Analysis of the assortment of narcotic drugs used for the treatment of pain in cancer patients in the palliative care unit

2021 ◽  
Vol 2 (88) ◽  
pp. 93-96
Author(s):  
N. V. Orlova ◽  
◽  
N.V. Abrosimova ◽  
Yu.A. Melnitskaya ◽  
I.V. Kryukova ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Palliative Care ◽  
Cancer Patients ◽  
Pain Syndrome ◽  
Opioid Analgesics ◽  
Dosage Forms ◽  
Palliative Care Unit ◽  
Chronic Pain Syndrome ◽  
Oncological Center ◽  
Narcotic Drugs

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

scholarly journals PROCESSING OF THE CONTROL REGIME OF MEDICINES FOR PHARMACOTHERAPY OF CHRONIC PAIN SYNDROME IN THE FIELD OF PALLIATIVE AID

2019 ◽  
pp. 111-118
Author(s):  
S. I. Zbrozhek ◽  
V. O. Shapovalova ◽  
V. V. Shapovalov (Jr.) ◽  
V. V. Andrieieva ◽  
V. V. Shapovalov
Keyword(s):  
Chronic Pain ◽  
Palliative Care ◽  
Pain Syndrome ◽  
Opioid Analgesics ◽  
Retail Trade ◽  
Chronic Pain Syndrome ◽  
Narcotic Analgesics ◽  
Medical Institutions ◽  
Reduction Of Pain ◽  
Control Regime

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.

scholarly journals Electronic educational course for medical specialists training in diagnostics of chronic pain syndrome in adult patients requiring palliative care

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Nevzorova Diana ◽  
Prirodova Olga Fedorovna ◽  
Sidorov Alexander ◽  
Guzel Rafailovna Abuzarova ◽  
Oksana Yurievna Kudrina ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Palliative Care ◽  
Pain Syndrome ◽  
Adult Patients ◽  
Chronic Pain Syndrome ◽  
Medical Specialists ◽  
Educational Course

scholarly journals Indicators of the psychoemotional state of palliative polymorbid cancer patients

2021 ◽  
Vol 20 (2) ◽  
pp. 69-74
Author(s):  
U. V. Kharlamova ◽  
О. V. Kurchenkova ◽  
A. О. Abdalov ◽  
К. A. Shubina ◽  
S. I. Samodurov
Keyword(s):  
Chronic Pain ◽  
Cancer Patients ◽  
Pain Syndrome ◽  
Chronic Pain Syndrome ◽  
Psychoemotional State ◽  
Personal Anxiety ◽  
Comorbidity Index ◽  
High Level ◽  
The Impact ◽  
Palliative Patients

Introduction. Palliative care is aimed at maintaining and improving the quality of life of the patient. Without taking into account the psychosocial aspects, psychological rehabilitation is impossible in the conditions of a psychotraumatic situation of the disease.The aim of the study was to assess the psychoemotional state of polymorbid palliative cancer patients.Materials and methods. An observational, analytical, single-stage (cross-sectional) study was conducted, which included 74 cancer patients of a palliative profile. The patients underwent laboratory and instrumental examination. The following tests were evaluated: resilience (S. Maddy's method, D. A. Leontiev's adaptation), life-sense orientations, the level of subjective control, C. D. Spielberger, the severity of chronic pain syndrome; the value of the Charlson comorbidity index, the Karnovsky index (ECOG) was calculated.Results. The level of the comorbidity index was 3 [2; 5] points, the intensity of chronic pain syndrome-2 [2; 3] points, ECOG-2 [2; 3] points. In polymorbid cancer palliative patients, the presence of a belief in the impact of the struggle on the outcome of what is happening was revealed, however, patients are not always ready to act in a difficult situation. In the examined group, signs of dissatisfaction with their life in the present prevailed, the lack of sufficient freedom of choice, the existence of hope for recovery as a result of the actions of others, primarily doctors. The average (and in some cases high) level of situational and personal anxiety was noted. The association of the comorbidity index and the indicators of the life-meaning orientations test; the indicator of the general internality scale and the ECOG value; the glomerular filtration rate and the indicator of resilience, risk acceptance was revealed. A number of correlations between the indicators of the psychoemotional state and laboratory parameters (the level of hemoglobin, albumin, iron, C-reactive protein) were noted.Conclusion. In cancer patients with a palliative profile, signs of mental maladaptation were revealed. The average (and in some cases high) level of situational and personal anxiety was noted. The revealed number of correlations focuses on the role of chronic non-communicable diseases in aggravating the psychoemotional status of chronic polymorbid cancer palliative patients.

scholarly journals EFFICACY AND SAFETY OF MORPHINE HYDROCHLORIDE IN CANCER PATIENTS WITH CHRONIC PAIN

2019 ◽  
Vol 18 (4) ◽  
pp. 27-33
Author(s):  
R. A. Zukov ◽  
O. P. Bobrova ◽  
G. N. Gildeeva ◽  
D. V. Butuzova ◽  
E. A. Ershova
Keyword(s):  
Chronic Pain ◽  
Adverse Effects ◽  
Cancer Patients ◽  
Pain Syndrome ◽  
Chronic Pain Syndrome ◽  
Efficacy And Safety ◽  
Strong Intensity ◽  
Group I ◽  
Significant Difference ◽  
Morphine Hydrochloride

Purpose of the study: to assess the efficacy and safety of morphine hydrochloride in the form of 10 mg filmcoated tablets and 1 % solution for injection in cancer patients with chronic pain syndrome of strong intensity.Material and Methods. The study included 110 cancer patients with chronic pain syndrome of strong intensity. The study was conducted in compliance with the principles of the Helsinki Declaration, ICH GCP, GOST R 52379-2005, as well as other Russian laws regulating the conduct of clinical trials and work with opioid analgesics. Patients were randomized at a 1:1 ratio. Group I received 10 mg film-coated morphine tablets, 1 tablet orally every 4 hours for 7 days. Group II received 1 % morphine solution for injection, intramuscularly, 4 mg every 4 hours for 7 days. A Numeric Rating Scale for Pain (NRS, 0–100 mm) was used to assess the level of pain. The safety assessment was based on the collection of data on the registration of adverse events, including opioid-associated adverse effects.Results. Enteral and parenteral morphine administration for 7 days demonstrated a statistically significant decrease in the intensity of pain syndrome in cancer patients. The use of morphine hydrochloride in tablets reduced the number of additional analgesics prescribed for cancer patients. Regarding opioid-associated adverse effects, a statistically significant difference in the incidence of constipation between two groups was observed.Conclusion. The study showed that tablets and injectable dosage forms of morphine hydrochloride were comparable in efficacy and safety profile, thus predetermining the widespread clinical use of drugs produced by the domestic manufacturer in accordance with the “pain relief ladder”, proposed by WHO. 

scholarly journals The Study of Pharmacokinetics Parameters of Morphine Hydrochloride, Long-acting Tablets in Cancer Patients with Severe Chronic Pain Syndrome

2020 ◽  
Vol 9 (2) ◽  
pp. 119-123
Author(s):  
E. A. Ezhova ◽  
I. G. Kotelnikova ◽  
A. V. Teteneva ◽  
D. V. Butuzova ◽  
K. F. Tetenev
Keyword(s):  
Chronic Pain ◽  
Cancer Patients ◽  
Maximum Concentration ◽  
Study Drug ◽  
Pain Syndrome ◽  
Pharmacokinetic Parameters ◽  
Chronic Pain Syndrome ◽  
Coated Tablet ◽  
Long Acting ◽  
Morphine Hydrochloride

Introduction. Effective drug therapy for cancer patients with chronic pain syndrome (CPS) of high intensity is one of the priorities of modern healthcare. Currently, non-narcotic and narcotic analgesics are used for pain relief according to a three-steps scheme. In the absence of contraindications, it is preferable to prescribe medications per os and prolonged forms, which will allow the patient to maintain selfcare and comfort.Aim. To study the pharmacokinetic properties of a drug with a prolonged mechanism of action «Morphine hydrochloride», in a film-coated tablet formof a dosage 30 mg, in cancer patients with severe CPS.Materials and methods. For the analysis of the pharmacokinetics of the studied drug after single and multiple doses of 20 patients who received 10- day analgesic therapy with the studied drug «Morphine hydrochloride», long-acting film-coated 30 mgtablets. manufacturer FSUE Moscow Endocrine Plant, Russia. Route of administration: per os. The study duration was 17 days: screening duration up to 7 days; duration of therapy up to 10 days.Results and discussion. The concentration of morphine in plasma was determined by HPLC-tandem mass spectrometry, within 12 hours after taking the study drug (1 of long-acting, film-coated tablet 30 mg). The following pharmacokinetic parameters were obtained on Day 5: T1/2 – 6.08 ± 4.37 hours and 14.46 ± 30.86 hours, Tmax – 2.5 ± 1.86 hours, Cmax – 43.91 ± 27.24 ng/ml. Values of pharmacokinetic parameters averaged over all days are presented. It was found that T1/2 for the studied drug T1/2 is 9.21 ± 14.94 hours, Tmax 2.87 ± 2.36 hours. The average maximum concentration (Cmax) on the day of the study drug was 36.52 ng/ml.Conclusion. As a result of the study of pharmacokinetics, it was found that the drug «Morphine hydrochloride», long-acting tablets film-coated with a of 30 mg was found in serum after oral administration after 15 minutes and reaches a maximum concentration in the blood in 3 hours, the half-life is on average 9 hours, the maximum concentration is 36.52 ng/ml.

scholarly journals Genetic Polymorphism of Cytokines as a Predictor of Phenotypic Development of Chronic Pain Syndrome in Cancer Patients

2017 ◽  
Vol 7 (4) ◽  
pp. 277-281
Author(s):  
Olga Bobrova ◽  
◽  
Natalia Shnayder ◽  
Marina Petrova ◽  
Oksana Gavrilyuk ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Genetic Polymorphism ◽  
Cancer Patients ◽  
Pain Syndrome ◽  
Chronic Pain Syndrome ◽  
Phenotypic Development

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
Keyword(s):  
Chronic Pain ◽  
Pain Syndrome ◽  
Opioid Analgesics ◽  
Chronic Pain Syndrome ◽  
Strong Opioid

Automation of the regional register of persons needing palliative medical care in Krasnodar region

2020 ◽  
pp. 6-14
Author(s):  
N. V. Kardashova ◽  
◽  
M. A. Korogod ◽  
A. A. Koshkarov ◽  
R. A. Murashko ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Palliative Care ◽  
Medical Care ◽  
Pain Syndrome ◽  
Orphan Diseases ◽  
Chronic Pain Syndrome ◽  
Health Authorities ◽  
Public Health Authorities ◽  
Krasnodar Region ◽  
Palliative Medical Care

The relevance of improving the management of the palliative care system in the Krasnodar region, the direct provision of medical care and the interaction of public health authorities is due to the processing of large amounts of data on the need for pain relief and equipment. In each municipality of the Territory, registers of patients suffering from chronic pain syndrome are maintained. The purpose of the article is to develop a methodology for integration municipal registers into a single register of people needed palliative care, and automation of management at the regional level. The paper discusses approaches to create a unified database (registers) of patients suffering from chronic pain syndrome receiving palliative care in order to assess the compliance of medical care with modern clinical guidelines. The possibilities of a unified information system for extracting and dispensing preferential recipes for the implementation of the technology for automated management of the regional registry along with the registers of federal and regional beneficiaries, orphan diseases are shown.

scholarly journals ENSURING ACCESS TO PAIN RELIEF AS HUMAN RIGHTS

2018 ◽  
Vol 5 (1) ◽  
pp. 10-18
Author(s):  
K. Shapoval-Deinega K. ◽  
A. Rokhanskiy ◽  
O. Riga ◽  
A. Penkov
Keyword(s):  
Chronic Pain ◽  
Palliative Care ◽  
Human Rights ◽  
Pain Relief ◽  
Professional Training ◽  
Pain Syndrome ◽  
Chronic Pain Management ◽  
Chronic Pain Syndrome ◽  
Long Time

ENSURING ACCESS TO PAIN RELIEF AS HUMAN RIGHTSK. Shapoval-Deinega, A. Rokhanskiy, O. Riga, A. PenkovThe article presents the results of a selective study on the access to anesthesia. It has been determined that in most cases the goal of chronic pain management has not been achieved for a long time, the expected level of successful anesthesia has not been achieved in 80-90% of those in need, anesthesia is prescribed formally (“any prescription is a good prescription”), without taking into account clinical recommendations and clinical guidelines, that is doctors do not adhere to the principles of the WHO regarding the prescription of analgesics, approved by the Order of the Ministry of Health No. 311 as of 15 April 2012 “On the approval and implementation of medical and technological documents for standardization of palliative care in chronic pain syndrome”. The authors believe that professional training of doctors requires changes regarding the quality of palliative care in accordance with WHO standards, wide implementation of modern scientific concepts of anesthesia in all areas of medical staff training.Key words: palliative care, anesthesia, human rights. ЗАБЕЗПЕЧЕННЯ ДОСТУПУ ДО ЗНЕБОЛЕННЯ ЯК ПРАВА ЛЮДИНИК. Шаповал-Дейнега, А. Роханський, О. Ріга, А. Пеньков У статті наведено результати вибіркового дослідження щодо забезпечення людини до знеболення. Визначено, що у більшості випадків не досягнута мета лікування хронічного больового синдрому протягом тривалого часу, не досягнуто очікуваного рівня успішного знеболення у 80–90 % осіб, що цього потребують, знеболення призначається формально («щось призначили – і гаразд»), без урахування клінічних рекомендацій та клінічних настанов, тобто лікарі не дотримуються принципів ВООЗ щодо призначення знеболюючих засобів, які містяться у наказі МОЗ № 311від 25.04.2012 "Про затвердження та впровадження медико-технологічних документів зі стандартизації паліативної медичної допомоги при хронічному больовому синдромі". Автори вважають, що ротребує змін фахова підготовка лікарів щодо якості надання паліативної допомоги відповідно до стандартів ВООЗ, широкої імплементації сучасних наукових уявлень про знеболення в усі ланки підготовки медичних працівників.Ключові слова: паліативна допомога, знеболення, права людини. ОБЕСПЕЧЕНИЕ ДОСТУПА К ОБЕЗБОЛИВАНИЮ КАК ПРАВО ЧЕЛОВЕКАК. Шаповал-Дейнега, А. Роханский, О. Рига, А. ПеньковВ статье приведены результаты выборочного исследования по обеспечению человека к обезболиванию. Определено, что в большинстве случаев не достигнута цель лечения хронического болевого синдрома в течение длительного времени, не достигнуто ожидаемого уровня успешного обезболивания в 80-90% лиц, нуждающихся, обезболивания назначается формально ( «что-то назначили - и ладно»), без учета клинических рекомендаций и клинических руководств, то есть врачи не соблюдают принципы ВОЗ по назначению обезболивающих средств, которые содержатся в приказе Минздрава № 311вид 25.04.2012 "Об утверждении и внедрении медико-технологических документов по стандартизации паллиативной медицинской помощи при хроническом болевом синдроме ". Авторы считают, что ротребуе изменений профессиональная подготовка врачей по качеству оказания паллиативной помощи в соответствии со стандартами ВОЗ, широкой имплементации современных научных представлений о обезболивания во все звенья подготовки медицинских работников.Ключевые слова: паллиативная помощь, обезболивание, права человека.

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