Considerations in selecting rapid-onset opioids for the management of breakthrough pain
Howard S SmithDepartments of Anesthesiology, Medicine, and Physical Medicine and Rehabilitation Albany Medical College, Albany, NY, USAAbstract: Breakthrough pain (BTP) is a transitory pain that occurs despite the use of long-term, around-the-clock analgesia. It is highly prevalent in certain popula...
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doaj-60852a0b14014a2e96e6dc5206ca61f82020-11-24T21:12:47ZengDove Medical PressJournal of Pain Research1178-70902013-03-012013default189200Considerations in selecting rapid-onset opioids for the management of breakthrough painSmith HSHoward S SmithDepartments of Anesthesiology, Medicine, and Physical Medicine and Rehabilitation Albany Medical College, Albany, NY, USAAbstract: Breakthrough pain (BTP) is a transitory pain that occurs despite the use of long-term, around-the-clock analgesia. It is highly prevalent in certain populations and places a significant burden on patients, their families, caregivers, and health-care systems. Despite its prevalence and impact, BTP is sometimes unrecognized and often undertreated. Various formulations of fentanyl – a rapid-onset opioid with short duration of action – are available for the management of BTP. The efficacy of formulations using transmucosal, transbuccal, sublingual, and intranasal administration routes has been demonstrated for BTP treatment in clinical trials. However, a lack of head-to-head trials evaluating their relative efficacy makes it challenging for physicians to reach informed decisions on the most efficacious intervention for individual patients. In the absence of clear data on the relative efficacy of fentanyl formulations, prescribing decisions need to be based on physician understanding and experience and product cost and availability, taking into account the individual patient's needs, the ability of the patient or caregivers to administer medication, and the patient's wishes. This review evaluates current pharmacologic methods of alleviating BTP and discusses factors that should be considered when selecting the most appropriate formulation for individual patients. With the range of fentanyl formulations available, it is now possible to successfully address BTP in the majority of patients.Keywords: rapid-onset opioid, breakthrough pain, pain, fentanylhttp://www.dovepress.com/considerations-in-selecting-rapid-onset-opioids-for-the-management-of--a12380 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Smith HS |
spellingShingle |
Smith HS Considerations in selecting rapid-onset opioids for the management of breakthrough pain Journal of Pain Research |
author_facet |
Smith HS |
author_sort |
Smith HS |
title |
Considerations in selecting rapid-onset opioids for the management of breakthrough pain |
title_short |
Considerations in selecting rapid-onset opioids for the management of breakthrough pain |
title_full |
Considerations in selecting rapid-onset opioids for the management of breakthrough pain |
title_fullStr |
Considerations in selecting rapid-onset opioids for the management of breakthrough pain |
title_full_unstemmed |
Considerations in selecting rapid-onset opioids for the management of breakthrough pain |
title_sort |
considerations in selecting rapid-onset opioids for the management of breakthrough pain |
publisher |
Dove Medical Press |
series |
Journal of Pain Research |
issn |
1178-7090 |
publishDate |
2013-03-01 |
description |
Howard S SmithDepartments of Anesthesiology, Medicine, and Physical Medicine and Rehabilitation Albany Medical College, Albany, NY, USAAbstract: Breakthrough pain (BTP) is a transitory pain that occurs despite the use of long-term, around-the-clock analgesia. It is highly prevalent in certain populations and places a significant burden on patients, their families, caregivers, and health-care systems. Despite its prevalence and impact, BTP is sometimes unrecognized and often undertreated. Various formulations of fentanyl – a rapid-onset opioid with short duration of action – are available for the management of BTP. The efficacy of formulations using transmucosal, transbuccal, sublingual, and intranasal administration routes has been demonstrated for BTP treatment in clinical trials. However, a lack of head-to-head trials evaluating their relative efficacy makes it challenging for physicians to reach informed decisions on the most efficacious intervention for individual patients. In the absence of clear data on the relative efficacy of fentanyl formulations, prescribing decisions need to be based on physician understanding and experience and product cost and availability, taking into account the individual patient's needs, the ability of the patient or caregivers to administer medication, and the patient's wishes. This review evaluates current pharmacologic methods of alleviating BTP and discusses factors that should be considered when selecting the most appropriate formulation for individual patients. With the range of fentanyl formulations available, it is now possible to successfully address BTP in the majority of patients.Keywords: rapid-onset opioid, breakthrough pain, pain, fentanyl |
url |
http://www.dovepress.com/considerations-in-selecting-rapid-onset-opioids-for-the-management-of--a12380 |
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