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Zeitschrift für Palliativmedizin 2008; 9(4): 219-237
DOI: 10.1055/s-0028-1090095
CME-Fortbildung

© Georg Thieme Verlag KG Stuttgart · New York

Durchbruchschmerzen

Epidemiologie, Charakteristik und Therapie unter Berücksichtigung verschiedener Applikationsformen starker OpioideBreakthrough PainEpidemiological Basis, Clinical Characteristics and Therapeutic Options with Regard to Modes of Application of Highly Potent OpioidsF.  Nauck, N.  Eulitz, A.  Geyer, B.  Alt-Epping
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Publication History

Publication Date:
28 November 2008 (online)

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Zusammenfassung

Mit der hier vorliegenden CME-zertifizierten Fortbildung soll ein Überblick über die Epidemiologie, die charakteristischen Merkmale und die Therapie der Durchbruchschmerzen gegeben werden. Obwohl Durchbruchschmerzen in den meisten Fällen am selben Ort wie der Dauerschmerz auftreten und ihnen die gleichen pathophysiologischen Abläufe zugrunde liegen, stellt ihre medikamentöse Therapie andere Herausforderungen an die verwendeten Substanzen und deren Applikationsformen. Während die Therapie des Dauerschmerzes im Idealfall auf der regelmäßigen Einnahme eines ausreichend dosierten retardierten Opioidpräparates beruht, bedarf die Behandlung von Durchbruchschmerzen hochwirksamer, rasch wirkender und rasch wieder abflutender Zubereitungen. Daher sind die verschiedenen, teilweise neu entwickelten Applikationsformen der Opioidbedarfsmediaktion ein Schwerpunkt dieser Fortbildung.

Abstract

This CME certified article will review the epidemiological basis, clinical characteristics and therapeutic options of breakthrough pain. Although breakthrough pain refers to the same clinical locations like the underlying chronic pain in most instances and although their pathophysiological processes are comparable, breakthrough pain therapy will require substances with extraordinary pharmacological characteristics and routes of application. Whilst chronic pain therapy consists ideally on a steady intake of prolonged released opioids, aiming at constant, sufficiently high substance levels, breakthrough pain therapy relies on highly potent, rapidly and shortly acting formulations. Therefore, the spectrum of different formulations and modes of application and their recent developments are of special emphasis in this article.

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Prof. Dr. Friedemann Nauck

Direktor Abteilung Palliativmedizin, Zentrum Anästhesiologie Rettungs- und Intensivmedizin, Georg-August-Universität Göttingen

Robert Koch-Straße 40

37075 Göttingen

Email: Friedemann.Nauck@med.uni-goettingen.de

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