Journal of opioid management
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Randomized Controlled Trial Comparative Study
Effect of intraoral and subcutaneous morphine on dyspnea at rest in terminal patients with primary lung cancer or lung metastases.
Dyspnea is considered as one of the most frequent and distressing symptoms in patients with advanced cancer, and systemic administration of morphine has been reported to have beneficial effect on this complaint. ⋯ The study confirms the beneficial effect of morphine on dyspnea in terminally ill patients, and we conclude that RMD is an attractive alternative to injected morphine, when self-administration is preferable.
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Multicenter Study
Switching from high doses of pure μ-opioid agonists to transdermal buprenorphine in patients with cancer: a feasibility study.
Several myths on buprenorphine's pharmacology exist: possible analgesic ceiling effect, feasibility of combination with other opioid agonists, and the reversibility of side effects. Aim to evaluate: 1) if cancer patients receiving high doses of pure agonists could obtain adequate pain relief after switching to transdermal (TD) buprenorphine and 2) whether the numbers of breakthrough pain episodes after switching increased and whether they could be treated with the same doses of pure agonist as before switching. ⋯ It is feasible to switch cancer patients from high doses of pure μ-opioid agonists to TD buprenorphine without eliciting any antagonist effects, but the dose conversion factor is individual and the switching process should be tailored for the individual patient.