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[Opioid induction using rapid release drugs and the shift to fentanyl patches].

Gan to kagaku ryoho. Cancer & chemotherapy (2014-08-19)
Shin Sasaki, Taiki Morohashi, Yukihiro Otsuka, Miho Ejima, Yu Tsujikawa, Kunihiko Yoshimura, Emi Terai, Noriyuki Suzuki, Hiroshi Nakayama, Toshiyuki Watanabe
ABSTRACT

From April 2011 to March 2013, 20 patients with cancer pain that was not controlled by non-opioid analgesics were treated with a short-acting opioid for cancer pain management.The primary carcinoma sites were the stomach( n=5), colo-rectum(n=5), lungs(n=3), urinary bladder(n=2), breast(n=2), pancreas(n=2), and liver(n=1). The analgesic effects and adverse events were evaluated, and a shift to fentanyl patches was made for patients whose cancer pain was relieved.After the shift, the efficiency and safety were validated. All 6 patients with a numeric rating scale (NRS)less than 5 at the time of opioid induction had a good analgesic effect, and in only 1 patient, grade 2 constipation and grade 3 anorexia was observed.Of the 14 patients who had an NRS of 6 or greater, 11 had a good analgesic effect.However, 3 patients experienced no effect, and their survival periods after opioid induction were very short.In the 11 patients with good pain control, only 3 patients exhibited grade 2 adverse events.Nine patients out of 17 with a good analgesic effect caused by short-acting opioids were shifted to fentanyl patches, and 8 patients were under good analgesic control for 2 weeks or more. Opioid induction using rapid release drugs was effective and safe.However, these drugs should be clinically considered at an early stage.Furthermore, in patients where a shift to a fentanyl patch was possible, good long-term pain control was achieved.

MATERIALS
Product Number
Brand
Product Description

Supelco
Fentanyl solution, 1.0 mg/mL in methanol, ampule of 1 mL, certified reference material, Cerilliant®
Sigma-Aldrich
Fentanyl citrate salt
Supelco
Fentanyl solution, 100 μg/mL in methanol, ampule of 1 mL, certified reference material, Cerilliant®