Pharmaceutical pitfalls in treating patients with advanced cancer.

IF 1.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Australian Journal of General Practice Pub Date : 2025-08-01 DOI:10.31128/AJGP-10-24-7442

Taylan Gurgenci, Jones Chen, Benjamin Jull, Claire Stokes, Dominic Eu, Phillip Good

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引用次数: 0

Abstract

Background: This paper presents a collection of important topics that are not related to the other Focus papers in this AJGP issue on palliative care but are nevertheless important for clinical practice.

Objective: This article reviews the safe use of fentanyl, the proper use of buprenorphine and oxycodone-naloxone, and the potential pitfalls of equianalgesic tables.

Discussion: Sublingual and transdermal fentanyl are contraindicated in patients who are opioid-naïve. Opioid-naïve has a strict definition. Buprenorphine does not reduce the efficacy of other analgesics. Equianalgesic tables should not be followed blindly - they have many shortcomings, even if they are the best guidance we have. The benefit of combined oxycodone-naloxone products is modest in patients receiving palliative care in whom there is a higher risk of therapeutic failure and adverse effects. In summary, these are clinical topics that frequently arise when specialist input is sought but are not directly addressed in most clinical articles.

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治疗晚期癌症患者的药物缺陷。

背景：本文提出了一系列重要的主题，这些主题与AJGP关于姑息治疗的其他焦点论文无关，但对临床实践仍然很重要。目的：综述芬太尼的安全使用，丁丙诺啡和羟考酮-纳洛酮的正确使用，以及等镇痛表的潜在缺陷。讨论：舌下芬太尼和透皮芬太尼是opioid-naïve患者的禁忌。Opioid-naïve有一个严格的定义。丁丙诺啡不降低其他镇痛药的疗效。不应该盲目地遵循等镇痛表——它们有许多缺点，即使它们是我们拥有的最佳指导。在接受姑息治疗的患者中，羟考酮-纳洛酮联合用药的获益不大，这些患者有较高的治疗失败和不良反应的风险。总之，这些临床主题在寻求专家意见时经常出现，但在大多数临床文章中没有直接涉及。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Australian Journal of General Practice Medicine-Family Practice

CiteScore

2.80

自引率

4.50%

发文量

284

期刊介绍： The Australian Journal of General Practice (AJGP) aims to provide relevant, evidence-based, clearly articulated information to Australian general practitioners (GPs) to assist them in providing the highest quality patient care, applicable to the varied geographic and social contexts in which GPs work and to all GP roles as clinician, researcher, educator, practice team member and opinion leader. All articles are subject to peer review before they are accepted for publication.