Opioids in Cancer Pain

by ; ;
Format: Hardcover
Pub. Date: 2005-09-01
Publisher(s): Oxford University Press
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Summary

There is a great deal of interest in the effective use of opioids for cancer pain due to concerns from both clinicians and patients about addiction. When used correctly, opioids are capable of relieving pain in more than 90% of cancer patients. In reality, patients world-wide continue toendure pain usually due to irrational fears about using them. Fear of addiction is fed by outdated knowledge about opioids and the unintended effects of the war on drugs. However, new research shows that using opioids appropriately for pain management is effective, safe, and has an extremely lowpotential to produce addiction. This book provides evidence (on which guidelines can be based) from an international group of editors and contributors on opioids in cancer pain management, aimed at palliative care doctors, pharmacists, pain specialists, and oncologists. It includes information on opioid pharmacokinetics as abasis for understanding opioid analgesia, dosing schedule, polymorphisms of analgesic receptors in relationship to tolerance, and intrinsic efficacy. The main body of the book covers individual opioids. Topics within each chapter include structure, pharmacokinetics, pharmacodynamics, routes ofadministration, toxicity, drug interactions and influences of dosing and kinetics related to organ function. A chapter is dedicated to the WHO analgesic guidelines and opioid choices.

Table of Contents

Contributors ix
List of Abbreviations
x
Introduction
1(10)
Mellar P. Davis
Opioid receptors and opioid pharmacodynamics
11(32)
Mellar P. Davis
Gavril W. Pasternak
Opioid pharmacokinetics
43(10)
Kenneth C. Jackson II
Codeine
53(6)
Janet R. Hardy
Hydrocodone
59(10)
Mellar P. Davis
Tramadol
69(14)
Mellar P. Davis
Dextroproxyphene
83(8)
Paul Glare
Morphine
91(30)
Paul Glare
Hydromorphone
121(8)
Paul Glare
Oxycodone
129(26)
Mellar P. Davis
The lipophilic opioids: fentanyl, alfentanil, sufentanil and remifentanil
155(18)
Tony Hall
Janet R. Hardy
Methadone
173(26)
Mellar P. Davis
Levorphanol
199(8)
Mellar P. Davis
Diamorphine
207(8)
Janet Hardy
Oxymorphone
215(6)
Paul Glare
Choice of opioids and WHO ladder
221(14)
Paul Glare
Opioid rotation
235(12)
Janet R. Hardy
Opioids equianalgesia: dynamics and kinetics
247(18)
Mellar P. Davis
Opioid dosing strategies
265(14)
Paul Glare
Mellar P. Davis
Patient controlled analgesia
279(16)
Mellar P. Davis
Spinal opioids in cancer pain
295(12)
Mellar P. Davis
Opioid-resistant pain
307(24)
Mellar P. Davis
Index 331

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