title: Breakthrough pain: the importance of baseline analgesic regimen with opioids.
abstract: Pain is one of the most common and often most feared symptoms in patients with cancer. Ongoing or progressive pain is physically debilitating and has a marked impact on quality of life. During their illness, at least 70% of patients will experience pain sufficiently severe to require chronic opioid treatment. Moreover, Breakthrough Pain (BTP) consists in transitory exacerbations of pain that occurs on a background of otherwise stable pain in a patient receiving chronic opioid therapy. An inadequate baseline therapy with opioids can be one of the causes of BTP. We will examine the molecular issues that influence the response of patients to opioids. Finally, we will discuss about the importance of individualizing therapy.
authors.affiliation: Department of Surgery, Anaesthesiology and Emergency-Resuscitation "Giuseppe Zannini", University of Naples "Federico II", Italy.
authors.forename: Maddalena
authors.initials: M
authors.lastname: Zampi
authors.forename: Antonietta
authors.initials: A
authors.lastname: Morabito
authors.forename: Fabiana
authors.initials: F
authors.lastname: Salvato
authors.forename: Annamaria
authors.initials: A
authors.lastname: Vinciguerra
keywords: Breakthrough Pain; Polimorphisms; μ-receptor
references.citation: Biochem Pharmacol. 2004 Jan 15;67(2):269-76
references.pmid: 14698039
references.citation: Minerva Anestesiol. 2012 Apr;78(4):462-72
references.pmid: 22310188
references.citation: N Engl J Med. 2004 Dec 30;351(27):2827-31
references.pmid: 15625333
references.citation: Biochemistry. 2011 Apr 19;50(15):3181-92
references.pmid: 21329361
references.citation: J Neurosci. 2001 Jun 1;21(11):4074-80
references.pmid: 11356895
references.citation: Biochem Pharmacol. 2008 Jan 1;75(1):76-84
references.pmid: 17880927
references.citation: Anesthesiology. 2006 Mar;104(3):570-87
references.pmid: 16508405
references.citation: Mol Pharmacol. 2008 May;73(5):1538-48
references.pmid: 18285510
references.citation: World Health Organ Tech Rep Ser. 1990;804:1-75
references.pmid: 1702248
references.citation: Minerva Anestesiol. 2011 Jan;77(1):33-9
references.pmid: 21150856
references.citation: Eur J Pain. 2009 Apr;13(4):331-8
references.pmid: 18707904
references.citation: FEBS Lett. 1997 Jul 21;412(1):35-8
references.pmid: 9257684
references.citation: Cancer. 2009 Jun 1;115(11):2571-9
references.pmid: 19373888
references.citation: Pharmacol Ther. 1995;68(3):343-64
references.pmid: 8788562
references.citation: Pain. 2009 Dec;146(3):270-275
references.pmid: 19683391
references.citation: Ann Neurol. 2010 May;67(5):559-69
references.pmid: 20437553
references.citation: Metabolism. 2010 Oct;59 Suppl 1:S47-52
references.pmid: 20837194
references.citation: Ann N Y Acad Sci. 2010 Feb;1187:341-52
references.pmid: 20201861
references.citation: Pain Pract. 2008 Jul-Aug;8(4):287-313
references.pmid: 18503626
references.citation: Annu Rev Pharmacol Toxicol. 2003;43:285-307
references.pmid: 12359865
references.citation: Trends Pharmacol Sci. 2001 Feb;22(2):67-70
references.pmid: 11166849
references.citation: Curr Med Res Opin. 2010 May;26(5):1037-45
references.pmid: 20199140