Articles: analgesics.
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Pain is a complex somato psychic experience that requires a multimodality approach to treatment. Pharmacologically, pain in cancer can be divided into opioid non-responsive, opioid partially responsive, opioid responsive (but do not use opioids) and opioid responsive (do use opioids). Three concepts govern the use of analgesics in opioid responsive pains: 'by the mouth', 'by the clock' and 'by the ladder'. ⋯ Useful alternative strong opioids include phenazocine, hydromorphone and buprenorphine. A number of controversial issues are discussed. These include the oral to parenteral potency ratio of morphine; the main site of metabolism of morphine; the relative merits of morphine and diamorphine; the risk of respiratory depression; the development of tolerance; and the risk of addiction.
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Drug Alcohol Depend · Dec 1987
ReviewPharmacological characteristics of agonist-antagonist analgesics.
A brief history and pharmacological characteristics of agonist-antagonist analgesics are presented. The importance of this class of compounds on the development of opioid-receptor concepts is described.
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Administration of opioids by less conventional routes may produce pain relief of more rapid onset, of longer duration, and fewer side effects in comparison with conventional oral or parenteral administration. This review will discuss the indications, efficacy, complications and potential advantages of these novel routes of administration.