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10.3238/arztebl.2018.0135 http://scihub22266oqcxt.onion/10.3238/arztebl.2018.0135 C5876542!5876542 !29563006     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=29563006 &cmd=llinks): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 215 Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\29563006 .jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117       Dtsch+Arztebl+Int 2018 ; 115 (9 ): 135-142 Nephropedia Template TP {{tp|p=29563006 |t=2018. Opioid Rotation in Cancer Pain Treatment |pdf=|usr=}}{{29563006 }} gab.com Text Opioid Rotation in Cancer Pain Treatment JO: Dtsch Arztebl Int http://www.kidney.de/pget.php?&tw=1&pmid=29563006 #FOAvip BACKGROUND: Rotating several different WHO level III opioid drugs is a therapeutic option for patients with chronic cancer-related pain who suffer from inadequate analgesia and/or intolerable side effects. The evidence favoring opioid rotation is controversial, and the current guidelines in Germany and other countries contain only weak recommendations for it. METHODS: This review is based on pertinent publications retrieved by a systematic review of the literature on opioid rotation for adult patients with chronic cancerrelated pain who are regularly taking WHO level III opioids by the oral or trans - dermal route. RESULTS: 9 individual studies involving a total of 725 patients were included in the analysis, and 3 previous systematic reviews of studies involving a total of 2296 patients were also analyzed. Morphine, oxycodone, fentanyl, hydromorphone, and buprenorphine were used as first-line opioid drugs, and hydromorphone, bupre - norphine, tapentadol, fentanyl, morphine, oxymorphone, and methadone were used as second-line opioid drugs. In all of the studies, pain control was achieved for 14 days after each rotation. In most of them, the dose of the new drug introduced in each rotation needed to be increased above the dose initially calculated from a rotation ratio, with the exception of rotations to methadone. The frequency of side effects was only rarely lessened, but patients largely considered the result of opioid rotation to be positive. No particular opioid drug was found to be best. CONCLUSION: Opioid rotation can improve analgesia and patient satisfaction. The success of opioid rotation appears to depend on the magnitude of the initial dose, among other factors. Tables of equianalgesic doses should be considered no more than a rough guide for determining the dose of the new drug. Rotations to methadone should be carried out under clinical supervision in experienced hands. Twit Text FOAVip Opioid Rotation in Cancer Pain Treatment ????Dtsch Arztebl Int http://www.kidney.de/pget.php?&tw=1&pmid=29563006 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=29563006 #FOAvip English Wikipedia <ref>{{Cite pmid|29563006 }}</ref> Opioid Rotation in Cancer Pain Treatment #MMPMID29563006 Schuster M ; Bayer O ; Heid F ; Laufenberg-Feldmann R Dtsch Arztebl Int 2018[Mar]; 115 (9 ): 135-142 PMID29563006 show ga BACKGROUND: Rotating several different WHO level III opioid drugs is a therapeutic option for patients with chronic cancer-related pain who suffer from inadequate analgesia and/or intolerable side effects. The evidence favoring opioid rotation is controversial, and the current guidelines in Germany and other countries contain only weak recommendations for it. METHODS: This review is based on pertinent publications retrieved by a systematic review of the literature on opioid rotation for adult patients with chronic cancerrelated pain who are regularly taking WHO level III opioids by the oral or trans - dermal route. RESULTS: 9 individual studies involving a total of 725 patients were included in the analysis, and 3 previous systematic reviews of studies involving a total of 2296 patients were also analyzed. Morphine, oxycodone, fentanyl, hydromorphone, and buprenorphine were used as first-line opioid drugs, and hydromorphone, bupre - norphine, tapentadol, fentanyl, morphine, oxymorphone, and methadone were used as second-line opioid drugs. In all of the studies, pain control was achieved for 14 days after each rotation. In most of them, the dose of the new drug introduced in each rotation needed to be increased above the dose initially calculated from a rotation ratio, with the exception of rotations to methadone. The frequency of side effects was only rarely lessened, but patients largely considered the result of opioid rotation to be positive. No particular opioid drug was found to be best. CONCLUSION: Opioid rotation can improve analgesia and patient satisfaction. The success of opioid rotation appears to depend on the magnitude of the initial dose, among other factors. Tables of equianalgesic doses should be considered no more than a rough guide for determining the dose of the new drug. Rotations to methadone should be carried out under clinical supervision in experienced hands. |Analgesics, Opioid/*administration & dosage/therapeutic use [MESH] |Buprenorphine/administration & dosage/therapeutic use [MESH] |Cancer Pain/*drug therapy [MESH] |Chronic Pain/drug therapy [MESH] |Fentanyl/administration & dosage/therapeutic use [MESH] |Germany [MESH] |Humans [MESH] |Hydromorphone/administration & dosage/therapeutic use [MESH] |Morphine/administration & dosage/therapeutic use [MESH] |Neoplasms/complications [MESH] |Oxycodone/administration & dosage/therapeutic use [MESH]Opioid Rotation in Cancer Pain Treatment (epmc).pdf DeepDyve Pubget Overpricing