 |  | 

ABSTRACT: Strategies to Manage the Adverse Effects of Oral Morphine:
An Evidence-Based Report
ABSTRACT: Successful pain management with opioids requires that
adequate analgesia be achieved without excessive adverse effects.
By these criteria, a substantial minority of patients treated
with oral morphine (10% to 30%) do not have a successful outcome
because of (1) excessive adverse effects, (2) inadequate analgesia,
or (3) a combination of both excessive adverse effects along
with inadequate analgesia.
The management of excessive adverse
effects remains a major clinical challenge. Multiple approaches
have been described to address this problem. The clinical challenge
of selecting the best option is enhanced by the lack of definitive,
evidence-based comparative data.
Indeed, this aspect of opioid
therapeutics has become a focus of substantial controversy. This
study presents evidence-based recommendations for clinical-practice
formulated by an Expert Working Group of the European Association
of Palliative Care (EAPC) Research Network.
These recommendations
highlight the need for careful evaluation to distinguish between
morphine adverse effects from comorbidity, dehydration, or drug
interactions, and initial consideration of dose reduction (possibly
by the addition of a co analgesic). If side effects persist,
the clinician should consider options of symptomatic management
of the adverse effect, opioid rotation, or switching route of
systemic administration.
The approaches are described and guidelines
are provided to aid in selecting between therapeutic options.
[05/01/2001; Journal of Clinical Oncology]
|
 |  |  | 
 School of Nursing/Medicine/Pharmacy
UCSF, 2001

|  |  |  | 
 Science Daily, 1/21/02
J Pharmacology 2/02

|  |  |  |  | 
 Cancer Research, 8/02

|  |  |  | 
 AACR Abstract #LB-149, 2003

|  |  |  |  | 
 JCO, 1/04

|  |  |  | 
 J Pain, Online August 2007

|  |
Remember we are NOT Doctors and have NO medical training.
This site is like an Encylopedia - there are many pages, many links on many topics.
Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM. |
|