Cic edizioni internazionali
Clinical Cases in mineral and bone metabolism

New therapeutic strategies in the management of chronic pain related to osteoporosis

Mini-Review, 41 - 42
doi: 10.11138/ccmbm/2018.15.1.041
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Abstract
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Osteoporosis inevitably accompanies the progression of age.
Chronic pain seems to have the characteristics and properties of nociceptive and sensory neuropathic pain.
The increasing use of opioids in the elderly for the treatment of osteoarticular pain is now accepted as a first choice, especially after the 2007 release of the recommen dations of the American Heart Association, which indicated “the short-term use of narcotic analgesics as the first step in pain management”.
Opioids are generally reserved for moderate or severe pain that has not responded to non-steroidal anti-inflammatory drugs. They are often used in combination with adjuvants or other analgesic agents.
The use of fentanyl is particularly indicated in cases of chronic pain with a predominantly nociceptive character.
As a transdermal patch, it is available in five different dosages. Once applied, each patch releases the drug continuously for up to 72 hours, after which it must be replaced. The proven efficacy, lack of roof effect and a favorable side-effect profile are among the key qualities of fentanyl as a treatment of moderate to severe chronic pain.
Transdermal administration is independent of food intake or intestinal absorption capacity. It is therefore ideal for patients with difficulty swallowing or with gastrointestinal disorders.
The multi-layer patch has a control membrane that allows a more regular release of the active substance, preventing the effects of overdoses from sudden emptying.
A new generation patch can be defined for the management of moderate to severe chronic pain that provides for continuous release of fentanyl at a systemic level up to 72 hours.

Vol. XV (No. 3) 2018 September - December

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