Clinical case discussion: treating severe pain syndrome with strong opioids in combination with nsaids in a cancer patient

Abstract

Approaches to treating pain in cancer patients are individual in each case. However, there are general principals. Most often, physicians encounter difficulties when transfer patients from tramadol to more potent tertiary preparations of WHO Analgesic Ladder. The administration and titration of strong opioids to a dose that will ensure adequate pain control with minimal side effects is not an easy task. Here, the physician focuses on the pathogenesis of pain and takes into account the tolerability of drugs prescribed. Individual selection of adjuvants that can affect the cause of pain can reduce the rate of strong opioid dose escalation their side effects. However, what to do, if the use of effective adjuvants is limited? The article provides the discussion of these issues.

Keywords

• oncology
• chronic pain therapy
• strong opioid analgesics
• nsaids
• clinical use