Opioids in Cancer Pain

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Mellar P. Davis, Paul A. Glare, Janet Hardy, Columba Quigley
OUP Oxford, 28.05.2009 - 487 Seiten
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.
 

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Inhalt

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
25 Spinal opioids in cancer pain
385
26 Opioid poorly responsive pain physical dependence tolerance and opioidinduced hyperalgesia
403
developing countries
419
paediatric population
431
29 Opioids in the terminal phase
455
30 Cancer pain and substance abuse
461
Index
479
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Über den Autor (2009)


Mel Davis is Director of Research at the Harry R. Horvitz Center of Palliative Medicine, Taussig Cancer Center, Division of Solid Tumor, Cleveland Clinic, USA. He also holds the positions of Editor-in-Chief of Progress in Palliative Care, and Chairman of the Palliative Section, Multinational Association of Supportive Care in Cancer. His research interests are in pain management, cancer pain, palliative medicine, symptom control and supportive cancer care.
Paul Glare is a Senior Staff Specialist Physician at Royal Prince Alfred Hospital (RPAH) in Sydney, Australia. He is Head of the Dept of Palliative Care at RPAH, and Head of Palliative Care Services for Sydney Cancer Centre and the eastern zone of Sydney South West Area Health Service (population 500,000). He is also Clinical Associate Professor of Medicine (Central Clincial School) at the University of Sydney.
Janet Hardy is the Director of Palliative Medicine for the Mater Health Services and is the Clinical Research Programme Leader for the Centre for Palliative Care Research and Education in Brisbane. She holds a chair in Palliative Medicine from the University of Queensland School of Medicine.
Columba Quigley previously held the post of Deputy Coordinating Editor of the Cochrane Collaboration Pain Palliative and Supportive Care Group. She has lectured and published in a range of areas, including opioid switching, alternative opioids, inter-individual variability in opioid responsiveness and the genetics of opioid response.

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