Opioids in Cancer Pain

About this book

• Editors from 3 continents have produced a truly global perspective on the use of opioids in malignant disease
• Aids understanding of opioids and their effectiveness, essential to any clinician prescribing this type of drug
• Includes a review of all the major opioids

New to this edition

• An editor from the UK, Columba Quigley, has joined the established editor team of Mellar Davis, Paul Glare and Janet Hardy, making the new edition even more international in scope
• New chapters on opioids in paediatrics, and opioids in developing countries, address the unique needs of these patient groups
• More focused attention on the differing uses of opioids, as separate chapters are devoted to dosing strategies in acute pain, and dosing strategies in chronic pain
• Buprenorphine has been added to the list of opioids covered, reflecting its common use in Europe and the debate surrounding its use in the US
• Organ failure is now covered
• Issues of addiction and substance abuse are now addressed
• The palliative care perspective has been strengthened, with the role of opioids in the terminal phase now included
• Incorporates new studies in opioid pharmacogenetics, a topic which may have significant implications for the use of these drugs in the future

Opioids have become invaluable in modern medicine but it is essential that they are prescribed with an understanding of the complex pharmacology behind their effectiveness; without this, they will frequently fail to achieve their enormous potential of pain relief, minimal side effects, and improved function. In addition, opioids come with problems, including side effects such as constipation, respiratory depression, and sedation, as well as the potential for substance abuse. Clinicians handling the complex pain problems of cancer patients must incorporate the insight of basic scientists and pharmacologists, and this new edition of this comprehensive text brings together a wealth of experience from those involved in all aspects of opioids, with a view to improving both clinician understanding and patient care.

The text includes comprehensive coverage of the principles of opioid pharmacodynamics, pharmacokinetics, and pharmacogenetics. A chapter is dedicated to each of the main opioids, with topics such as structure, routes of administration, toxicity, drug interactions, and effects on organ function included within each one. The book concludes with several chapters dedicated to discussion of the major issues relevant to opioid use, including substance abuse, dosing strategies for acute and chronic pain, patient controlled analgesia, equianalgesia, spinal opioids, pain that doesn't respond to opioids, and the terminal phase.

This text is the most complete and extensive work available on the use of opioids for cancer pain, and is an important reference for those clinicians treating individuals with cancer.

Readership: This book is compulsory reading for anyone involved in administering opioids for the treatment of cancer pain; this includes palliative care doctors, oncologists, pain specialists and pharmacists.

Table of Contents

1: Mellar P. Davis and Gavril W. Pasternak: Opioid receptors and opioid pharmacodynamics
2: Kenneth C. Jackson, Mellar P. Davis & Columba Quigley: Opioid pharmacokinetics
3: Mellar P. Davis: Liver disease and exogenous opioid pharmacokinetics
4: Janet Hardy & Columba Quigley: Opioids in renal failure
5: Janet Hardy & Kenneth C. Jackson: Codeine
6: Mellar P. Davis: Hydrocodone
7: Mellar P. Davis & Paul A. Glare: Tramadol
8: Paul A. Glare: Dextropoxyphene
9: Paul A. Glare: Morphine
10: Paul A. Glare & Mellar P. Davis: Oxycodone
11: Tony Hall & Janet Hardy: The lipophilic opioids - fentanyl, alfentanil, sufentanil and remifentanil
12: Mellar P. Davis: Buprenorphine
13: Columba Quigley & Mellar P. Davis: Methadone
14: Columba Quigley & Paul A. Glare: Hydromorphone
15: Mellar P. Davis: Levorphanol
16: Janet Hardy & Columba Quigley: Diamorphine
17: Paul A. Glare: Oxymorphone
18: Paul A. Glare: Choice of opioids and the WHO ladder
19: Joy Ross & Columba Quigley: Pharmacogenetics and opioids
20: Janet Hardy, Columba Quigley & Joy Ross: Opioid rotation
21: Mellar P. Davis & Kenneth C. Jackson: Equianalgesia
22: Mellar P. Davis: Dosing strategies for acute pain
23: Mellar P. Davis: Opioid dosing strategies for chronic pain and the management of opioid side effects
24: Mellar P. Davis: Patient controlled analgesia
25: Costantino Benedetti, Steven Paquelet & Mellar P. Davis: Spinal opioids in cancer pain
26: Mellar P. Davis: Opioid poorly responsive pain, physical dependence, tolerance and opioid-induced hyperalgesia
27: Mhoira Leng: Opioids in special populations: developing countries
28: Ross Drake: Opioids in special populations: pediatric population
29: Janet Hardy: Opioids in the terminal phase
30: Kenneth L. Kirsh, Tatiana D. Starr, Lauren J. Rogak & Steven D. Passik: Cancer pain and substance abuse

Author Information

Edited by Mellar P. Davis, Director of Research, Harry R. Horvitz Center of Palliative Medicine, Taussig Cancer Center, Division of Solid Tumor, Cleveland Clinic, USA, Paul A. Glare, Chief, Pain and Palliative Care Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA, Janet Hardy, Director of Palliative Care, Mater Health Services, South Brisbane, Queensland, Australia, and Columba Quigley, Formerly Consultant/Honorary Senior Lecturer in Palliative Medicine, Hammersmith Hospitals Trust, London, UK