Cancer-Related Breakthrough Pain 2009
DOI: 10.1093/med/9780199215676.003.0005
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Chapter 5 Oral opioid drugs

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Cited by 10 publications
(13 citation statements)
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“…Equally, it should be remembered that oral opioids have a relatively prolonged duration of action (i.e. 3–6 h) (Bailey and Farley, 2006), and this prolonged duration of action may be associated with ongoing/delayed adverse effects. The perceived median onset of action of the transmucosal fentanyl products was 10 min, and the perceived median time to peak effect was also 10 min.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…Equally, it should be remembered that oral opioids have a relatively prolonged duration of action (i.e. 3–6 h) (Bailey and Farley, 2006), and this prolonged duration of action may be associated with ongoing/delayed adverse effects. The perceived median onset of action of the transmucosal fentanyl products was 10 min, and the perceived median time to peak effect was also 10 min.…”
Section: Discussionmentioning
confidence: 99%
“… Diagnostic algorithm used to identify patients with breakthrough pain (adapted from Davies et al, 2009). …”
Section: Methodsmentioning
confidence: 99%
“…The established strategy of using immediate release (IR) morphine to manage breakthrough pain is likely to be inadequate in CIBP. IR oral morphine starts to provide benefit, at best, at 30 min, takes 45-60 min to reach peak plasma concentration, and has duration of action of 3-4 h [32]. As breakthrough pain in CIBP has a more rapid onset and is of considerably shorter duration, it is likely that patients will suffer significant opioid-related side effects, as their pain resolves without gaining effective analgesia for their breakthrough pain.…”
Section: Discussionmentioning
confidence: 99%
“…In theory, if a patient had taken an IR opioid for their breakthrough pain, this may have limited the duration of their pain. At best, IR opioids have an onset of analgesic effect at 30 min with peak effect at 60 min [32]. Most patients had breakthrough pain of less than 30-min duration; so it is unlikely that IR opioids would have impacted on this.…”
Section: Discussionmentioning
confidence: 99%
“…It appears to be vitally important to match the characteristics of the opioid utilized to treat BTP; to the type of BTP experienced. Immediate release oral morphine has, at best, an onset of action of about 30 min [41]. This means that in patients with rapid-onset, short duration breakthrough pain, immediate release morphine will probably be ineffective.…”
Section: Opioidsmentioning
confidence: 99%