| Conversión de dosis en la rotación de opioides desde infusiones intravenosas contínuas de morfina a parches de fentanil en el manejo del dolor por cáncer |
Dose conversion in opioid rotation from continuous intravenous infusion of morphine hydrochloride injection to fentanyl patch in the management of cancer pain. Kawano C, Hirayama T, Kuroyama M. Pharmacy Practice and Science II (Kitasato University East Hospital), School of Pharmacy, Kitasato University. c-kawano@kitasato-u.ac.jpYakugaku Zasshi. 2011 Mar;131(3):463-7.Abstract Opioid rotation has been proposed for management of cancer pain. No studies directly investigating dose equivalence between morphine injection (continuous IV administration) and the transdermal fentanyl patch have been reported. Therefore, we examined dose conversion ratios in patients undergoing opioid rotation from morphine injection to fentanyl patches. The subjects consisted of 45 patients admitted to Kitasato University East Hospital. Medical records were consulted to determine the "basic dose of morphine injection immediately prior to rotation" and the "basic dose of fentanyl patch after rotation". Equivalent doses and conversion ratios obtained with the expression of (daily dose of morphine injection (mg)/daily delivered dose of fentanyl patch (mg)) were determined from the relationship between the data by regression analysis. The regression equation obtained was Y=50.882X-13.96, r²=0.8922, where X and Y are daily doses of morphine injection and fentanyl patch, respectively. Equivalent doses and conversion ratios for daily dose of morphine injection (mg): daily delivered dose of fentanyl patch (mg) (patch dose mg/3 days) were 16.6 mg: 0.6 mg (2.5 mg)=28:1, 47.1 mg: 1.2 mg (5 mg) = 39:1 and 169.2 mg: 3.6 mg (15 mg)=47:1. In other reports, the ratio of morphine vs. fentanyl at 50:1 had no relation to the dose. While the present study suggested that in opioid rotation from low dose, 50:1 is not enough for the fentanyl patch. The dose conversion ratio of morphine injection to fentanyl patch was different at the low doses and high doses of morphine. http://www.jstage.jst.go.jp/article/yakushi/131/3/463/_pdf |
| Efecto de parches de fentanil transdérmico sobre la motilidad del esfínter de Oddi |
Effect of transdermal fentanyl patches on the motility of the sphincter of oddi.
Koo HC, Moon JH, Choi HJ, Hwang KH, Maeng HJ, Kim HK, Park JK, Hong SJ, Cheon YK, Cho YD, Lee JS, Lee MS.
Digestive Disease Center, Department of Internal Medicine, Soon Chun Hyang University School of Medicine, Bucheon and Seoul, Korea.
Gut Liver. 2010 Sep;4(3):368-72. Epub 2010 Sep 24.
Abstract
BACKGROUND/AIMS: Pain is one of the most troublesome symptoms of pancreatitis. Transdermal fentanyl patches (TFPs) are long-acting analgesics with a reduced risk of dependency. This prospective study evaluated the effect of TFPs on sphincter of Oddi (SO) motility for the management of pain in pancreatitis. METHODS: SO manometry (SOM) was performed using triple-lumen catheters anterogradely inserted through the percutaneous transhepatic route during cholangioscopy in 16 patients. The basal pressure, amplitude, and frequency of the SO were assessed before and after applying a TFP at 24 hour at doses of 25 and 12.5µg/hr, respectively. RESULTS: Two of 16 patients receiving a 25µg/hr. TFP were excluded because of adverse side effects (headache and/or nausea). The mean basal pressure, amplitude, and frequency of SOM did not change significantly in the 25µg/hr TFP group (n=4 patients). Parameters of SO function also did not significantly change in the 12.5µg/hr TFP group (n=11 patients). CONCLUSIONS: TFPs below a dose of 25µg/hr may not affect the motility of the SO. Administration of TFPs at lower dosages seems to be a safe analgesic treatment for the pain control of patients with pancreatitis without affecting the function of the SO.
http://pdf.medrang.co.kr/ekjg/ekjg004-03-11.pdf
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| Efecto del tratamiento con parches de fentanilo sobre el alivio y mejoramiento del funcionamiento diario en pacientes con neuralgia postherpética |
The effect of treatment with fentanyl patches on pain relief and improvement in overall daily functioning in patients with postherpetic neuralgia. Mordarski S, Lysenko L, Gerber H, Zietek M, Gredes T, Dominiak M. Department of Anesthesiology and Intensive Care, Pain Clinic, University of Medicine, Wroclaw, Poland. J Physiol Pharmacol. 2009 Dec;60 Suppl 8:31-5.Abstract Postherpetic neuralgia often causes persistent pain, which can compromise patients' quality of life. The aim of the study was to examine the effect of pain reduction after the application of transdermal fentanyl on the quality of life of patients with postherpetic neuralgia. The study lasted 12 weeks. The study population included adult patients experiencing spontaneous pain, expressed by 4 points on the pain numeric rating scale (NRS). To assess quality of life questionnaire SF-36, the Zung depression scale and NRS were used. Pharmacotherapy included amitryptyline (Amitriptylinum VP) 10 mg orally once daily, gabapentine (Gabapentin TEVA 100 mg) 200-900 mg/24 hour orally twice daily and fentanyl skin patches (Durogesic) 12.5-100 microg/hour. Thirty four patients were qualified for the study. Comparison of pain intensity before the treatment and after 12 weeks showed that all the patients experienced relief. The treatment evidently reduced limitations in the physical and social domains. There was little improvement in the general physical capacity and mental condition. Analysis of correlation between changes in quality of life in the emotional, physical and social domains revealed that they were strongly interlinked. Increase in physical activity was accompanied by positive changes in the mental condition, better general wellbeing was correlated with increased social activity, and increased social activity was accompanied by improved physical condition. The more effective the treatment was, the more evident was improvement in the patients' quality of life in the physical, social and mental domains. http://www.jpp.krakow.pl/journal/archive/12_09_s8/pdf/31_12_09_s8_article.pdf |
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