Pharmacotherapy of neoplasmatic pain

Pain always accompanies neoplasmatic disease, especially in its finalstage.In about 90% of patients pain can be canceled using only pharmacotherapy. The treatment of neoplasmatic painis based on the recommendations of WHO. According with them in pain therapy drugs should be given individually, in regular intervals, and in most convenient way for the patient. It is also necessary to monitor the efficacy and safety (adverseevents) of therapy.In case of ‘piercing’ pains each patients should receive additional doses of analgetics. The choice of medicineis based on the “three degrees analgesic scale” First choice treatment: paracetamol and non steroidal anti-inflammatory drugs (NSAIDs) are described as no nopioidanalgesics. The second line drugs (tramadol, codeine, dihydrocodeine) are weekopioids.Strong opioids are on the third degree of analgesics scale, morphine, phentanyl, buprenorphine and metadon are representatives of this group in Poland. In necessary the adjuvant therapy could be added to each group of medicines. (Clin. Exp. Med. Lett. 2006; 47(1):3-8)

Keywords: cancer pain, WHO analgesic ladder, opioids