Search results for "Breakthrough Pain"

Oral trasmucosal fentanyl citrate for breakthrough pain treatment in cancer patients.

2012

Breakthrough cancer pain has been defined as a transitory increase in pain intensity that occurs either spontaneously or in relation to a specific predictable or unpredictable trigger, despite relatively stable and adequately controlled background pain. The availability of supplemental doses of oral opioids, in addition to the continuous analgesic medication, is the main treatment suggested to manage pain flares.Oral transmucosal fentanyl citrate (OTFC) is the first product of a new generation of delivery systems, named rapid-onset opioids (ROOs), characterized by rapidity of effect and the short duration of analgesia. Controlled studies and long-term experience have shown that OTFC is an e…

Patients' Acceptability of Different Fentanyl Products for Breakthrough Cancer Pain

2014

OTFC (6) 1.7 (0.5) 1.5 (0.5) 2.0 (0.6) 1.5 (0.8) 1.5 (0.5) 33.1 (43.5) FBT (19) 2.0 (0.6) 2.0 (0.7) 1.8 (0.7) 1.8 (0.8) 1.9 (0.7) 15.9 (7.3) SLF (37) 2.1 (0.5) 2.2 (0.4) 1.8 (0.4) 2.0 (0.6) 2.1 (0.5) 16.7 (12.5) INFS (7) 2.1 (0.4) 2.1 (0.4) 2.0 (0.6) 2.0 (0.8) 2.0 (0.8) 15.7 (13.7) PFEN (11) 2.4 (0.5) 2.2 (0.4) 1.8 (0.4) 1.9 (0.7) 2.1 (0.5) 15.0 (13.7) P 0.120 0.043* 0.870 0.595 0.178 0.015x *,x Oral transmucosal fentanyl was significantly considered to be more problematic.

Analgesics for breakthrough pain

2012

Rapid onset opioids for breakthrough pain: Titrating or not titrating, this is the question!

2011

Abstract Breakthrough cancer pain (BTcP) has been defined as a transitory increase in pain intensity that occurs either spontaneously, or in relation to a specific predictable or unpredictable trigger, despite relatively stable and adequately controlled background pain. Traditional dosing recommendations for BTcP have suggested that the effective dose of oral opioids should be a percentage of a patient’s total daily opioid dose. In the last years a number of new formulations that deliver fentanyl directly through mucous membranes have been developed in an effort to provide a more rapid onset of effect (rapid onset opioids, ROOs). Recent recommendations suggest that the dose of ROOs for BTcP…

The use of rapid onset opioids for breakthrough cancer pain: the challenge of its dosing.

2011

Breakthrough cancer pain (BTcP) has been defined as a transitory increase in pain intensity on a baseline pain of moderate intensity in patients on analgesic treatment regularly administered. This review provides updated information about the use of opioids for the treatment of BTcP, with special emphasis on the use of new rapid onset opioids (ROOs). Due to its slow onset to effect oral opioids cannot be considered an efficacious treatment for BTcP. Parenteral opioids may provide rapid onset of analgesia, but not always available particularly at home. Different technologies have been developed to provide fast pain relief with potent opioid drugs such fentanyl, delivered by non-invasive rout…

World Health Organization guidelines for cancer pain: a reappraisal

2005

Pain is a prevalent symptom experienced by at least 30% ofpatients undergoing an oncological treatment for metastaticdisease and by more than 70% of advanced cancer patients[1]. In 1986 the World Health Organization [2] published a setof guidelines for cancer pain management based on the three-step analgesic ladder [2]. The main aim of WHO guidelienswas to legitimize the prescribing of strong opioids, arisingfrom evidence of poor management of cancer pain, due toreluctance of health care professionals, institutions, and gov-ernment to use opioids because of fears of addition, toleranceand illegal abuse.Its application is reported to achieve satisfactory pain reliefin up to 90% of patients w…

Treatment strategies for cancer patients with breakthrough pain.

2009

Breakthrough pain (BTP) is a transitory flare of pain superimposed on an otherwise stable pain pattern in patients treated with opioids. It is normally severe in intensity, has a rapid onset, has a variable duration (on average 30 min) and is considered a negative prognostic factor. OBJECTIVE: To verify the data in the literature about therapy strategies for BTP in cancer patients. METHODS: To find clinical trials investigating drug therapy for BTP. CONCLUSION: The treatment of BTP in cancer patients receiving opioids is principally based on the use of opioids, preferentially with a short onset. Fentanyl delivered by recently developed systems seems to be the best option to cover the tempor…

Breakthrough pain in cancer patients

2015

The aim of this article was to examine the definition, the characteristics, and the management of breakthrough cancer pain (BTP) in cancer patients by a critical review of recent literature.BTP should be more correctly defined as an episode of severe intensity in patients receiving an adequate treatment with opioids able to provide at least mild analgesia. BTP is a heterogeneous condition as episodes vary between individuals. BTP can be classified into two big distinct pictures: spontaneous-type and incident-type pain. The principal pharmacological treatment of BTP is represented by the administration of opioids as needed. Recent reviews revealed that transmucosal preparation of fentanyl pr…

Dissatisfaction with post-operative pain management—A prospective analysis of 1071 patients

2005

Summary A total number of 1071 patients was investigated using a modified questionnaire of the American Pain Society to evaluate the pain profile and satisfaction/dissatisfaction on the second post-operative day after different types of surgery (abdominal, traumatic, orthopaedic, urologic, gynaecologic, ENT). Patients were either treated with non-standardized pain management (no measurement of pain intensities, no regular administration of analgesics) (non-APS; n = 575) under responsibility of surgical specialties or with standardized pain management (regular assessment of pain and dose adaptation with i.v. PCA or epidurals) (APS; n = 496) by an anaesthesiology-based acute pain service. Pat…

Breakthrough Cancer Pain: Ten Commandments

2016

The term "breakthrough cancer pain" (BTcP) was introduced about 25 years ago. Peaks of pain intensity reported in patients with cancer had been invariably examined in the past years, providing relevant information for a better knowledge of this phenomenon and its treatment. The aim of this critical review was to provide the golden rules, namely, the 10 commandments, for a correct diagnostic pathway of BTcP and a consequent personalized pharmacological treatment. These are as follows: 1) assessment of background analgesia, 2) drugs used for background analgesia, 3) BTcP is a frequent phenomenon, 4) characteristics of BTcP, 5) diagnosis of BTcP, 6) continuous assessment, 7) tailored pharmacol…