Palliative treatment involves taking strong painkillers that help alleviate the patient’s condition. Oncology painkillers are different from those shown to healthy people. In the final stages of cancer, narcotic analgesics are used, affecting the centers of pain in the cerebral cortex.
Types of drugs
The choice of a drug directly depends on some indicators:
- Stage of cancer and the features of its course in a patient – the more progressive the disease, the more powerful analgesics will be needed.
- Individual features of the body – the degree of effectiveness and the likelihood of an allergic reaction are evaluated.
- Combination with other drugs in complex therapy.
A three-step staircase for anesthetizing cancer patients, recommended by WHO, is used:
- With a weak, intermittent pain – prescribe drugs group non-opioid analgesics.
- For severe persistent pain, short-lasting opioid analgesics.
- With severe pain that can trigger the development of a painful shock – prolonged exposure opioid analgesics.
The following drugs may be prescribed from the group of non-opioid analgesics in the presence of oncology:
These drugs are freely available and are applied according to the scheme prescribed by the doctor.
Degrees of pain and drugs
The choice of a drug depends on the degree of discomfort. Each patient has his own pain threshold, which is a purely individual indicator. Therefore, the doctor selects those drugs that are able to stop the pain in a particular patient.
Analgesics are prescribed from the group of NSAIDs that cope with pain, heat, and swelling. The most effective of them are:
They are used in the form of tablets, starting with the minimum dosage. The course of treatment is calculated so that the therapeutic effect is achieved when all the substances of the drug are accumulated in the body. The choice of dose depends on the age, body weight and susceptibility to allergic reactions.
Since tablets are absorbed from the digestive tract, they are taken after meals. Metabolism of the liver cells dictates the need to simultaneously take hepatoprotectors.
Enhance the effectiveness of NSAIDs can papaverine, which relieves vascular spasm and promotes the active absorption of trace elements medications.
As ancillary drugs that are prescribed to reduce the load on all organs and systems, are:
- Corticosteroids – improve the appetite and increase the analgesic effect.
- Anticonvulsants – prevent spasm of blood vessels and smooth muscles.
- Neuroleptics – suppress attacks of nausea and vomiting, increasing the analgesic effect.
Muscle relaxants of central action – relax the body, normalizing sleep.
The need to use a particular drug is due to the characteristics of the course of cancer.
Severe pain in the whole body
Non-steroidal anti-inflammatory drugs are not able to anesthetize to the desired state, therefore, weak opioid preparations containing narcotic substances are prescribed. Their principle of action is based on the impact on the centers of pain in the brain, which causes the complete absence of unpleasant sensations in the body.
Recently, the drug Tramadol has been used in the treatment of cancer patients. Now they are inclined to use the drug Zaldiar, which contains minimal doses of opioid in combination with Paracetamol, which allows to achieve a complex therapeutic effect.
The choice of method of administration
In the case when there are no problems with the gastrointestinal tract and liver, it is recommended to use tablets for oral administration. To reduce irritation of the gastric mucosa, Omeprazole is prescribed in parallel.
Injections can reduce pain in the shortest possible time. The first noticeable results appear after 3-5 minutes after administration, which is effective in acute bouts of pain.
In some cases, pain relief patches may be prescribed. They are attached to the skin, through which the process of slow absorption of the drug. The therapeutic effect is manifested in the accumulative system, when there is enough analgesic in the body.
In the presence of moderate and persistent pain, tablets can be combined with injections to achieve maximum effect. The choice of the best means and method of administration into the body depends on the recommendations of the doctor.
In the case when the opioid drug has ceased to produce the desired effect, it can be replaced by an analogue. The initial dose should be slightly lower than that used before.
If the therapeutic effect is absent completely, it is mandatory to inform the doctor about this. The treatment is adjusted and some medicines are replaced.
How to get painkillers
Nonsteroidal anti-inflammatory drugs are freely available and purchased at the pharmacy. Opioid analgesics are given on the hands only with the approval of the head of the medical unit of the polyclinic. For this, the patient or his relatives write a statement asking to give the appropriate medication. The application is signed by the attending physician, arguing the selected dosage and frequency of administration. Further, the application is considered by the head, after which the drugs are handed over to the family of the patient.
This scheme is quite long, so in some cases resort to the help of the attending physician, whose actions are based on the stepped use of medicines, given the intensity of pain. Prescription medication is carried out only once. First, inject drugs of the NSAID group, then add a small dose of Tramadol. The frequency of medication – 3 times a day.
With increasing pain, Tramadol is prescribed 2 times a day, complementing it with Paracetamol. Launched forms of the oncological process and unbearable pain dictate the need for the introduction of Fentanyl and Morphine.
In the future, the attending physician is entitled to independently prescribe the right amount of pain medicine, which is controlled by the head of the medical unit. Medicines are handed out only to relatives. Preferential queues for receiving medicines are issued through the Department of Labor and Social Protection of the Population.