Farmakološki modaliteti liječenja karcinomske boli

master's thesis

• Title (english): Pharmacological modalities of cancer pain treatment
• Author: Lorena Imširović
• Mentor: Petra Turčić (mentor)
• Mentor: Jasminka Peršec (mentor)
• Committee member: Petra Turčić (predsjednik povjerenstva)
• Committee member: Jasminka Peršec (član povjerenstva)
• Committee member: Valerije Vrček (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Department of pharmacology); Zagreb
• Defense date and country: 2025-02-28, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Karcinomska bol najsloženiji i najteži je simptom karcinoma i značajno utječe na kvalitetu života pacijenata. Naglasak je na razumijevanju patofiziološke podloge karcinomske boli kao i njezinoj klasifikaciji kako bi se mogla odrediti učinkovita i sigurna farmakoterapija. Za kontrolu karcinomske boli koriste se različite farmakološke skupine lijekova. Paracetamol i nesteroidni protuupalni lijekovi predstavljaju prvi liniju liječenja. Tramadol i tapentadol prethode terapiji opioidima. Opioidi se smatraju zlatnim standardom liječenja karcinomske boli, naglasak je na titraciji doze i sprječavanju pojave nuspojava. Adjuvanti, antidepresivi, antikonvulzivi i kortikosteroidi, koriste se kada opioidi nisu učinkoviti, najčešće kod neuropatske boli ili za pojačavanje analgetskog učinka neopioida i opioida. Ketamin se primjenjuje kod boli koja se ne može kontrolirati drugim terapijskim opcijama. Medicinski kanabinoidi dodatak su drugim propisanim analgeticima, djeluju na neuropatsku komponentnu. Kombinacija lijekova različitog mehanizma djelovanja povećava analgetski učinak svakog pojedinog lijeka, sa smanjenjem učestalosti nuspojava zbog primjene nižih doza lijekova. Uz karcinomsku bol veže se i probijajuća bol koja se kontrolira optimizacijom osnovne analgezije uz primjenu specifične terapije za liječenje probijajuće boli. Cilj liječenja karcinomske boli je očuvati dostojanstvenu kvalitetu života pacijenata do samog kraja.

Abstract (english)

Cancer pain is the most complex and severe symptom of cancer, significantly affecting the quality of life of patients. Emphasis is placed on understanding the pathophysiological basis of cancer pain as well as its classification to enable the determination of effective and safe pharmacotherapy. Various pharmacological groups of drugs are used for the control of cancer pain. Paracetamol and nonsteroidal anti-inflammatory drugs represent the first line of treatment. Tramadol and tapentadol precede opioid therapy. Opioids are considered the gold standard for the treatment of cancer pain, with focus on dose titration and preventing the occurrence of side effects. Adjuvants, antidepressants, anticonvulsants, and corticosteroids are used when opioids are ineffective, most commonly in neuropathic pain or to enhance the analgesic effect of non-opioid and opioid analgesics. Ketamine is used for pain that cannot be controlled by other therapeutic options. Medical cannabinoids are an addition to other prescribed analgesics and act on the neuropathic component. The combination of drugs with different mechanisms of action increases the analgesic effect of each individual drug while reducing the frequency of side effects by applying lower doses of each medication. Along with cancer pain, breakthrough pain is often present and is controlled by optimizing the basic analgesia, with the application of specific therapies for treating breakthrough pain. The goal of cancer pain treatment is to preserve the dignified quality of life of patients until the end.

• Keywords: bol; karcinom; karcinomska bol; farmakoterapija; NSAIL; opioidi; paracetamol; tramadol; tapentadol; adjuvantni lijekovi; kortikosteroidi; antidepresivi; antikonvulzivi; ketamin; kanabinoidi
• Keywords (english): pain; cancer; cancer pain; pharmacotherapy; NSAIDs; opioids; paracetamol; tramadol; tapentadol; adjuvant drugs; corticosteroids; antidepressants; anticonvulsants; ketamine; cannabinoids
• Language: croatian
• URN:NBN: urn:nbn:hr:163:619825
• Study programme: Title: Pharmacy - integrated undergraduate and graduate - university study; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: sveučilišni magistar farmacije (sveučilišni magistar farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2025-04-02 13:02:46