Morphine and alternative opioids in cancer pain: the EAPC recommendations
Humans; Analgesics; Drug Administration Schedule; Administration; Oral; Palliative Care/standards; Injections; Intravenous; Subcutaneous; Oxycodone/administration & Pain/drug therapy; Opioid/administration & dosage/adverse effects/therapeutic use; Spinal; Chemistry; Fentanyl/administration & dosage/therapeutic use; Hydromorphone/administration & Infusions; Methadone/pharmacokinetics/therapeutic use; Morphine/administration & Neoplasms/drug therapy; Pharmaceutical
An expert working group of the European Association for Palliative Care has revised and updated its guidelines on the use of morphine in the management of cancer pain. The revised recommendations presented here give guidance on the use of morphine and the alternative strong opioid analgesics which have been introduced in many parts of the world in recent years. Practical strategies for dealing with difficult situations are described presenting a consensus view where supporting evidence is lacking. The strength of the evidence on which each recommendation is based is indicated.
2001
Hanks GW; Conno F; Cherny NI; Hanna M; Kalso E; McQuay HJ; Mercadante S; Meynadier J; Poulain P; Ripamonti C; Radbruch L; Casas JR; Sawe J; Twycross RG; Ventafridda V; Expert Working Group of the Research Network of the European Association for Palliative Care
British Journal Of Cancer
2001
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1054/bjoc.2001.1680" target="_blank" rel="noreferrer">10.1054/bjoc.2001.1680</a>
Patient-controlled dose regimen of methadone for chronic cancer pain
Female; Humans; Male; Adult; Aged; Middle Aged; Drug Administration Schedule; Non-U.S. Gov't; Research Support; Chronic disease; Palliative Care/methods; Neoplasms/therapy; Self Administration; Methadone/administration & dosage/blood
Fourteen patients with severe cancer pain participated in a trial of methadone given in a fixed dose (10 mg) but at intervals selected by the patients themselves during the loading phase. The aim was to achieve rapid pain relief while avoiding the risk of toxicity from accumulation of methadone. As expected, the dosage intervals increased gradually over the first few days of treatment, the daily dose decreasing from 30-80 mg on the first day to 10-40 mg at the end of the week. Plasma concentrations of methadone varied sevenfold after four to five days (0.24 to 1.75 mumol/1; 7.4 to 54.2 microgram/100 ml). Eleven patients reported complete or almost complete pain relief and elected to continue with methadone after the study. In no case was treatment withdrawn because of intoxication. From these findings a patient-controlled dosage regimen of oral methadone may be an effective and safe alternative to parenteral narcotic medication, adjusting both for individual variation in pain intensity and for pharmacokinetics.
1981
Sawe J; Hansen J; Ginman C; Hartvig P; Jakobsson PA; Nilsson MI; Rane A; Anggard E
British Medical Journal (clinical Research Ed.)
1981
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1136/bmj.283.6284.138-c" target="_blank" rel="noreferrer">10.1136/bmj.283.6284.138-c</a>