Pharmacy Medical News about Severe Cancer Pain; Combined Strong Opioids

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Patient Affected by Severe Cancer Pain and Treated with Combined Strong Opioids
Advances in Pain Management, 06/30/09

Catala E et al. - Cancer pain is one of the most important challenges for pain specialists and doctors treating cancer patients. For this reason treating pain early on in the disease and aggressively is one of the goals of care. The authors describe a patient with multiple myeloma who developed nociceptive and neuropathic pain, which was controlled with the addition of a second strong opioid and an anticonvulsant to her existing treatment regimen...The observations of this case report support the notion that a combination of two opioids with different profiles of receptor affinity may result in better pain relief in a selected group of patients in whom the primary opioid cannot be uptitrated due to side effects. It has been speculated that synergism occurs due to the different profiles of receptor affinity but the underlying mechanism has not yet been elucidated. Large controlled studies need to be conducted to clarify which opioids have this potential.