Differenzialindikation von Opioiden in der Schmerztherapie

Heyn, Jens; Azad, Shahnaz Christina

doi:10.1007/s00101-017-0369-2

Cited by 4 publications

(2 citation statements)

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“…• The processes of opioid elimination and associated mechanisms of effect prolongation or toxic accumulation of the substances are influenced by various factors, including [40,65,66]:…”

Section: What Needs To Be Considered For Differentiated Opioid Therap...mentioning

confidence: 99%

Pain Management in Palliative Care: What Is Significant?

Hait

2024

Pain Management - From Acute to Chronic and Beyond

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In pain management of advanced ill patients, various factors appear to be of significance: multidimensional approach and realisation of pain as a complex perception (Total Pain). Existential fear and an exceptional role of pain as a leading symptom in palliative patients ought to be mentioned—chronification of pain progresses rapidly, oftentimes with less preconditions. In advanced ill patients, even the slightest pain stimulus may result in a sensation of total pain. We discuss mechanisms-centred pain therapy (opioid therapy in particular), depending on the pain character—nociceptive, inflammatory, neuropathic, dysfunctional, mixed pain—as a challenge in palliative care: -contemporary understanding of the significance and role of WHO pain management—genetically determined polymorphism of (opioid) receptors and enzyme systems—problems of plasma protein binding and interactions of analgetic drugs—differences in the elimination of various opioid drugs—active metabolites of opioids, peculiarities of the onset, duration and regulation of action—asymmetric pain distribution, breakthrough pain, end-of-dose failure, opioid-induced hyperalgesia—practical considerations on preferred choice of analgetics in patients with different comorbidities and of advanced age.

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“…• The processes of opioid elimination and associated mechanisms of effect prolongation or toxic accumulation of the substances are influenced by various factors, including [40,65,66]:…”

Section: What Needs To Be Considered For Differentiated Opioid Therap...mentioning

confidence: 99%

Pain Management in Palliative Care: What Is Significant?

Hait

2024

Pain Management - From Acute to Chronic and Beyond

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“…In ihrer ausführlichen Übersichtsarbeit"DifferenzialindikationvonOpioiden in der Schmerztherapie" zeigen Heyn und Azad [3]…”

Section: Das Richtige Opioid Für Meinen Patientenunclassified

Das richtige Opioid für meinen Patienten

Schäfer¹

2017

Anaesthesist

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Das richtige Opioid für meinen PatientenBei der Anwendung von Opioidanalgetika im klinischen Alltag kommt es immer wieder zu der Frage, ob es relevante Unterschiede zwischen den einzelnen Opioidsubstanzen gibt, und ob diese mögli-cherweise zu einer unterschiedlichen Indikation ihrer Anwendung führen.Die erst kürzlich überarbeiteten Empfehlungen zur Langzeitanwendung von Opioiden bei nichttumorbedingten Schmerzen (LONTS) konstatieren, dass es keine Unterschiede in Wirksamkeit, Sicherheit und Verträglichkeit gibt [8].In ihrer ausführlichen Übersichtsar-beit"DifferenzialindikationvonOpioiden in der Schmerztherapie" zeigen Heyn und Azad [3], dass diese Einschätzung so nicht uneingeschränkt zutrifft und relevante Unterschiede zwischen einzelnen Opioiden und deren Indikationsgebieten existieren: insbesondere im Hinblick auf die pharmakokinetischen und pharmakodynamischen Eigenschaften der einzelnen Substanzen, die möglichen Komorbiditäten der individuellen Patienten und dem Vorhandensein mögli-cher Organschäden.

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