Strong opioid analgesics in therapy for chronic pain syndrome. Which drug should be preferred?

2017 ◽  
Vol 6 (6) ◽  
pp. 62 ◽  
Author(s):  
G. R. Abuzarova ◽  
R. R. Sarmanaeva ◽  
S. E. Lapina ◽  
S. V. Kuznetsov
Author(s):  
N. V. Orlova ◽  
◽  
N.V. Abrosimova ◽  
Yu.A. Melnitskaya ◽  
I.V. Kryukova ◽  
...  

A study of the assortment of narcotic drugs for the relief of acute and chronic pain syndrome in cancer patients in the palliative care unit of the Oncological Center was carried out. It has been shown that practically all registered dosage forms of opioid analgesics are used


2019 ◽  
pp. 111-118
Author(s):  
S. I. Zbrozhek ◽  
V. O. Shapovalova ◽  
V. V. Shapovalov (Jr.) ◽  
V. V. Andrieieva ◽  
V. V. Shapovalov

In the world from 10 to 55% people suffer from chronic pain syndrome. Therefore, timely reduction of pain helps to improve the quality of their life in all areas of activity. To improve the organizational and legal procedure for providing patients with drugs as part of palliative care, a control regime for non-steroidal anti-inflammatory drugs, non-narcotic and narcotic (opioid) analgesics and adjuvant (auxiliary) drugs, which prescribed by doctors for chronic pain syndrome was developed. The research materials were the current regulatory, legislative and instructive documents; statistics of the Ministry of Healthcare of Ukraine; instructions for medical use of medicines, websites of the Verkhovna Rada of Ukraine, the Ministry of Healthcare of Ukraine, the State Expert Center of the Ministry of Healthcare of Ukraine and others. We used documentary, comparative, systemic and regulatory methods of analysis. In the article, based on the analysis of the normative base, analyzed the medical and technological documents concerning the pharmacotherapy of chronic pain syndrome, allocated three classes of medicines. Processed the control regime of non-steroidal medicines, non-narcotic analgesics, narcotic (opioid) analgesics and adjuvant (auxiliary) drugs prescribed by doctors for chronic pain syndrome. Analyzed the normative and legal documents on the procedure for the circulation of narcotic, psychotropic and potent medicines in medical and pharmaceutical healthcare institutions in accordance with the licensed conditions for the conduct of economic activity. Established that the circulation of medicines for pharmacotherapy of chronic pain syndrome within palliative care in medical institutions carried out based on a license for medical practice, and in pharmacy institutions – based on a license for wholesale and retail trade of medicines.


2019 ◽  
Vol 98 (1) ◽  
pp. 115-121
Author(s):  
A.V. Pshonkin ◽  
◽  
I.V. Serkova ◽  
N.V. Myakova ◽  
N.N. Kotskaya ◽  
...  

Pain ◽  
1990 ◽  
Vol 41 ◽  
pp. S333 ◽  
Author(s):  
F.R. James ◽  
R.G. Large

Author(s):  
Maksim Vladimirovich Shpagin ◽  
Mikhail Valerievich Kolesnikov ◽  
Olga Yurievna Khutorskaya ◽  
Dmitriy Evgenievich Timoshkin ◽  
Artem Andreevich Belikin ◽  
...  

From the informational and structural point of view, the chronicity of pain is associated with the migration of nociogenic zones. The phenomenon of migration is based on the mechanisms of neuroplasticity, compensatory-restorative processes in the nervous system. On the basis of the phenomenon of migration of the nociogenic zone, a system of regional integrative therapy of chronic pain syndrome has been developed. Recommendations on the advisability of invasive shutdown of the nociogenic zone using invasive pharmacotherapy or surgical denervation have been proposed. In the course of studying the characteristics of chronic pain, depending on the duration of the disease, a direct proportional correlation was revealed between the increase in the components of pain and the duration of the pain syndrome, which can be explained by the increase in the number of nociogenic structures that form the complexity and stability of the pain syndrome. Thus, the necessity of neurodestructive interventions increases for attaining positive results. An important area of therapy is the inclusion of psychotherapy, pharmacotherapy and neuromodulation into the system of regional-integrative influence.


2020 ◽  
Vol 14 (2) ◽  
pp. 72-85
Author(s):  
Arina P. Spasova ◽  
I. V. Kurbatova ◽  
O. Y. Barysheva ◽  
G. P. Tikhova

The goal of the study was to explore the influence of single-nucleotide polymorphisms of the COMT gene on the formation and features of pain syndrome, the level of anxiety, and the need for narcotic analgesics in patients with breast cancer. Materials and methods. The intensity of pain and opioid consumption in the postoperative period were evaluated in 58 patients who met the inclusion criteria of the study and were operated for breast cancer. The frequency of chronic pain syndrome after mastectomy was studied in the same group of patients after a year by using short pain questionnaires, McGill Pain Questionnaire and PainDetect. The anxiety level was assessed by using the HADS questionnaire. Genotyping was performed for single-nucleotide polymorphisms, rs4680, rs740603, rs2097603 = rs2070577, rs4633, of the COMT gene localized in the 22q11.21 region in the studied group of patients. The relationship between the carrier of different genotypes and the intensity of acute and chronic pain, the severity of the pain rating index for sensory and affective characteristics, the presence of a neuropathic component of pain, and the severity of anxiety were studied in the entire sample. The use of narcotic analgesics was evaluated in the postoperative period (IU/day and IU/course) and for the relief of chronic pain. Results. It is shown that the intensity of postoperative pain and the severity of anxiety do not depend on the presence of a mutant allele for the studied polymorphisms of the COMT gene, while the postoperative consumption of opioids in patients with the rs4680 missense mutation in the exon of this gene is significantly less. The dependence of the intensity of chronic pain syndrome and the severity of anxiety on the presence of a mutant allele for the polymorphic locus rs4680 localized in the exon of the COMT gene was established. No significant relationship was observed between the mutant alleles and the use of opioids for chronic pain relief after mastectomy. Conclusion. Genotyping for the COMT gene polymorphisms can be useful for choosing the optimal tactics of pain management in patients with breast cancer.


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