Pregledni rad

Pathophysiology and treatment of oncologic pain

Renata Dobrila-Dintinjana ; Klinika za radioterapiju i onkologiju, KBC Rijeka, Rijeka
Jelena Vukelić ; Klinika za otorinolaringologiju i kirurgiju glave i vrata, KBC Rijeka, Rijeka
Marijan Dintinjana ; Ordinacija opće medicine, Rijeka
Nenad Vanis ; Klinika za gastroenterologiju, KBC Sarajevo, Sarajevo, Bosna i Hercegovina
Alen Ružić ; Zavod za kardiologiju, Klinika za internu medicinu, KBC Rijeka, Rijeka
Morana Brkljačić-Žagrović ; Poliklinika “Sv. Rok – M. D.”, Zagreb
Sanja Pleština ; Klinika za pulmologiju “Jordanovac”, KBC Zagreb
Zlatko Kolić ; Klinika za neurokirurgiju, KBC Rijeka

Sažetak

According to the definition of the International Association for the Study of Pain (IASP), pain is a noticeably uncomfortable and emotional experience associated with actual or potential tissue damage or described at the time of such damage. Pain can be divided into nociceptive, neuropathic and inflammatory. Cancer pain includes all three mechanisms. Nociceptive pain causes stimulation of nociceptors (free nerve endings that are peripheral pain receptors). Neuropathic pain occurs as a result of damage to the peripheral or central nervous system, without simultaneous stimulation of nociceptors. Effect of analgesic system is mediated through endogenous opiates (enkefalins, endorphins and dinorfins). They act as neurotransmitters and neuromodulators, causing analgesia trough mu, kappa and delta opioid receptors. Malignant pain is treated according to basic principles of palliative medicine, and they are fast and effective pain management, treatment of “total” pain and pain treatment planning. Pharmacotherapeutic approach, respecting the Guidelines’ “three stage ladder” or “model lift” in over 90% of patients may be sufficient to treat pain. The gold standard in the treatment of malignant pain are opioids. Morphine and its agonists are widely used in the treatment of cancer pain. Constipation, vomiting, sedation, confusion, hallucinations, urinary retention, dizziness and respiratory depression are side effects. Treatment of intractable pain, pain in the elderly and small children, opioid rotation, use of corticosteroids, placebo in the treatment of pain and a number of ethical questions for now is still a real challenge for researchers and for clinicians, primary care doctors and ethicists.

Ključne riječi

cancer pain; pharmacology; treatment

Hrčak ID:

86939

URI

https://hrcak.srce.hr/86939

Datum izdavanja:

3.9.2012.

Podaci na drugim jezicima: hrvatski

Posjeta: 2.538 *