Day-to-day titration to initiate transdermal fentanyl in patients with cancer pain: Short- and long-term experiences in a prospective study of 39 patients

Journal of Pain and Symptom Management

Volumn 11, Issue 3, 1996, Pages 139-146

  Korte, Wolfgang ^a,c   De Stoutz, Noémi ^b   Morant, Rudolf ^b  

^a CANTONAL HOSPITAL ST GALLEN   (Switzerland)

^b Kantonsspital St Gallen Division of Oncology Haematology   (Switzerland)

^c UNIVERSITY OF COLORADO   (United States)

Author keywords

5 fluorouracil; cancer pain; constipation; dose finding; pain control; side effects; titration; toxicity; Transdermal fentanyl

Indexed keywords

FENTANYL; FLUOROURACIL; LAXATIVE; MORPHINE;

ADULT; AGED; ANALGESIA; ARTICLE; CANCER PAIN; CANCER PALLIATIVE THERAPY; CANCER PATIENT; CLINICAL ARTICLE; CLINICAL TRIAL; CONSTIPATION; DOSIMETRY; DRUG EFFICACY; DRUG SAFETY; DYSPNEA; FEMALE; HUMAN; HYPOTENSION; MALE; NAUSEA; PATIENT MONITORING; PROSPECTIVE STUDY; RASH; RESPIRATION DEPRESSION; TRANSDERMAL DRUG ADMINISTRATION; TREATMENT OUTCOME; VERTIGO;

EID: 0029969666     PISSN: 08853924     EISSN: None     Source Type: Journal    
DOI: 10.1016/0885-3924(95)00162-X     Document Type: Article

References (22)

1. Lehmann KA, Zech D. Transdermal fentanyl: clinical pharmacology. J Pain Symptom Manage 1992;7:S8-16.
2. Zech D. Schmerztherapie auf einer Palliativstation: ein Modellversuch. In: Peter K, Groh J, eds. Reihe Anästhesiologie und Intensivmedizin, 205. ZAK München 1987, Band III - Hauptthemen. Berlin; Springer-Verlag, 1988:216-228.
3. Grond S, Zech D, Schug SA, Lynch J, Lehmann KA. Validation of World Heath Organization guidelines for cancer pain relief during the last days and hours of life. J Pain Symptom Manage 1991;6:411-422.
4. Portenoy RK, Southam MA, Gupta SK, et al. Transdermal fentanyl for cancer pain: repeated dose pharmacokinetics. Anesthesiology 1993; 78:36-43.
5. Zech DFJ, Grond SUA, Lynch J, Dauer HG, Stollenwerk B, Lehmann KA. Transdermal fentanyl and initial dose-finding with patient-controlled analgesia in cancer pain: a pilot study with 20 terminally ill cancer patients. Pain 1992;50:293-301.
6. Zech D, Gornd S, Lynch J. Clinical experience. In: Lehmann KA, Zech D, eds. Transdermal Fentanyl. Berlin: Springer-Verlag, 1991:171-187.
7. Gourlay GK, Mather LE. Pharmacokinetics and Pharmacodynamics. In: Lehmann KA, Zech D, eds. Transdermal Fentanyl. Berlin: Springer-Verlag, 1991:119-140.
8. Sandler AN, Baxter AD, Katz J, et al. A double-blind placebo-controlled trial of transdermal fentanyl after abdominal hysterectomy: analgesic, respiratory and pharmacokinetic effects. Anesthesiology 1994;81:1169-1180.
9. Korte W, Morant R. Transdermal fentanyl in uncontrolled cancer pain: titration on a day-to-day basis as a procedure for effective and safe dose finding: a pilot study in 20 patients. Support Care Center 1994;2:123-127.
10. Korte W. Titration with TTS fentanyl for previously uncontrolled cancer pain [Lipman AG, Ashburn MA, reply]. Anesth Analg 1994;79:612-614.
11. Brooks D. Day to day titration of transdermal fentanyl is unwise [Korte W, Morant R, reply]. J Support Care Cancer 1995;3:210-211.
12. Miser AW, Narang PK, Dothage JA, Young RC, Sindelar W, Miser JS. Transdermal fentanyl for pain control in cancer patients. Pain 1989;37:15-21.
13. World Health Organization. Cancer pain relief and palliative care: report of a WHO expert committee. World Health Organization Technical Report Series, 804. Geneva, Switzerland: World Health Organization.
14. Duragesic (fentanyl transdermal system) package insert.
15. Bailey PL, Stanley TH. Package inserts and other dosage guidelines are especially useful with new analgesics and new analgesic delivery systems. Anesth Analg 1992;75:873-875.
16. Ashburn MA, Lipman AG. Management of pain in the cancer patient. Anesth Analg 1993;76:402-416.
17. Scholtz M. Information on Fentanyl (Duragesic) Patches. ECOG Horizons January-March 1992;2:14-15.
18. Rose PG, Macfee MS, Boswell MV. Fentanyl transdermal system overdose secondary to cutaneous hyperthermia. Anesth Analg 1993;77:390-391.
19. Whipple JK, Ausman RK, Quebbeman EJ. Narcotic use in the hospital: reasonably safe? Ann Pharmacother 1992;26:897-901.
20. Baserga R. Principles of molecular cell biology of cancer: the cell cycle. In: DeVita VT Jr, Hellmann S, Rosenberg SA, eds. Cancer: Principles & Practice of Oncology, 4th edition. Philadelphia: JB Lippincott, 1993:60-66.
21. Moertel CG, Fleming TR, Macdonald JS, Haller DG, Laurie JA. Hepatic toxicity associated with fluorouracil plus levamisole adjuvant therapy. J Clin Oncol 1993;11:2386-2390.
22. Li Y, Looney G, Hurwitz A. Opiate effects on fluorouracil disposition in mice [abst]. FASEB 1992; 6:A992.