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Co-analgesics and adjuvant medication in opioid treated cancer pain

Johan Menten Coordinator Palliative Care, University Hospital Gasthuisberg, Herestraat, 49, B-3000 Leuven, Belgium Introduction Although opioids continue to be the mainstay approach for the management of moderate or severe pain in patients with serious illness, the outcome of opioid therapy is not uniformly favourable and clinicians must know a range of alternative analgesic strategies. The appropriate use of co-analgesics is one of the strategies to the neuropathic, skeletal related and visceral component of the pain. Co-analgesics are administered to those patients whose pain has not completely responded to optimal analgesic therapy according to the WHO 3-step ladder. The existence of large inter-individual and intra-individual variability in the response to co-analgesics suggests that sequential therapeutic trials are often advocated to identify the most effective drug for each individual patient. The useful analgesic dose of opioids is, due to the absence of a ceiling effect, mainly limited by the appearance of adverse effects. The effective treatment of the opioidinduced adverse effects with adjuvant medication, is secondly of paramount importance in the successful opioid treatment of pain. class of drugs with analgesic, anti-inflanmlatory and antipyretic effects and to use them properly in cancer pain. These drugs have a potent inhibitory effect http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Cancer Supplements Elsevier

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