Transdermal opioids for cancer pain

<p>Abstract</p> <p>Patients with moderate to severe malignancy-related pain frequently require the use of opioid pharmacotherapy. Unfortunately, many cancer patients continue to be prescribed subtherapeutic doses of pain medications resulting in undo suffering and diminished qualit...

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Main Author: Skaer Tracy L
Format: Article
Language:English
Published: BMC 2006-03-01
Series:Health and Quality of Life Outcomes
Online Access:http://www.hqlo.com/content/4/1/24
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author Skaer Tracy L
author_facet Skaer Tracy L
author_sort Skaer Tracy L
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description <p>Abstract</p> <p>Patients with moderate to severe malignancy-related pain frequently require the use of opioid pharmacotherapy. Unfortunately, many cancer patients continue to be prescribed subtherapeutic doses of pain medications resulting in undo suffering and diminished quality of life. The choice of analgesic pharmacotherapy should be individualized and based on the intensity and etiology of pain reported by the patient. Health care providers must be able to readily quantify the relative analgesic potency when converting from one opioid to another or from one route of administration to another. Transdermal fentanyl is effective and well tolerated pharmacotherapy for the cancer pain patients. However, clinicians need to be cognizant that the U.S./U.K. manufacturer's recommendations for equilalagesic dosing of transdermal fentanyl may result in initial doses that produce subtherapeutic levels and unrelieved pain in some patients. A more aggressive dosing algorithm for transdermal fentanyl using a 2:1 (mg/day of oral morphine: mcg/hr of transdermal fentanyl) conversion ratio that considers both a review of the literature and clinical experience should help clinicians individualize cancer pain pharmacotherapy. Transdermal buprenorphine is now being prescribed in Europe and Australia for chronic and cancer pain management. Buprenorphine's mixed agonist/antagonist activity, dosage ceiling, and high affinity to the opiate receptor limits its use to those patients who do not already require large daily doses of opioids. Thus, buprenorphine may not be an appropriate medication for some patients with advanced unremitting cancer pain.</p>
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spelling doaj.art-f1cfbffe404b489b9569861f31b3d5712022-12-21T21:18:28ZengBMCHealth and Quality of Life Outcomes1477-75252006-03-01412410.1186/1477-7525-4-24Transdermal opioids for cancer painSkaer Tracy L<p>Abstract</p> <p>Patients with moderate to severe malignancy-related pain frequently require the use of opioid pharmacotherapy. Unfortunately, many cancer patients continue to be prescribed subtherapeutic doses of pain medications resulting in undo suffering and diminished quality of life. The choice of analgesic pharmacotherapy should be individualized and based on the intensity and etiology of pain reported by the patient. Health care providers must be able to readily quantify the relative analgesic potency when converting from one opioid to another or from one route of administration to another. Transdermal fentanyl is effective and well tolerated pharmacotherapy for the cancer pain patients. However, clinicians need to be cognizant that the U.S./U.K. manufacturer's recommendations for equilalagesic dosing of transdermal fentanyl may result in initial doses that produce subtherapeutic levels and unrelieved pain in some patients. A more aggressive dosing algorithm for transdermal fentanyl using a 2:1 (mg/day of oral morphine: mcg/hr of transdermal fentanyl) conversion ratio that considers both a review of the literature and clinical experience should help clinicians individualize cancer pain pharmacotherapy. Transdermal buprenorphine is now being prescribed in Europe and Australia for chronic and cancer pain management. Buprenorphine's mixed agonist/antagonist activity, dosage ceiling, and high affinity to the opiate receptor limits its use to those patients who do not already require large daily doses of opioids. Thus, buprenorphine may not be an appropriate medication for some patients with advanced unremitting cancer pain.</p>http://www.hqlo.com/content/4/1/24
spellingShingle Skaer Tracy L
Transdermal opioids for cancer pain
Health and Quality of Life Outcomes
title Transdermal opioids for cancer pain
title_full Transdermal opioids for cancer pain
title_fullStr Transdermal opioids for cancer pain
title_full_unstemmed Transdermal opioids for cancer pain
title_short Transdermal opioids for cancer pain
title_sort transdermal opioids for cancer pain
url http://www.hqlo.com/content/4/1/24
work_keys_str_mv AT skaertracyl transdermalopioidsforcancerpain