The Committee of Experts on the Selection and Use of Essential Medicines recommends that all medicines listed in Cancer Pain Relief: with a Guide to Opioid Availability, 2 nd edition. Geneva: WHO 1996 is a key drug. These drugs are listed in the relevant sections of the model list according to their therapeutic use, for example analgesics.
Palliative care includes both relieving pain and relieving the symptoms of cases that include shortness of breath, restlessness, confusion, loss of appetite, constipation, itching, nausea, vomiting, and insomnia. Health authorities should be encouraged to develop their palliative care services.
The pain relief can be achieved with drugs, neurosurgery, psychological and behavioral methods to suit the patient's personal needs. If properly performed, most patients with cancer pain can have an effective discharge. Pain is best treated by combining pharmacological and non-pharmacological measures. Some types of pain respond well to a combination of non-opioid and opioid drugs. In other types of pain, excretion occurs with a combination of corticosteroids and opioids. Neurodegenerative pain shows a weak response to non-opioid and opioid drugs, but can be alleviated with tricyclic antidepressants and anticonvulsants (see below). Cancer patients often suffer from many fears and anxieties and may become depressed. Patients with severe anxiety or deep depression may need psychotropic medication as well as analgesic. If this fact is not taken into account, pain may continue to be resistant to healing.
In most patients, the pain of cancer can be alleviated with analgesics:
- Oral: Oral analgesics should be given whenever possible. Anorexia is useful in patients with dyspepsia, uncontrollable vomiting or obstruction of the gastrointestinal tract. Continuous subcutaneous infusion provides an alternative route.
Analgesics are more effective in preventing pain than in relieving the pain actually occurring. Therefore, doses should be given at specific intervals and calibrated according to the patient's pain. If the pain occurs between the doses, a rescue dose should be given and the following dose is increased.
- Peace: The first step is to give non-opioid analgesics such as acetyl salicylic acid, paracetamol or ibuprofen, with adjuvant if necessary. If this can not relieve the pain, an opioid drug should be added to mild to moderate pain such as Codamine. If this combination fails to relieve pain, it should be replaced with opioid analgesic for moderate to severe pain, such as morphine.
- Per capita: There are no standard doses of opioids. The range of oral morphine doses ranges from 5 mg to more than 100 mg every 4 hours.
Attention to detail: The first and last doses of the day should be linked with the time of waking and sleeping patient. The best way to write a complete medication system is for the patient and his or her family. The patient should be warned of possible adverse effects.
Palliative care includes both relieving pain and relieving the symptoms of cases that include shortness of breath, restlessness, confusion, loss of appetite, constipation, itching, nausea, vomiting, and insomnia. Health authorities should be encouraged to develop their palliative care services.
The pain relief can be achieved with drugs, neurosurgery, psychological and behavioral methods to suit the patient's personal needs. If properly performed, most patients with cancer pain can have an effective discharge. Pain is best treated by combining pharmacological and non-pharmacological measures. Some types of pain respond well to a combination of non-opioid and opioid drugs. In other types of pain, excretion occurs with a combination of corticosteroids and opioids. Neurodegenerative pain shows a weak response to non-opioid and opioid drugs, but can be alleviated with tricyclic antidepressants and anticonvulsants (see below). Cancer patients often suffer from many fears and anxieties and may become depressed. Patients with severe anxiety or deep depression may need psychotropic medication as well as analgesic. If this fact is not taken into account, pain may continue to be resistant to healing.
In most patients, the pain of cancer can be alleviated with analgesics:
- Oral: Oral analgesics should be given whenever possible. Anorexia is useful in patients with dyspepsia, uncontrollable vomiting or obstruction of the gastrointestinal tract. Continuous subcutaneous infusion provides an alternative route.
Analgesics are more effective in preventing pain than in relieving the pain actually occurring. Therefore, doses should be given at specific intervals and calibrated according to the patient's pain. If the pain occurs between the doses, a rescue dose should be given and the following dose is increased.
- Peace: The first step is to give non-opioid analgesics such as acetyl salicylic acid, paracetamol or ibuprofen, with adjuvant if necessary. If this can not relieve the pain, an opioid drug should be added to mild to moderate pain such as Codamine. If this combination fails to relieve pain, it should be replaced with opioid analgesic for moderate to severe pain, such as morphine.
- Per capita: There are no standard doses of opioids. The range of oral morphine doses ranges from 5 mg to more than 100 mg every 4 hours.
Attention to detail: The first and last doses of the day should be linked with the time of waking and sleeping patient. The best way to write a complete medication system is for the patient and his or her family. The patient should be warned of possible adverse effects.
