treated with TTS fentanyl at SOflg/h and experienced adequate pain control. Pigs treated with 25 flg/h TTS fentanyl had serum levels below the human analgesic range, experienced less adequate analgesia, and required supplemental analgesia in some cases. Based on existing pharmacokinetic data for fentanyl in pigs, the rate of uptake of TIS fentanyl when attached on inter-scapular skin was lower than predicted. Clinical pain scores and time intervals between each major postural change were not affected by analgesics in the absence of pain, but increased in all groups after surgery regardless of treatment. Food consumption was unaffected by analgesic treatment alone but decreased in all groups after surgery regardless of treatment. Analgesic effects on postoperative activity level were variable. TTS fentanyl at appropriate doses is a cost effective means of delivering basal analgesia following major surgery in pigs.

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A new approach to the administration of opiates: TTS (fentanyl) in the management of pain in patients with cancer

Cited by 16 publications

References 0 publications

The role of methadone in opioid rotation—a Polish experience

The role of methadone in opioid rotation—a Polish experience

Symptom Control in Patients with Cancer

Transdermal fentanyl compared with parenteral buprenorphine in post-surgical pain in swine: a case study

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