Trudności w leczeniu bólu nowotworowego – na podstawie literatury oraz 12-letnich doświadczeń Kliniki Opieki Paliatywnej w Poznaniu

Aleksandra Kotlińska-Lemieszek, Jacek Łuczak

Summary
Good pain control in cancer pain, which is experienced by 30 to 45% of patients at the time of diagnosis and by about 75% of patients with advanced disease, can be achieved in the majority of patients (85-90%) by following the commonly known principles of pharmacotherapy introduced in 1986 and 1990 by the WHO. In the remaining patients pain is termed morphine insensitive/ resistant, difficult or intractable. The main factors that may interfere with an appropriate analgesic response such as: neuropathic pain, breakthrough pain, tolerance, the fail in dose adjustment, insufficient adjuvant treatment, the appearance of intractable side-effects, pharmacokinetic and pharmacodynamic factors, as well as psychological distress and alcoholism or drug addiction, have been reviewed in the article.

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