Quality of life and cancer pain: satisfaction and side effects with transdermal fentanyl versus oral morphine.

“…Four controlled studies, however, found that transdermal fentanyl was associated with less frequent laxative use compared with morphine [19][20][21][22]. Tapentadol is a novel μ-opioid agonist that also inhibits norepinephrine, which is believed to augment its analgesic activity [23].…”

Section: Novel Opioids With Less Constipationmentioning

confidence: 99%

Opioid-induced bowel dysfunction

Chang¹,

Lembo

2008

Curr Treat Options Gastro

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Opioid-induced bowel dysfunction (OIBD) is a potentially debilitating side effect of chronic opioid use. It refers to a collection of primarily gastrointestinal motility disorders induced by opioids, of which opioid-induced constipation (OIC) is the most common. Management of OIBD is difficult, and affected patients will often limit their opioid intake at the expense of experiencing more pain, to reduce the negative impact of OIBD on their quality of life. Effective pharmacologic therapy for OIC is considered an unmet need and several agents have recently been given priority review and approval for OIC. Furthermore, multiple agents currently in development show promise in treating OIC without significant impact on analgesia or precipitation of withdrawal symptoms. The approval and availability of such medications would represent a significant improvement in the management of OIC and OIBD in patients with chronic pain.

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“…Large, randomized, controlled trials have not been done to directly compare opioids, and smaller individual trials are underpowered to demonstrate superiority of one opioid over another [14][15][16][17][18][19]. In addition, studies involving more recently available opioids have been undertaken in mainly noncancer populations.…”

Section: Evidence-based Rationale For Switching: Clinical Trialsmentioning

confidence: 99%

“…Drug company trials have focused on acute and/or nonmalignant pain [12,13], such as chronic back pain, and care should be taken when extrapolating data from those trials to support use in patients with cancer who, by nature, are less well and often taking multiple concomitant medications. To date, large RCTs have not been undertaken to directly compare opioids for cancer-related pain, and smaller individual trials are underpowered to demonstrate superiority of one opioid over another [14][15][16][17][18][19]. Therefore, www.TheOncologist.com the decision by both the WHO and the European Association for Palliative Care (EAPC) to recommend morphine as the opioid of choice is based largely on clinical expertise and pragmatic reasons, such as the general availability of morphine sulphate worldwide and the considerable clinical experience in using this drug.…”

Section: Evidence-based Rationale For Switching: Clinical Trialsmentioning

confidence: 99%

Clinical Pharmacology and Pharmacotherapy of Opioid Switching in Cancer Patients

Ross¹,

Riley²,

Quigley³

et al. 2006

The Oncologist

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Pain is one of the most common and often most feared symptoms in patients with cancer. Ongoing or progressive pain is physically debilitating and has a marked impact on quality of life. Since a third of the population will die from cancer, and of these, 80% will experience severe pain in their final year of life, effective treatment of cancer-related pain remains both a high priority and an ongoing challenge in clinical practice. Individuals with moderate to severe cancer-related pain require treatment with strong analgesics, namely opioids.There is evidence to support the therapeutic maneuver of opioid switching in clinical practice, but further evidence is needed to elucidate the underlying mechanisms for interindividual differences in response to different opioids. Large, robust clinical trials will be needed if clinical differences among side-effect profiles of different opioids are to be clearly demonstrated. This review discusses candidate genes, which contribute to opioid response; many other genes have also been implicated in "pain" from animal or human studies. In order to continue to evaluate the genetic contributions to both pain susceptibility and analgesic response, further candidate genes need to be considered. Good pain control remains a high priority for clinicians and patients, and there is much work to be done to further individualize analgesic therapy for patients with cancer.

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Quality of life and cancer pain: satisfaction and side effects with transdermal fentanyl versus oral morphine.

Cited by 206 publications

References 9 publications

Dermal and Transdermal Drug Delivery Systems: Current and Future Prospects

Dermal and Transdermal Drug Delivery Systems: Current and Future Prospects

Opioid-induced bowel dysfunction

Clinical Pharmacology and Pharmacotherapy of Opioid Switching in Cancer Patients

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