Posted by ed_uk on June 22, 2005, at 18:03:44
In reply to bupe, posted by Chairman_MAO on June 22, 2005, at 15:52:22
Hi Chair,
>Buprenorphine is useless for chronic pain, mostly, due to its "ceiling effect".
It's sometimes useful for patients who only require low opioid doses.
>Moreover, it stimulates the ORL1 receptor, which significantly undermines the analgesia induced by its partial mu-agonistic action.
True :-(
Here's some info about the Transtec patch.......
Expert Rev Neurother. 2005 May;5(3):315-23.
Transdermal buprenorphine in the treatment of chronic pain.
Sittl R.
University of Erlangen, Pain Clinic, Krankenhausstr, 91054 Erlangen, Germany. Reinhard.Sittl@kfa.imed.uni-erlangen.de
The transdermal matrix patch formulation of buprenorphine has been shown to be effective in managing moderate-to-severe cancer pain and severe pain unresponsive to nonopioid analgesics. Clinical trials have revealed that it is possible to switch from weak opioids or low doses of step III opioids to transdermal buprenorphine without any problems. With buprenorphine patches, the sublingual buprenorphine intake was dose-dependently reduced and was superior to placebo in this respect. The proportion of responders increased with the buprenorphine dose, and a higher proportion of patients receiving buprenorphine patches reported uninterrupted sleep for longer than 6 h compared with those receiving placebo. In a long-term, open, follow-up study in which the mean duration of treatment was 7.5 months, analgesia was rated as at least satisfactory by 90% of patients. Almost 60% of patients could manage their pain with one patch alone or with one additional sublingual tablet a day during the whole period of treatment, indicating a low incidence of tolerance development. The buprenorphine transdermal patch was assessed as user friendly by 94.6% of patients. In a postmarketing surveillance study, pain relief with transdermal buprenorphine was rated as good or very good by 70% of the responders. Postmarketing surveillance studies have shown that transdermal buprenorphine is also effective in the management of nociceptive and neuropathic pain, which some studies have shown to be relatively insensitive to mu-opioid analgesics, such as morphine. Transdermal buprenorphine was well tolerated. Most adverse events were either local reactions to the patch that generally subsided within 24 h or systemic events typical of treatment with opioid analgesics, such as nausea, vomiting and constipation.
~Ed
poster:ed_uk
thread:5053
URL: http://www.dr-bob.org/babble/20050622/msgs/517197.html