PAIN  MANAGEMENT  AND  SYMPTOM  CONTROL

​

®©

​

CANCER  PAIN  MANAGEMENT    PROGRAM  AND  NEW  ANALGESIC  CLASSIFICATION:

​

1.OPIOID

1.1 STRONG OPIOID

1.2 WEAK  OPIOID

​

2.NONOPIOID

2.1 ADJUVANT

2.2 NSAID

​

PHARMACOLOGIC  MANAGEMENT  OF  PAIN

​

OPIOID/NONOPIOID

OBJECTIVE  PAINLESS  CRITERIA

GRADE/STAGE  4

GRADE/STAGE  3

GRADE/STAGE  2

GRADE/STAGE  1

​

​

TYPES  OF  PAIN:

1. NEUROPATHIC

2. SOMATIC

3.VISCERAL

4.PSYCHOGENIC

​

CLASSIFICATION  OF  CANCER  PATIENTS   

WITH  PAIN  SYMPTOMS/SYNDROME:

MALIGNANT/

NONMALIGNANT

1) PERACUTE

(ONCOLOGIC  EMERGENCIES)

2)ACUTE

3)SUBACUTE

4)CHRONIC

​

​

ACUTE  & SUBACUTE

STAGE  1-2

PERACUTE & CHRONIC 

STAGE 3-4

​

DEPENDING  OF CANCER  PATIENT  PAIN  DEGREE  AND  CAUSATIVE  FACTORS  DEPENDING  OF  ONCOLOGIC  STAGING  SYSTEM:

STAGE 1-2-3-4  PHASES  SYSTEM  SO THAT  OBJECTIVE  OPTIMAL  PAIN  RELIEF  SUCCESSFULLY  MANAGEMENT  AND  REFUSED-CANCELLED  ALL OF  THE  SUBJECTIVE  CONCEPTS.

​

MALIGNANT & NONMALIGNANT  PATHOPHYSIOLOGICAL   RESPONSIVENESS  HAD  BEEN  "CHANGED"  NEUROPATHIC,SOMATIC,VISCERAL,PSYCHOGENIC  PAIN  CATAGORIES  AS  MECHANICAL  OR  CHEMICAL "ALL OR NONE"  PHENOMENON.

​

OPIOID  ANALGESICS  LONG HALF LIFE  AND  REPETETIVE  DOSING  ADVERSE  EFFECTS  SHOULD BE  COMPENSATION  WITH  SHORT  HALF  LIFE  OF  COUNTERPARTS  OPIOID  ANALGESICS  AS  ROTATIONAL  STYLE  METHOD.

​

OPIOID  MILD  TO  MODERATE

OPIOID  MODERATE  TO  SEVERE

​

PAIN  MEDICATION  MANAGEMENT  SYSTEM:

1)DUAL-BINARY

2)ROTATIONAL

​

​

PAIN  MANAGE  SYSTEM

1)OPIOID+NONOPIOID  STYLE

2) 2.1)OPIOID  ANALGESICS  DRUGS  GROUP  ROTATION

2.2)NONOPIOID  ANALGESICS  DRUGS  GROUP  ROTATION

​

​

​

PAIN  MANAGEMENT  ANALGESICS  DRUGS  ROUTE  OF  ADMINISTRATION:

​

1)NONOPIOID  ANALGESICS  DRUGS 

PARENTERAL + ORAL

2)OPIOID  ANALGESICS  DRUGS  PARENTERAL + ORAL  

​

PRINCIPLES:RAPID  ACTION  SHORTER  DURATION + SLOWER  ACTION    LONGER  DURATION

​

OR

COMBINED  STRATEGIES  DUAL/BINARY  ROUTE OF  ADMINISTRATION ,

INTRANASAL,

SUBLINGUAL,

BUCCAL,RECTAL,

TRANSDERMAL ETC.

​

​

CANCER  PATIENT  HAVE  MULTIPLE  SITES-PLACE OF BODY   AND TYPES

OF PAIN  HAVE  MIXED  NEUROPHATIC,

SOMATIC , VISCERAL,

PSYCHOGENIC  PAIN  SYNDROME  SHOULD BE COMBINED  MULTIPLE  THERAPY:

OPIOID+LOCAL  ANASTETIC.

​

OPIOID+ADJUVANT ETC. 

SINGLE OR REPETATING,

ALONE OR COMBINATION, TEMPORARY  OR  PERMANENT.

CLINICAL  PAIN  THERAPEUTIC  APPLICATION.

​

​

​