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      Analgésicos opioides disponíveis em Portugal aprovados para dor crónica Translated title: Opioid analgesics available in Portugal approved for chronic pain

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          Abstract

          RESUMO A prevalência de dor crónica na população portuguesa é de 37%, provocando limitações físicas, psicológicas, sociais e uma clara diminuição da qualidade de vida. Em alguns tipos de dor crónica, os analgésicos opioides mostraram-se como as únicas alternativas passíveis de proporcionar controlo de dor, devendo a terapêutica recorrendo a este grupo ser iniciada quando todas as outras opções falharam. Este artigo pretende rever as principais características dos analgésicos opioides, incluindo efeitos secundários e formas farmacêuticas disponíveis, tanto para terapêutica basal como de resgate.

          Translated abstract

          SUMMARY Chronic pain has a prevalence of 37% in the Portuguese population, causing physical limitations, psychological and social problems and a great decrease in the quality of life. In many types of chronic pain, opioid drugs are the only options that can provide pain relief, and therapy using this pharmacotherapeutic group should be started when other options have failed. This paper aims to review the main characteristics of opioid analgesics, including side effects and available pharmaceutical forms, both for baseline and rescue therapy.

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          Most cited references9

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          Basic opioid pharmacology: an update

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            Epidemiology of chronic pain: a population-based nationwide study on its prevalence, characteristics and associated disability in Portugal.

            A cross-sectional nationwide epidemiological study was performed in a random sample of the Portuguese adult population, aiming to describe the prevalence and impact of chronic pain (CP). The 5,094 participants were selected by random digit dialing, between January 2007 and March 2008, and estimates were adequately weighted for the population. Prevalence of CP was 36.7% (95% confidence interval [CI] [35.3-38.2]), based on the definition of the International Association for the Study of Pain. Recurrent or continuous pain was present in 85% of those with CP, and moderate-to-severe intensity and disability were present in 68 and 35%, respectively. Highest CP prevalence was observed among the elderly, retired, unemployed, and less educated. Highest disability was found in relation with family/home responsibilities, recreational activities, occupation/work, and sleep/rest; 13% reported a diagnosis of depression and 49% reported interference in their job. The main factors associated with disability were sex, pain intensity, and depression or depressive symptoms. CP is highly prevalent, causes high personal and social burden, and affects particularly the most vulnerable subgroups. Portugal, depending on CP definition, could be placed in the lower prevalence group in Europe. Improvement in pain intensity management and special attention to affective components of CP are recommended. In this cross-sectional nationwide epidemiological study, we showed that chronic pain is a significant problem that is present in 37% of the Portuguese adult general population, is associated with high personal, family, and social burden, and affects in particular the most vulnerable subgroups of the population. Copyright © 2012 American Pain Society. Published by Elsevier Inc. All rights reserved.
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              Practical management of opioid rotation and equianalgesia

              Purpose To review the recent literature on opioid rotation (ie, switching from one opioid drug to another or changing an opioid’s administration route) in cancer patients experiencing severe pain and to develop a novel equianalgesia table for use in routine clinical practice. Methods The MEDLINE database was searched with terms “cancer pain,” “opioid rotation,” “opioid switching,” “opioid ratio,” “opioid conversion ratio,” and “opioid equianalgesia” for the major opioids (morphine, oxycodone, fentanyl, and hydromorphone) and the intravenous, subcutaneous, oral, and transdermal administration routes. Selected articles were assessed for the calculated or cited opioid dose ratio, bidirectionality, and use of the oral morphine equivalent daily dose or a direct drug-to-drug ratio. Results Twenty publications met our selection criteria and were analyzed in detail. We did not find any large-scale, prospective, double-blind randomized controlled trial with robust design, and most of the studies assessed relatively small numbers of patients. Bidirectionality was investigated in seven studies only. Conclusion The updated equianalgesic table presented here incorporates the latest data and provides information on bidirectionality. Despite the daily use of equianalgesic tables, they are not based on high-level scientific evidence. More clinical research is needed on this topic.
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                Author and article information

                Journal
                ofil
                Revista de la OFIL
                Rev. OFIL·ILAPHAR
                Organización de Farmacéuticos Ibero-Latinoamericanos (Madrid, Madrid, Spain )
                1131-9429
                1699-714X
                2020
                : 30
                : 4
                : 363-364
                Affiliations
                [1] Covilhã orgnameFarmácia Covilhã Portugal
                [2] Caria orgnameFarmácia Central Portugal
                Article
                S1699-714X2020000400020 S1699-714X(20)03000400020
                10.4321/s1699-714x2020000400020
                d71fafcd-ac43-437a-bbee-5f015d5e2a89

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 02 February 2019
                : 28 February 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 9, Pages: 2
                Product

                SciELO Spain


                analgesia,analgésico,Portugal,Opioid,pain,analgesic,Opioide,dor
                analgesia, analgésico, Portugal, Opioid, pain, analgesic, Opioide, dor

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