Pain management in palliative care. Morphine and the 'new' opioids in 2000.
BACKGROUND
Although morphine is the mainstay of pharmacological therapy in cancer pain, it remains feared and suboptimally used. Different formulations and the advent of 'new' opioids facilitate the attainment of pain control.


OBJECTIVE
To clarify the current role of various opioids including morphine in the management of cancer pain. To provide a practical framework to guide 'best practice' opioid use in a general practice setting.


CONCLUSIONS
The optimal application of opioids is governed by their clinical pharmacology and hindered by unfounded fears and misunderstanding. Different formulations within different types of opioids augment a favourable balance in the pain relief versus adverse effects equation and used within a four point approach, should serve to deliver optimal pain control.
Virik
K
K
Royal Prince Alfred Hospital, Sydney, New South Wales. kiran@pal.cs.nsw.gov.au
Glare
P
P
D000701:Analgesics, Opioid / Q000494:pharmacology*; D003071:Cognition / Q000187:drug effects; D003692:Delayed-Action Preparations; D006801:Humans; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects; D059408:Pain Management; D010166:Palliative Care
D000701:Analgesics, Opioid; D003692:Delayed-Action Preparations; D009020:Morphine