Introduction: More than 20 years ago the World Health Organization (WHO) published the booklet 'Cancer Pain Relief', including the fundamentals and clear principles, which was summarized in five simple sentences: 'by mouth', 'by the clock', 'by the ladder', 'for the individual' and 'attention to detail'. Over the years, several modifications to the analgesic ladder have been proposed, as the addition of two further steps, related to the switch of opioid and/or non-invasive route of administration, and to the use of invasive approaches, or again the skip of the second step; nevertheless the educational value and benefits related to the worldwide dissemination are of paramount importance. Areas covered: To date, all the guidelines are inspired by the strategy of WHO; below some of the most important international guidelines published in the last two years are compared, particularly as regards the criteria of choice of opioids for moderate/severe pain. Expert opinion: The discussion on the role of the second step of the WHO analgesic ladder is still open. The challenge for new formulations of 'old' opioids will be to better manage cancer pain, with more tailored efficacy and possibly less side effects.

'Old' and 'new' drugs for the treatment of cancer pain / Santini, Daniele; Lanzetta, Gaetano; Dell'Aquila, Emanuela; Vincenzi, Bruno; Venditti, Olga; Russano, Marco; Papapietro, Nicola; Denaro, Vincenzo; Tonini, G; Ripamonti, Carla. - In: EXPERT OPINION ON PHARMACOTHERAPY. - ISSN 1465-6566. - 14:4(2013), pp. 425-433. [10.1517/14656566.2013.774375]

'Old' and 'new' drugs for the treatment of cancer pain

Santini Daniele;
2013

Abstract

Introduction: More than 20 years ago the World Health Organization (WHO) published the booklet 'Cancer Pain Relief', including the fundamentals and clear principles, which was summarized in five simple sentences: 'by mouth', 'by the clock', 'by the ladder', 'for the individual' and 'attention to detail'. Over the years, several modifications to the analgesic ladder have been proposed, as the addition of two further steps, related to the switch of opioid and/or non-invasive route of administration, and to the use of invasive approaches, or again the skip of the second step; nevertheless the educational value and benefits related to the worldwide dissemination are of paramount importance. Areas covered: To date, all the guidelines are inspired by the strategy of WHO; below some of the most important international guidelines published in the last two years are compared, particularly as regards the criteria of choice of opioids for moderate/severe pain. Expert opinion: The discussion on the role of the second step of the WHO analgesic ladder is still open. The challenge for new formulations of 'old' opioids will be to better manage cancer pain, with more tailored efficacy and possibly less side effects.
2013
01 Pubblicazione su rivista::01a Articolo in rivista
'Old' and 'new' drugs for the treatment of cancer pain / Santini, Daniele; Lanzetta, Gaetano; Dell'Aquila, Emanuela; Vincenzi, Bruno; Venditti, Olga; Russano, Marco; Papapietro, Nicola; Denaro, Vincenzo; Tonini, G; Ripamonti, Carla. - In: EXPERT OPINION ON PHARMACOTHERAPY. - ISSN 1465-6566. - 14:4(2013), pp. 425-433. [10.1517/14656566.2013.774375]
File allegati a questo prodotto
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1642102
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 8
  • ???jsp.display-item.citation.isi??? 6
social impact