Romanian Society of Pharmaceutical Sciences
 

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EVIDENCE OF STRONG OPIOID THERAPY FOR PALLIATION OF BREATHLESSNESS IN CANCER PATIENTS

ANDA-NATALIA CIUHU1*, ROXANA-ANDREEA RAHNEA-NIȚĂ2, MIHAELA POPESCU3, CRISTINEL DUMITRU BADIU4, ANCA-MIHAELA PANTEA STOIAN5, DUMITRU LUPULIASA6, FLORENTINA GHERGHICEANU6, CAMELIA CRISTINA DIACONU7, GABRIELA RAHNEA-NIȚĂ1

1.“Sf. Luca” Chronic Diseases Hospital, Department of Oncology–Palliative Care, Bucharest, Romania
2 .“Dr. Constantin Gorgos” Titan Psychiatric Hospital, Department of Oncology, Bucharest, Romania
3 .“Colentina” Clinical Hospital, Department of Haematology, Bucharest, Romania
4 .”Bagdasar Arseni” Clinical Emergency Hospital, “Carol Davila” University of Medicine and Pharmacy, Department of Surgery, Bucharest, Romania
5 .“Carol Davila” University of Medicine and Pharmacy, Department of Hygiene, 8 Eroii Sanitari Street, Bucharest, Romania
6 .“Carol Davila” University of Medicine and Pharmacyy, Faculty of Pharmacy, 8 Eroii Sanitari Street, Bucharest, Romania
7 .Internal Medicine Clinic, Clinical Emergency Hospital of Bucharest,8 Floreasca Street, Bucharest, Romania

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At the end of life, approximately one third of cancer patients experience moderate to severe breathlessness. A good control of this symptom requires non-pharmacological and pharmacological interventions, the latter being limited to bronchodilators, furosemide, steroids, and strong opioids. The role of oral, subcutaneous, or intravenous morphine has been proven to manage breathlessness since the 19th century. Highlighting the peripheral opioid receptors in the respiratory tract, the treatment with strong opioids has become the gold standard in the management of intractable breathlessness. The present research aimed to find new evidence regarding the use of strong opioids in the treatment of breathlessness, for the doses and type of opioids indicated, the concurrent drugs allowed and the influence on respiratory parameters. Questions regarding the establishment of the standard opioid dose and the efficiency of the nebulized, transmucosal or intranasal administration remained unanswered.