Analgesics for Cancer Pain by Frank Porreca download in iPad, ePub, pdf
It is usually desirable to establish pain control with immediate release morphine and then switch to the transdermal system for convenience. If surgical decompression is not feasible, the need to control pain and other obstructive symptoms, including distension, nausea, and vomiting, becomes paramount. Regular or immediate-release morphine should always be ordered concomitantly on a p. Nonetheless, a trial of clonazepam can still be justified in refractory neuropathic pain on the basis of anecdotal experience, especially in the case of the common coexistence of pain and anxiety. In the setting of advanced disease, a corticosteroid also is commonly added.
Because of its long plasma half life, adequate pain relief may be difficult to achieve initially with methadone alone and rapid dose adjustments are more difficult. Hydromorphone hydrochloride Dilaudid Hydrochloride - a strong, short-acting hours opioid agonist.
The efficacy of so-called muscle relaxants and other drugs commonly used for the treatment of musculoskeletal pain has not been evaluated in cancer patients. These formulations have established effectiveness for musculoskeletal pains. For patients with moderate-to-severe pain, strong opioids are recommended as initial therapy rather than beginning treatment with weak opioids. This can be used in conjunction with the Duragesic system. Doses are increased gradually until efficacy is established.
Because of these characteristics, mixed opioid agonist-antagonists are not recommended for treatment of chronic pain. Like mixed opioid agonist-antagonist, there is a propensity to develop psychomimetic effects with prolonged or high dose therapy. Currently available data are, however, too meager to support recommending its use. An understanding of the types of drug interactions can help a clinician anticipate and minimize risk. Anticholinergic Drugs Anticholinergic drugs could theoretically relieve the symptoms of bowel obstruction by reducing propulsive and nonpropulsive gut motility and decreasing intraluminal secretions.
This formulation is approved in the U. Radiation therapy is usually considered when bone pain is focal and poorly controlled with an opioid, or is associated with a lesion that appears prone to fracture on radiographic examination. It is marketed under the trade name of Duraclon.
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