Opioids in Cancer PainMellar P. Davis Opioids have become invaluable in modern medicine but it is essential that they are prescribed with an understanding of the complex pharmacology behind their effectiveness; without this, they will frequently fail to achieve their enormous potential of pain relief, minimal side effects, and improved function. In addition, opioids come with problems, including side effects such as constipation, respiratory depression, and sedation, as well as the potential for substance abuse. Clinicians handling the complex pain problems of cancer patients must incorporate the insight of basic scientists and pharmacologists, and this new edition of this comprehensive text brings together a wealth of experience from those involved in all aspects of opioids, with a view to improving both clinician understanding and patient care. The text includes comprehensive coverage of the principles of opioid pharmacodynamics, pharmacokinetics, and pharmacogenetics. A chapter is dedicated to each of the main opioids, with topics such as structure, routes of administration, toxicity, drug interactions, and effects on organ function included within each one. The book concludes with several chapters dedicated to discussion of the major issues relevant to opioid use, including substance abuse, dosing strategies for acute and chronic pain, patient controlled analgesia, equianalgesia, spinal opioids, pain that doesn't respond to opioids, and the terminal phase. This text is the most complete and extensive work available on the use of opioids for cancer pain, and is an important reference for those clinicians treating individuals with cancer. |
Contents
1 Opioid receptors and opioid pharmacodynamics | 1 |
2 Opioid pharmacokinetics | 29 |
3 Liver disease and exogenous opioid pharmacokinetics | 39 |
4 Opioids in renal failure | 69 |
5 Codeine | 81 |
6 Hydrocodone | 89 |
7 Tramadol | 99 |
8 Dextropropoxyphene | 119 |
17 Oxymorphone | 269 |
18 Choice of opioids and the WHO ladder | 275 |
19 Pharmacogenetics and opioids | 287 |
20 Opioid rotation | 301 |
21 Equianalgesia | 313 |
22 Dosing strategies for acute pain | 329 |
23 Opioid dosing strategies for chronic pain and the management of opioid side effects | 347 |
24 Patientcontrolled analgesia | 367 |
9 Morphine | 127 |
10 Oxycodone | 155 |
fentanyl alfentanil sufentanil and remifentanil | 175 |
12 Buprenorphine | 193 |
13 Methadone | 211 |
14 Hydromorphone | 245 |
15 Levorphanol | 253 |
16 Diamorphine | 263 |
Other editions - View all
Opioids in Cancer Pain Mellar P. Davis,Paul A. Glare,Janet Hardy,Columba Quigley No preview available - 2009 |
Common terms and phrases
abuse acetaminophen activity acute addiction administration agonist alfentanil analgesia analgesic analgesic effect Anesth Analg Anesthesiology antinociceptive binding bioavailability buprenorphine cancer pain cancer patients chronic pain clearance Clin Pharmacol Ther clinical codeine compared constipation cytochrome diamorphine double—blind efficacy epidural equivalent excreted Exp Ther fentanyl G—protein gene glucuronidation half—life hepatic hydrocodone hydromorphone increased individuals influence infusion intrathecal intravenous IPain kappa levels levorphanol liver disease medications metabolism metabolites methadone mg/day morphine morphine dose mu opioid receptor mu—opioid receptor naloxone nausea neuropathic pain Oncol opiate opioid analgesics opioid dose opioid receptor oral morphine oxycodone oxymorphone P—glycoprotein pain control pain management pain relief Pain Symptom Manage palliative palliative care paracetamol parenteral patient—controlled pharmacodynamics pharmacokinetics polymorphisms postoperative pain potent protein ratio reduced remifentanil renal failure reported rescue doses respiratory depression response route side effects spinal subcutaneous sublingual sufentanil therapy titration tolerance toxicity tramadol transdermal fentanyl treatment trial