Paliatívna medicína a liečba bolesti 1/2008

NEW THERAPEUTIC SYSTEMS WITH CONTROLLED RELEASE IN THE TREATMENT OF CHRONIC PAIN

Opioid analgesics are the most useful drugs for the moderate to severe pain. Recent guidelines emphasize individualization of opioid therapy, especially selection of the appropriate drug and route of administration for each patient. Persistent or recurrent pain requires treatments based on the regularly scheduled regiment. Although oral morphine is generally considered the standard opioid for severe particularly cancer pain, need for high doses and side effects may often require discontinuation of therapy. In the late nineteenth and early twentieth centuries new knowledge in the pharmacology led to new synthetic and semisynthetic morphine derivates. The use of alternative μ-receptor agonists in chronic pain requires frequent administration in 4 – 6 hourly regiment because of their short elimination half-life. The development of new controlled-release oral and transdermal therapeutic systems has been the one of the most advanced in the therapy of sever chronic pain that has had a substantial impact on clinical practice. Modified-release opioid products have becomes the standard therapy for the management of moderate to severe chronic pain. To effectively manage chronic pain, healthcare providers must have a complete knowledge of this new therapeutic system.

Keywords: opioids, oral controlled-release formulations, transdermal therapeutic systems.