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Treatment of pain in chronic bowel subobstruction with self-administration of methadone
Chronic treatment with opioids in cancer patients with chronic intestinal obstruction is hazardous, as uncontrolled constipation may result in definitive bowel obstruction. Intermittent use of opioids adjusted for fluctuating pain levels may enable patients to take the lowest opioid doses that will...
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Published in: | Supportive care in cancer 1997-07, Vol.5 (4), p.327-329 |
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container_title | Supportive care in cancer |
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creator | MERCADANTE, S SAPIO, M SERRETTA, R |
description | Chronic treatment with opioids in cancer patients with chronic intestinal obstruction is hazardous, as uncontrolled constipation may result in definitive bowel obstruction. Intermittent use of opioids adjusted for fluctuating pain levels may enable patients to take the lowest opioid doses that will have sufficient effect, with a consequently lower risk of intestinal side effects. Methadone has many pharmacokinetic characteristics that fit it for use in this clinical situation. In two patients with recurrent episodes of bowel obstruction, methadone used at low doses and at flexible intervals regulated by the patients according to their pain level avoided the occurrence of new episodes of intestinal obstruction. Oral patient-controlled analgesia with methadone may be a simple, safe and cheap method of treating patients with pain associated with subtotal intestinal obstruction. |
doi_str_mv | 10.1007/s005200050082 |
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Intermittent use of opioids adjusted for fluctuating pain levels may enable patients to take the lowest opioid doses that will have sufficient effect, with a consequently lower risk of intestinal side effects. Methadone has many pharmacokinetic characteristics that fit it for use in this clinical situation. In two patients with recurrent episodes of bowel obstruction, methadone used at low doses and at flexible intervals regulated by the patients according to their pain level avoided the occurrence of new episodes of intestinal obstruction. Oral patient-controlled analgesia with methadone may be a simple, safe and cheap method of treating patients with pain associated with subtotal intestinal obstruction.</description><identifier>ISSN: 0941-4355</identifier><identifier>EISSN: 1433-7339</identifier><identifier>DOI: 10.1007/s005200050082</identifier><identifier>PMID: 9257431</identifier><language>eng</language><publisher>Heidelberg: Springer</publisher><subject>Adult ; Analgesia, Patient-Controlled ; Analgesics, Opioid - administration & dosage ; Analgesics, Opioid - adverse effects ; Biological and medical sciences ; Breast Neoplasms - complications ; Chronic Disease ; Fatal Outcome ; Female ; Humans ; Hypnotics. Sedatives ; Intestinal Obstruction - chemically induced ; Intestinal Obstruction - prevention & control ; Medical research ; Medical sciences ; Methadone - administration & dosage ; Methadone - adverse effects ; Middle Aged ; Neuropharmacology ; Ovarian Neoplasms - complications ; Pain ; Pain, Intractable - drug therapy ; Pharmacology. Drug treatments ; Psychology. Psychoanalysis. 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Intermittent use of opioids adjusted for fluctuating pain levels may enable patients to take the lowest opioid doses that will have sufficient effect, with a consequently lower risk of intestinal side effects. Methadone has many pharmacokinetic characteristics that fit it for use in this clinical situation. In two patients with recurrent episodes of bowel obstruction, methadone used at low doses and at flexible intervals regulated by the patients according to their pain level avoided the occurrence of new episodes of intestinal obstruction. Oral patient-controlled analgesia with methadone may be a simple, safe and cheap method of treating patients with pain associated with subtotal intestinal obstruction.</description><subject>Adult</subject><subject>Analgesia, Patient-Controlled</subject><subject>Analgesics, Opioid - administration & dosage</subject><subject>Analgesics, Opioid - adverse effects</subject><subject>Biological and medical sciences</subject><subject>Breast Neoplasms - complications</subject><subject>Chronic Disease</subject><subject>Fatal Outcome</subject><subject>Female</subject><subject>Humans</subject><subject>Hypnotics. Sedatives</subject><subject>Intestinal Obstruction - chemically induced</subject><subject>Intestinal Obstruction - prevention & control</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Methadone - administration & dosage</subject><subject>Methadone - adverse effects</subject><subject>Middle Aged</subject><subject>Neuropharmacology</subject><subject>Ovarian Neoplasms - complications</subject><subject>Pain</subject><subject>Pain, Intractable - drug therapy</subject><subject>Pharmacology. Drug treatments</subject><subject>Psychology. Psychoanalysis. 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Sedatives</topic><topic>Intestinal Obstruction - chemically induced</topic><topic>Intestinal Obstruction - prevention & control</topic><topic>Medical research</topic><topic>Medical sciences</topic><topic>Methadone - administration & dosage</topic><topic>Methadone - adverse effects</topic><topic>Middle Aged</topic><topic>Neuropharmacology</topic><topic>Ovarian Neoplasms - complications</topic><topic>Pain</topic><topic>Pain, Intractable - drug therapy</topic><topic>Pharmacology. Drug treatments</topic><topic>Psychology. Psychoanalysis. 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subjects | Adult Analgesia, Patient-Controlled Analgesics, Opioid - administration & dosage Analgesics, Opioid - adverse effects Biological and medical sciences Breast Neoplasms - complications Chronic Disease Fatal Outcome Female Humans Hypnotics. Sedatives Intestinal Obstruction - chemically induced Intestinal Obstruction - prevention & control Medical research Medical sciences Methadone - administration & dosage Methadone - adverse effects Middle Aged Neuropharmacology Ovarian Neoplasms - complications Pain Pain, Intractable - drug therapy Pharmacology. Drug treatments Psychology. Psychoanalysis. Psychiatry Psychopharmacology |
title | Treatment of pain in chronic bowel subobstruction with self-administration of methadone |
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