The Role of Opioids in Cancer Pain Management

Fukshansky, Mikhail; Are, Madhuri; Burton, Allen W.

doi:10.1111/j.1533-2500.2005.05106.x

Cited by 30 publications

(41 citation statements)

References 39 publications

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“…µ receptor agonist opioids have the same action mechanism; however, they are different in pharmacodynamics and in the affinity for the receptor, which could explain differences in analgesia and side effects 25 . Nevertheless, the regular use of osmotic and stimulating laxatives in adequate doses has improved constipation--related symptoms in 50% of patients, which is in line with the literature 26,27 . In three weeks of follow up it was possible to evaluate the intestinal habit profile of patients under morphine, confirming the high incidence of constipation, its difficult control and the need for an organized multidisciplinary protocol to diagnose, prevent and treat constipation secondary to morphine.…”

Section: Discussionsupporting

confidence: 87%

Avaliação do hábito intestinal em pacientes com câncer que utilizam morfina para o controle da dor

Marmo¹,

Caran²,

Puty³

et al. 2012

Rev. dor

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Section: Discussionsupporting

confidence: 87%

Avaliação do hábito intestinal em pacientes com câncer que utilizam morfina para o controle da dor

Marmo¹,

Caran²,

Puty³

et al. 2012

Rev. dor

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“…The intake of opiates was noted and the data were converted to oral morphine-equivalents (in mg), by multiplication by a factor depending of the drug taken (codeine: 0.15; dextropropoxyphen: 0.17; hydrocodone: 3.3; hydromorphone: 7.5; oxycodone: 2; tramadol: 0.17) (Fukshansky et al, 2005;VIDAL, 2007). If spontaneous pain was reported and if it was located at a relevant site (i.e.…”

Section: Methodsmentioning

confidence: 99%

Perioperative ketamine does not prevent chronic pain after thoracotomy

Dualé

Sibaud

Guastella

et al. 2009

European Journal of Pain

124

100

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Thoracotomy is often responsible for chronic pain, possibly of neuropathic origin. To confirm preclinical studies, the preventive effects of perioperative ketamine were tested in a randomized, double-blind, placebo-controlled clinical trial on persistent neuropathic pain after thoracotomy. Eighty-six patients scheduled for thoracotomy under standardised general anaesthesia were randomised to receive either ketamine (1 mg kg(-1) at the induction, 1 mg kg(-1) h(-1) during surgery, then 1 mg kg(-1) during 24 h; n=42) or normal saline (n=44). Postoperative analgesia included a single dose of intrapleural ropivacaine, intravenous paracetamol and nefopam, and patient-controlled intravenous morphine. Vital parameters and analgesia were recorded during the 48 first postoperative hours. Seventy-three patients were followed up. The patient's chest was examined 1-2 weeks, 6 weeks and 4 months after surgery. At the last two observations, spontaneous pain score over a one-week period (visual analogue scale), neuropathic pain score (NPSI), and intake of analgesics, were assessed. No drug affecting neuropathic pain (except opiates) was given during the follow-up. Two patients in each group were lost to follow-up after the 6 week visit. Ketamine improved immediate postoperative pain, but the groups were similar in terms of neuropathic pain and intake of analgesics, 6 weeks (NPSI score: ketamine: 1.25 [0-4.125]; placebo: 1 [0-4]) and 4 months after surgery. Thus, ketamine given in 24-h infusion failed to prevent chronic neuropathic pain after thoracotomy. Other perioperative preventive long-lasting treatments or techniques could be tested in this context.

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“…The IR phase is achieved by dissolution and diffusion drug from drug-containing particles at the surface of the tablet, while the ER phase arises from the dissolution and diffusion of drug that is entrapped within the matrix. Another benefit of the AcroContin™ system is that the nature of the polymers that make up the hydrophobic matrix allow for pH-independent release and resistance to food effects (Anderson, Fritz, & Muto, 2002;Fukshansky, Are, & Burton, 2005).…”

Section: Oxycodonementioning

confidence: 99%

Advanced Formulation Design: Improving Drug Therapies for the Management of Severe and Chronic Pain

Miller

DiNunzio

Williams

2008

Drug Development and Industrial Pharmacy

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Chronic pain is a condition affecting a vast patient population and resulting in billions of dollars in associated health care costs annually. Sufferers from severe chronic pain often require [correction of requite] twenty-four hour drug treatment through intrusive means and/or repeated oral dosing. Although the oral route of administration is most preferred, conventional immediate release oral dosage forms lead to inconvenient and suboptimal drug therapies for the treatment of chronic pain. Effective drug therapies for the management of chronic pain therefore require advanced formulation design to optimize the delivery of potent analgesic agents. Ideally, these advanced delivery systems provide efficacious pain therapy with minimal side effects via a simple and convenient dosing regime. In this article, currently commercialized and developing drug products for pain management are reviewed with respect to dosage form design as well as clinical efficacy. The drug delivery systems reviewed herein represent advanced formulation designs that are substantially improving analgesic drug therapies.

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The Role of Opioids in Cancer Pain Management

Cited by 30 publications

References 39 publications

Avaliação do hábito intestinal em pacientes com câncer que utilizam morfina para o controle da dor

Avaliação do hábito intestinal em pacientes com câncer que utilizam morfina para o controle da dor

Perioperative ketamine does not prevent chronic pain after thoracotomy

Advanced Formulation Design: Improving Drug Therapies for the Management of Severe and Chronic Pain

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