title: High dose of buprenorphine in terminally ill patient with liver failure: efficacy and tolerability.
abstract: Pain in terminally ill patients with cancer can be often hard to manage, due to the unpredictable kinetics of drugs caused by progressive kidney and liver dysfunction. Plasma concentrations of active metabolites-also a cause of dangerous side effects--could be difficult to estimate. This case report holds the idea that buprenorphine, a partial agonist of m-receptors, even at high dosage, may be effective and safe to use in terminally ill patients with significant liver and kidney impairment.
authors.affiliation: Intensive Care and Pain Medicine, Department of Health Sciences, University of L'Aquila, L'Aquila, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Ciccozzi
authors.forename: Chiara
authors.initials: C
authors.lastname: Angeletti
authors.forename: Giada
authors.initials: G
authors.lastname: Baldascino
authors.forename: Emiliano
authors.initials: E
authors.lastname: Petrucci
authors.forename: Cristina
authors.initials: C
authors.lastname: Bonetti
authors.forename: Stefania
authors.initials: S
authors.lastname: De Santis
authors.forename: Antonella
authors.initials: A
authors.lastname: Paladini
authors.forename: Giustino
authors.initials: G
authors.lastname: Varrassi
authors.forename: Franco
authors.initials: F
authors.lastname: Marinangeli
mesh_terms: D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D002047:Buprenorphine / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008099:Liver / Q000503:physiopathology; D017093:Liver Failure / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D010147:Pain Measurement / Q000379:methods; D010190:Pancreatic Neoplasms / Q000150:complications / Q000503:physiopathology; D019452:Terminally Ill
chemical_list: D000701:Analgesics, Opioid; D002047:Buprenorphine