Opioid switching in cancer pain: From the beginning to nowadays
•Opioid therapy in cancer patients should be highly individualized.•Opioid switching may allow to establish a more advantageous analgesia/toxicity relationship.•Indications for opioid switching require different modalities of intervention.•The knowledge of opioid pharmacology is of paramount importa...
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| Vydáno v: | Critical reviews in oncology/hematology Ročník 99; s. 241 - 248 |
|---|---|
| Hlavní autoři: | , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
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Netherlands
Elsevier Ireland Ltd
01.03.2016
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| Témata: | |
| ISSN: | 1040-8428, 1879-0461, 1879-0461 |
| On-line přístup: | Získat plný text |
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| Abstract | •Opioid therapy in cancer patients should be highly individualized.•Opioid switching may allow to establish a more advantageous analgesia/toxicity relationship.•Indications for opioid switching require different modalities of intervention.•The knowledge of opioid pharmacology is of paramount importance.•Opioid switching requires meticulous monitoring, particularly when using high doses of opioids.
Opioid switching is the process of changing from one opioid to another to obtain a satisfactory clinical balance between analgesia and adverse effects. This pharmacological technique has been introduced about 20 years ago to enhance the opioid response in advanced cancer patients with chronic pain. More information is now available. This review will examine many different aspects of opioid switching, including the history and evolution through the last decades, some clinical aspects based on the most recent experience, controversies on the indications, conversion ratios and modalities of switching in some specific circumstances, and evidence based recommendations. |
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| AbstractList | •Opioid therapy in cancer patients should be highly individualized.•Opioid switching may allow to establish a more advantageous analgesia/toxicity relationship.•Indications for opioid switching require different modalities of intervention.•The knowledge of opioid pharmacology is of paramount importance.•Opioid switching requires meticulous monitoring, particularly when using high doses of opioids.
Opioid switching is the process of changing from one opioid to another to obtain a satisfactory clinical balance between analgesia and adverse effects. This pharmacological technique has been introduced about 20 years ago to enhance the opioid response in advanced cancer patients with chronic pain. More information is now available. This review will examine many different aspects of opioid switching, including the history and evolution through the last decades, some clinical aspects based on the most recent experience, controversies on the indications, conversion ratios and modalities of switching in some specific circumstances, and evidence based recommendations. Opioid switching is the process of changing from one opioid to another to obtain a satisfactory clinical balance between analgesia and adverse effects. This pharmacological technique has been introduced about 20 years ago to enhance the opioid response in advanced cancer patients with chronic pain. More information is now available. This review will examine many different aspects of opioid switching, including the history and evolution through the last decades, some clinical aspects based on the most recent experience, controversies on the indications, conversion ratios and modalities of switching in some specific circumstances, and evidence based recommendations.Opioid switching is the process of changing from one opioid to another to obtain a satisfactory clinical balance between analgesia and adverse effects. This pharmacological technique has been introduced about 20 years ago to enhance the opioid response in advanced cancer patients with chronic pain. More information is now available. This review will examine many different aspects of opioid switching, including the history and evolution through the last decades, some clinical aspects based on the most recent experience, controversies on the indications, conversion ratios and modalities of switching in some specific circumstances, and evidence based recommendations. Opioid switching is the process of changing from one opioid to another to obtain a satisfactory clinical balance between analgesia and adverse effects. This pharmacological technique has been introduced about 20 years ago to enhance the opioid response in advanced cancer patients with chronic pain. More information is now available. This review will examine many different aspects of opioid switching, including the history and evolution through the last decades, some clinical aspects based on the most recent experience, controversies on the indications, conversion ratios and modalities of switching in some specific circumstances, and evidence based recommendations. Highlights • Opioid therapy in cancer patients should be highly individualized. • Opioid switching may allow to establish a more advantageous analgesia/toxicity relationship. • Indications for opioid switching require different modalities of intervention. • The knowledge of opioid pharmacology is of paramount importance. • Opioid switching requires meticulous monitoring, particularly when using high doses of opioids. |
| Author | Mercadante, Sebastiano Bruera, Eduardo |
| Author_xml | – sequence: 1 givenname: Sebastiano orcidid: 0000-0001-9859-6487 surname: Mercadante fullname: Mercadante, Sebastiano email: terapiadeldolore@la-maddalena.it organization: Pain Relief & Palliative Care Unit, La Maddalena Cancer Center, Palermo, Italy – sequence: 2 givenname: Eduardo surname: Bruera fullname: Bruera, Eduardo organization: Department of Palliative Care and Rehabilitation Medicine, UT M. D. Anderson Cancer Center, Houston, TX, USA |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/26806145$$D View this record in MEDLINE/PubMed |
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| Keywords | Opioid switching Cancer pain Opioid rotation |
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| Snippet | •Opioid therapy in cancer patients should be highly individualized.•Opioid switching may allow to establish a more advantageous analgesia/toxicity... Highlights • Opioid therapy in cancer patients should be highly individualized. • Opioid switching may allow to establish a more advantageous... Opioid switching is the process of changing from one opioid to another to obtain a satisfactory clinical balance between analgesia and adverse effects. This... |
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| SubjectTerms | Analgesics, Opioid - therapeutic use Cancer pain Hematology, Oncology and Palliative Medicine Humans Neoplasms - complications Neoplasms - therapy Opioid rotation Opioid switching Pain - drug therapy Pain - etiology Palliative Care |
| Title | Opioid switching in cancer pain: From the beginning to nowadays |
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