Cancer pain is often painful and unbearable for cancer patients, and pain medication also plays a very important role in cancer treatment. Many people are not very clear about how to take pain medication, so I hope the article pushed today can give you a deeper understanding of cancer pain medication.
How to take painkillers for cancer pain patients?
1.Do I have to take painkillers on time?
Patients with chronic diseases like hypertension and diabetes know that they need to take medication on time in order to control blood pressure and blood sugar well; the same goes for cancer pain, which also persists 24 hours a day, and taking medication on time is the only way to stabilize the concentration of drugs in patients’ body so as to control pain well. If the regularity is always disrupted, the concentration of drugs will be high and low, forming a vicious cycle of pain, and the pain will not be controlled even with higher doses at a later stage, so cancer pain patients must take drugs on time to keep the blood concentration stable.
2.Do I have to wait until the next medication for the outbreak of pain?
There are various types of pain in cancer patients, and it is normal to have outbreak pain. The so-called outbreak pain is a short but intense pain that occurs on top of the original stable and continuous pain. Peak effect is reached in 60 minutes.
It should be especially noted that if the patient always has painful outbreaks, it means that the painkillers that the patient has been taking on time are no longer effective for analgesia, and it is necessary to contact the doctor for adjustment.
3.If the patient mainly has pain at night, can I take the medication at night instead?
It can be considered at your discretion. However, any dose adjustment should be made under the guidance of a doctor.
4.Can patients take other drugs at the same time as painkillers?
Painkillers and other drugs can be used at the same time, but it is necessary to remind patients not to take a handful of drugs together, because many drugs have mutual reactions and even produce some toxicity, it is recommended that when patients take a variety of drugs, the time between each kind of medication is half an hour.
5.Can painkillers and sleeping pills be taken at the same time?
Yes, when used reasonably, the two drugs can play a 1+1>2 effect. For example, some patients have insomnia and toss and turn at night, and they are more sensitive to pain at this time.
6.Can patients increase the dose of pain control by themselves?
If the pain is out of control, it is possible to increase the dose of medication, but it must be done under the guidance of a doctor. For example, if a patient takes 100mg of morphine a day (2 times a day, one meal is 50mg), the increase is 20% of the dose, that is, 20mg, so now the patient takes 60mg of morphine a meal, a total of 120mg a day.
If the patient’s medication does not work after two doses, it is important to consult the doctor if there is a new problem, is the disease aggravated? Or are there other symptoms that need to be supplemented with medication? If you just add drugs, not only is the pain not well controlled, the side effects are getting worse, which is not worth the loss.
7. How to deal with patients who forget to take their medication on time?
If the patient forgets to take this medication, the one he forgot to take does not need to be specially made up. If there is an outbreak of pain, it will be treated as an outbreak of pain, and the subsequent medication will be taken on time. Many patients and their families have a good habit of recording the time of medication, its effect, and the side effects after taking the medication in detail, so that when they come to the clinic, the doctor can quickly understand the patient’s medication situation.
8.Can patients stop taking the medication by themselves? What are the consequences?
Stopping the medication without permission can cause sudden withdrawal reactions, such as profuse sweating and increased pain, which can be very uncomfortable for the patient. If the patient feels that the pain is well controlled, the doctor will help you gradually reduce the dosage and stop the medication. For example, if you are now taking 100mg of morphine, you should first reduce 20%-30%, which means you should take 70-80mg of morphine a day, and then observe for 1~3 days after the reduction.
9.What is the cost of medication? Is it reimbursable by medical insurance?
Depending on the dose, the cost of drugs is not quite the same. The daily cost of a patient using a small dose of morphine or oxycodone is generally about 20~40 RMB, and the cost of a small dose of fentanyl patch is generally about 25 RMB a day, which can be reimbursed by medical insurance. (Specific reimbursement matters are still subject to local reimbursement policies)
What are the side effects of taking painkillers for a long time?
1. What are the side effects of taking non-steroidal anti-inflammatory drugs? What should patients do?
Non-steroidal anti-inflammatory drugs can act directly on the gastrointestinal tract, so there is some damage to the mucosa of the gastrointestinal tract, and serious patients can even have gastric bleeding, so patients with a history of gastric ulcers need to be used with caution; some non-steroidal anti-inflammatory drugs (such as celecoxib), there is no gastrointestinal reaction, but its side effect is to increase the risk of cardiovascular disease; in addition, acetaminophen drugs, the liver has a certain toxicity. If patients have stomach discomfort in the course of medication, we must hurry to stop, once the stomach bleeding, according to the condition of gastrointestinal bleeding to stop bleeding treatment, or add gastric mucosal protective agents, proton pump inhibitors and other drugs to do remediation.
2.What are the adverse effects of taking opioid drugs? What should patients do?
The main side effects of opioids are constipation, nausea and vomiting, drowsiness, respiratory depression and urinary retention.
The incidence of constipation is the highest, about 80% or more, and many tumor patients are already weak in the gastrointestinal tract because they are bed-ridden and old, plus the side effects of opioids, constipation may be more serious. In order to relieve constipation, patients should go down to the ground more often, eat some fruits and vegetables that are easy to digest, and use some laxatives such as senna and lactulose.
The second type of adverse reaction is nausea and vomiting, which occurs in about 60% of patients who first start using the drug. But the nausea and vomiting caused by opioids is not caused by damage to the gastrointestinal tract, it is because opioids have a “receiver” in the vomiting center of the brain, after the drug takes effect, in addition to analgesia will also activate the vomiting center, if the patient can overcome the nausea and vomiting caused by the drug in the first two weeks of taking the drug, the later will gradually adapt to If the patient can overcome the nausea and vomiting caused by the medication in the first two weeks, the patient will gradually adapt. If necessary, antiemetic drugs such as gastrofacial and ondansetron can be added.
The most serious adverse reaction to opioid drugs is drug poisoning. Patients may experience respiratory depression in the early stage: the number of breaths slowly decreases, the breathing becomes shallow, and the amount of exhalation and inhalation becomes less, which should be handled promptly if found. There are also a very small number of patients will appear urinary retention, that is, the bladder is full of urine but can not urinate, this situation can be treated with hot compresses, acupuncture and other treatments in the bladder area.
3.Does taking medication have any other effects on the patient’s daily life?
Since these drugs are commonly used as central nervous system depressants, many patients, especially elderly patients, will experience symptoms of confusion, inattention, and even drowsiness after taking the drugs. Therefore, this group of patients must not drive or do some delicate work. In addition, I would like to remind patients that smoking and drinking are not recommended for patients with tumor. If analgesic drugs are used, drinking alcohol will lead to the decrease of liver enzyme function, which will affect the metabolism of the drugs and make the drugs accumulate in the body and produce toxicity.