[Drug application forms in chronic pain therapy]
1Abteilung Innere Medizin VI, Klinische Pharmakologie und Pharmakoepidemiologie, Medizinische Klinik (Krehl-Klinik), Universitätsklinikum Heidelberg, Heidelberg. thilo.bertsche@med.uni-heidelberg.de
Abstract:
The choice of the appropriate application form is a critical prerequisite to ensure therapeutic success in pain therapy. Tablets, capsules, and oral liquids are the classical application forms. Slow release formulas have optimized the therapy of chronic pain and offer the possibility of an oral basic medication with only two applications a day. Transdermal delivery systems of highly effective opioids offer particular advantages in chronic and stable pain conditions. Oromucosal delivery systems are an option for a rapidly effective rescue medication, while suppositories are not an application form of first choice because of their low acceptance by the patients and poorly reproducible bioavailability. PCA (patient controlled analgesia) needs to be reserved for patients lacking other therapeutic options. For many of those application forms specific information about prescription and application is needed to ensure good therapeutic results.
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