Postgraduate medical journal
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The well established use of oral morphine in the treatment of chronic cancer pain has developed empirically and a knowledge of its pharmacokinetics is not necessary in order to use the drug effectively. However recent information about the pharmacokinetics of morphine may help resolve the controversy about oral to parenteral relative potency ratios, and may also in the future shed some light on the problem of patients whose pain does not respond to morphine.
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Chronic somatic pain patients often present more than one pain location with concomitant different pain complaints (pain qualities) which may need to be treated individually. Major attention should be given to the identification of opioid insensitive neurogenic pain qualities, and to a lesser degree the pain intensity. ⋯ Other special pain qualities should be treated as specifically as possible. With this differentiated pharmacological therapy approximately 70-90% of somatic pain patients can be treated with satisfactory pain relief or freedom from pain, at least at rest.