Pharmacokinetics Of Tramadol lnstant Release Capsules In Patients With liver Cancer

Abstract

As cancer survival improves, the number of cancer patients with chronic pain as distinct from acute or terminal pain, increases. There are a number of reasons that patients with cancer experience chronic pain, either related to the disease itself or to its treatment, these are: •Peripheral neuropathies due to radiation, chemotherapy, tumor erosion.

•Radiation fibrosis.

•Chronic post-surgical incisional pain.

•Phantom limb pain.

•Arthropathies and muscloskeletal pain due to changes in posture or mobility. •Visceral pain due to damage to vtscera or tumor or treatment-related blockage (Ballantyne, 2003).

Cancer pain treatment following the WHO guidelines is effective and feasible. However, the evidence supporting the use of opioids for the treatment of moderate pain in the second step of the WHO analgesic ladder is widely discussed (Grond et aL, 1999).

The use of opioids is limited by their numerous, and sometimes severe, side effects (Bono and Cuffari, 1997). It was found that these side effects were more pronounced in patients with liver cancer, where the incidence of respiratory depression was higher in patients with primary liver cancer, while sedation and nausea were the main side effects noticed in