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1: J Pain Symptom Manage. 2001 Apr;21(4):338-54.Click here to read Links

Opioid poorly-responsive cancer pain. Part 3. Clinical strategies to improve opioid responsiveness.

Mercadante S, Portenoy RK.

Anesthesia and Intensive Care Unit & Pain Relief and Palliative Care Unit, La Maddalena Cancer Center, Palermo, Italy.

Some pain syndromes may be difficult to treat due to a poor response to opioids. This situation demands a range of alternative measures, including the use of adjuvant drugs with independent effects, such as antidepressants, sodium channel-blocking agents, steroids and anti-inflammatory drugs (NSAIDs); drugs that reduce opioid side effects; and drugs that enhance analgesia produced by opioids, such as N-methyl-D-aspartate (NMDA) antagonists, calcium channel antagonists, and clonidine. Other approaches, including opioid trials, neural blockade when necessary, and psychological interventions, also may be useful.

PMID: 11312049 [PubMed - indexed for MEDLINE]

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