Cancer Pain Drug

By | April 25, 2012

Cancer pain drug, according to the priorities of pain in patients with disease, the analgesic dose is divided into three categories.
1. For mild pain drugs can be used non-simplified categories analgesics (NSAIDs), and (or) plant-based painkillers. The analgesic mechanism of NSAIDs by inhibiting metastasis of cancer caused by invasion or pathological products such as prostaglandin E2 (PGE2) synthesis, thereby reducing pain caused by substances in the body (such as histamine, bradykinin, etc.) of the release. PGE2 has to maintain the normal function of the kidney and platelets, the role of protecting the gastrointestinal mucosa, but the body can cause histamine, bradykinin and other substances caused the release of pain with inflammation, pain caused by role. NSAIDs in pain at the same time, there are some side effects such as stimulation of the gastrointestinal tract, renal damage and coagulopathy. Since 1899 developed by Bayer in Germany since the advent of aspirin, the emergence of many new NSAIDs, in recent years was 50% PGE2 in vitro inhibition of the synthesis of aspirin dose of I, on a comparative study of these drugs NSAIDs found that: acetaminophen (paracetamol) <0.01, salicylic acid <0.02 2.7 trazodone phenylbutyrate, 22 ibuprofen, naproxen, 45, indomethacin (indomethacin) was 257, ibuprofen for the 5610 double-fluoride (in vitro only).
Mainly used in clinical treatment of selective inhibition of PGE2, NSAIDs, and NSAIDs by changing the chemical structure or the use of sustained-release and controlled-release technology to reduce the side effects of prolonged analgesic effect. Representative of the current drugs are often used:
salicylic acid: on behalf of drug aspirin (Aspirin);
pyrazolone: Representative drugs phenylbutazone, non-Pula cases (feprazone, Department of phenylbutazone derivatives of the drug, efficacy is 10 times as phenylbutazone, because of its chemical structure and the introduction of anti-ulcer protect the gastrointestinal mucosa of the isoprene-based, so to stimulate the stomach to reduce the drug, commonly used dose of O.19-0.2g / second, 1 3 times);
other anti-inflammatory organic acids: on behalf of drug indomethacin, for the indole derivatives, often use more rectal suppository of indomethacin administration, the general formulation of 50mg or 100mg / tablets, commonly used dose of 50-100mg / times , 3-4 times a day, regular delivery, but also oral administration, the general formulation of the 25mg / tablets, commonly used dose of 25-50mg, 1. 3 times a day, orally after a meal is appropriate. Indomethacin tablets because of gastrointestinal irritation, and the risk of gastric diseases after chemotherapy should be used with caution, and not long-term use. Controlled release tablets of indomethacin does not reduce the bioavailability of the original, we can maintain 12 hours of anti-inflammatory analgesic effect, thus avoiding excessive plasma concentrations, reducing the side effects, there are certain advantages. Fenbid is ibuprofen sustained release capsule, slow release of drugs, plasma concentration steady, no obvious peak and valley phenomenon, reduced side effects, maintain longer. Dosage is 300-600mg / time, 1 to 2 times, not long-term use. Ketorolac (torolactoradol, is a potent NSAIDs, also known as glycerol ketone ammonium acetate butyrate), the efficacy of indomethacin is equivalent to 2 times, 3.6 times Fenbid, aspirin 100 – 200 times. Moderate to severe pain, intramuscular ketorolac, the analgesic effect of morphine 10mg 6mg, 50mg pethidine quite. Commonly used dose of 10 – 20mg / times a day 3-4 times. Liver, kidney dysfunction and elderly patients should be appropriate reductions. Austria wet g [(arthrotec), containing 50mg sodium dichloro acid and misoprostol 200. Misoprostol is a synthetic prostaglandin PGE1 analogue, can inhibit gastric acid secretion and mucosal protection features to prevent the NSAIDs caused stomach and duodenal mucosal injury and ulcers, and its anti-ulcer effect than Rainey several times for the Ding. Commonly used dosage of 1 tablet 2 times a day, if necessary, may be increased to 3-4 times a day. Some patients with abdominal pain can occur early in the medication and (or) diarrhea, diarrhea, mostly mild or moderate, in 2 – 3 days to heal itself, can continue medication. Plant has analgesic lappaconitine, Rotundine (Tetrahydropalmatine), paeonol and so on.
Cancer pain drug, 2. For moderate pain is usually weak opioid drugs to codeine as a representative. Commonly used drugs:
codeine: the drug after oral administration is easy to absorb most of the activity in the liver metabolism of the non-product, about 10% after demethylation into morphine. Intraventricular administration of animal experiments show no analgesic effect of codeine, so that the codeine into morphine by the body play a role. Morphine in its analgesic effect is 1 / 12, duration similar to morphine. Euphoria and the addictive than morphine weak inhibition of the respiratory center slightly, no significant constipation, urinary and orthostatic hypotension remain full of such side effects. Oral dose of codeine 30-120mg, every 4 / hours. Recently developed controlled-release tablets hydrocodone tartrate, trade names, double-grams for (DHC), extended treatment intervals, every 12 / h time, 60-120mg / time, can control more than moderate pain, analgesia 2 times the role of the codeine, and adverse reactions are mild, the patient compliance good.
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