Prescriptions of Strong Opioid Analgesics in Primary Care (Pharmacy Care)

Objective: Pain is a part of every human life and typically, example is a chronic pain in tumour diseases. In therapy of the chronic cancer pain, opioid analgesics have irreplaceable role. Methods: This retrospective analysis was conducted from January 2015 to March 2015 using the prescriptions of strong opioid analgesics accepted by pharmacy VITAE. Prescriptions of strong analgesics were written in the Oncology Institute in Kosice to adult patients. Opioid prescriptions for all patients in analyses had cancer medical diagnosis. Characterization of patients, diagnosis of cancer type, characterization of prescribed opioids analgesics – generic name and rug forms of prescribed medicament were analyzed in retrospective analyses of the prescriptions. Results: In total, there were 332 prescriptions (100 % of cancer) of strong opioids for 151 (54% male; 46% female) patients treated in the East-Slovak Oncology Institute in Kosice, Slovakia, during the study period. The youngest patient - woman was 27 and the oldest patient - woman was 88. The most frequent cancer diagnosis were the carcinoma of respiratory and thorax organs (male) and the carcinoma of breast (female). The number of package of strong opioids was 543 (fentanyl (44%), buprenorphine (26%), oxycodone (12%), tapentanol (10%), morphine (7%) and hydromorphone (1%)). Conclusions: Our analysis demonstrated, that despite the fact that morphine is still considered as a gold standard in the oncologic pain therapy, other opioids are more frequently prescribed as fentanyl, buprenorphine, oxycodone or new molecule tapentadol. All substances were prescribed for intense pain emerged from different type of advanced tumour diseases.

[1]  N. Knezevic,et al.  New Cancer Pain Treatment Options , 2017, Current Pain and Headache Reports.

[2]  U. Hochberg,et al.  Interventional Analgesic Management of Lung Cancer Pain , 2017, Front. Oncol..

[3]  M. von Zastrow,et al.  Molecular Pharmacology of δ-Opioid Receptors , 2016, Pharmacological Reviews.

[4]  R. Chou,et al.  CDC Guideline for Prescribing Opioids for Chronic Pain--United States, 2016. , 2016, JAMA.

[5]  R. Al-Hasani,et al.  Pain and Poppies: The Good, the Bad, and the Ugly of Opioid Analgesics , 2015, The Journal of Neuroscience.

[6]  I. Andsoy,et al.  Anxiety and pain in surgically treated breast cancer patients. , 2015, Asian Pacific journal of cancer prevention : APJCP.

[7]  M. Etropolski,et al.  Ready Conversion of Patients with Well-Controlled, Moderate to Severe, Chronic Malignant Tumor–related Pain on Other Opioids to Tapentadol Extended Release , 2014, Clinical Drug Investigation.

[8]  T. Tzschentke,et al.  The Mu-Opioid Receptor Agonist/Noradrenaline Reuptake Inhibition (MOR–NRI) Concept in Analgesia: The Case of Tapentadol , 2014, CNS Drugs.

[9]  Marek Hakl Zásady podávání analgetik , 2013 .

[10]  Ondřej Sláma Léčba průlomové bolesti u onkologických pacientů , 2013 .

[11]  F. Roila,et al.  Management of cancer pain: ESMO Clinical Practice Guidelines. , 2010, Annals of oncology : official journal of the European Society for Medical Oncology.

[12]  A. Casy,et al.  Opioid Analgesics , 1986, Springer US.

[13]  S. Taillibert,et al.  Neoplastic Meningitis Due to Lung, Breast, and Melanoma Metastases. , 2017, Cancer control : journal of the Moffitt Cancer Center.

[14]  Marek Hakl,et al.  Farmakoterapie léčby onkologické bolesti , 2007 .