Morphine and alternative opioids in cancer pain: the EAPC recommendations.
An expert working group of the European Association for Palliative Care has revised and updated its guidelines on the use of morphine in the management of cancer pain. The revised recommendations presented here give guidance on the use of morphine and the alternative strong opioid analgesics which have been introduced in many parts of the world in recent years. Practical strategies for dealing with difficult situations are described presenting a consensus view where supporting evidence is lacking. The strength of the evidence on which each recommendation is based is indicated.
Hanks
G W
GW
Palliative Medicine, University of Bristol, Bristol Haematology and Oncology Centre, UK.
Conno
F
F
Cherny
N
N
Hanna
M
M
Kalso
E
E
McQuay
H J
HJ
Mercadante
S
S
Meynadier
J
J
Poulain
P
P
Ripamonti
C
C
Radbruch
L
L
Casas
J R
JR
Sawe
J
J
Twycross
R G
RG
Ventafridda
V
V
D000284:Administration, Oral; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D002626:Chemistry, Pharmaceutical; D004334:Drug Administration Schedule; D005283:Fentanyl / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D004091:Hydromorphone / Q000008:administration & dosage / Q000627:therapeutic use; D007262:Infusions, Intravenous; D007278:Injections, Spinal; D007279:Injections, Subcutaneous; D008691:Methadone / Q000493:pharmacokinetics / Q000627:therapeutic use; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D009369:Neoplasms / Q000188:drug therapy*; D010098:Oxycodone / Q000008:administration & dosage / Q000627:therapeutic use; D010146:Pain / Q000188:drug therapy; D010166:Palliative Care / Q000592:standards*
D000701:Analgesics, Opioid; D009020:Morphine; D010098:Oxycodone; D004091:Hydromorphone; D008691:Methadone; D005283:Fentanyl