Effective treatment can greatly improve the patient's quality of life and should be tailored for each patient, taking into consideration the cause and type of the BTP episodes. Short-acting opioid analgesics are the primary treatment.
The absorption characteristics, onset of action, and duration of effect vary among the available opioid compounds based on their lipophilicity. This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.
Contact afpserv aafp. Want to use this article elsewhere? Get Permissions. Read the Issue. Sign Up Now. Next: Patching for Corneal Abrasions? Dec 1, Issue. Clinical Scenario A year-old man uses long-acting opioids for chest wall pain associated with lung cancer. Clinical Question What evidence is there for the use of rapid-acting opioids in the management of breakthrough cancer pain? Evidence-Based Answer Oral transmucosal fentanyl citrate OTFC [Actiq] , a rapid-acting opioid, has been shown to be an effective treatment for breakthrough cancer pain.
Practice Pointers Cancer pain comes in many forms and often is undertreated. Cochrane Abstract Background: Breakthrough pain is a transient increase in pain intensity over background pain. Read the full article. Get immediate access, anytime, anywhere.
Choose a single article, issue, or full-access subscription. Earn up to 6 CME credits per issue. Purchase Access: See My Options close. Best Value! To see the full article, log in or purchase access. More in Pubmed Citation Related Articles. Doctors and cancer care teams may prescribe opioids for patients having increasing or severe pain from their cancer or their treatment.
Opioids should be prescribed and used with great care for several reasons:. Your cancer care team will understand any safety concerns you or your loved ones may have about opioids. They also know it's their responsibility to treat your cancer-related pain in the most effective way. Sometimes opioids are needed as part of a pain relief plan.
Because of safety concerns, you will always need a signed, written prescription not faxed, emailed, or called in for opioid pain medicines. If you have 2 or more doctors, be sure that one does not prescribe opioids for you without talking to the others about it. Your doctor may ask you and your loved ones questions before prescribing opioids to be sure they will not be used in wrong or unsafe ways.
They may ask you who you live with, if children are in the home, how your medications are stored, and other questions. While taking opioids, you may need to have regular urine or blood tests to check drug levels.
If you drink alcohol or take tranquilizers, sleeping pills, antidepressants, antihistamines, or any other medicines that make you sleepy, your doctor will need to know how much and how often you do this. Taking opioids even small doses while drinking alcohol or taking tranquilizers may cause problems and can lead to overdoses and symptoms like weakness, trouble breathing, confusion, anxiety, or more severe drowsiness or dizziness. Here are some of the opioids used in cancer care.
Methods: In 66 patients consecutive patients admitted to a pain relief and palliative care unit, the efficacy and safety of different opioids used in doses proportional to the basal opioid regimen for the management of breakthrough pain BP were assessed.
The choice of the opioid to be administered as rescue medication was based on the characteristics of patients, clinical stability, compliance, preference, and so on.
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