Terapéutica en Atención Primaria. Uso de los opioides en pacientes con dolor oncológico
Therapy in Primary Health Care. Use of opioids in cancer patients with pain
Opioids are the best therapeutic armamentarium for the control of pain in the oncology patient. More than half of the cancer patients with pain will need treatment with opioid treatment (WHO step 3) during their follow-up to be controlled. The type of interaction with the opioid receptors determines the different drug actions and their adverse effects. However, opioid substances can also interact on other neurotransmitter systems and other receptors. Codeine and tramadol make up the second level on the WHO scale, and are effective in moderate pain. They are characterized by having an analgesic ceiling effect. Buprenorphine are included within this group. Morphine, oxycodone, phentanyl and methadone are as effective to control pain. Choosing one or the other depends on the administration route, drug cost, side effects. Morphine is the opioid of choice, although there are no conclusive studies. Treatment of cancer pain should always include rescue opioid dose to control irruptive pain. We should always keep the side effects of opioids in mind and prevent them. Rotation or change of opiates is a therapeutic alternative to improve the relationship between analgesic efficacy and appearance of side effects of opiate treatment.
opioides, dolor, cáncer
opioids, pain, cancer