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Grundlagen der Palliativmedizin

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Uroonkologie

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Die Weltgesundheitsorganisation (WHO) definierte 1990 Palliativmedizin (PM) als die „umfassende und aktive Behandlung von Patienten, deren Erkrankung einer kurativen Therapie nicht mehr zugänglich ist und für die das Behandlungsziel die bestmögliche Lebensqualität für sie selbst und ihre Angehörigen ist“ und räumte ihr höchste Priorität ein. Dies konnte auch auf dem Hintergrund erheblicher Fortschritte auf dem Gebiet der Schmerztherapie (u. a. durch Einführung der oralen retardierten Opioide) und einer stetigen Weiterentwicklung evidenzbasierter Strategien zur Symptomkontrolle (z. B. Konzepte bei terminal deliranten Zuständen, nicht operablen intestinalen Obstruktionen, Atemnotsyndromen etc.) geschehen.

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Literatur

Literatur zu Kap. 12.1-12.2

  • Arzneimittelkommission der Deutschen Ărzteschaft (2000) Empfehlungen zur Tumorschmerztherapie

    Google Scholar 

  • Ballantyne J (2003) Chronic pain following treatment for cancer: the role of opioids. Oncologis 8.6: 567–575

    Article  Google Scholar 

  • Bruera E, Schoeller T, Wenk R et al. (1995) A prospective multicenter assessment of the Edmonton staging system for cancer pain. J Pain Symptom Manag 10.5: 348–355

    Article  Google Scholar 

  • Bruera E, Pereira J, Watanabe S et al. (1996) Opioid rotation in patients with cancer pain. A retrospective comparison of dose ratios between methadone, hydromorphone and morphine. Cancer 78: 852–857

    Article  PubMed  CAS  Google Scholar 

  • Caraceni A, Portenoy RK, and a working group of the IASP force on cancer pain (1999) An international survey of cancer patients characteristic and syndromes. Pain 82: 263–274

    Article  PubMed  CAS  Google Scholar 

  • Davis MP, Walsh D (2001) Methadone for relief of cancer pain: a review of pharmacokinetics, pharmacodynamics, drug interactions and protocols of administration. Support Care Cancer 9: 73–83

    Article  PubMed  CAS  Google Scholar 

  • Deutsche Interdisziplinäre Vereinigung zur Schmerztherapie (DIVS) (1999) Leitlinien zur Tumorschmerztherapie. Tumordiag Ther 20: 105–129

    Google Scholar 

  • Expert Working Group of EAPC (1996) Morphine in cancer pain: modes of administration. Br Med J 312: 823–826

    Google Scholar 

  • Expert Working Group of EAPC (2001) Morphine and alternative opioids in cancer pain: the EAPC recommandation. Br J Cancer 84: 587–593

    Article  Google Scholar 

  • Fainsinger RL, Nekolaichuk C, Lawlor P, Neumann C, Vigano A (2004) The revised Edmonton staging system for cancer pain. Palliat Med 18.4: 307

    Google Scholar 

  • Foley KM (2003) Opioids and chronic neuropathic pain N Engl J Med 348: 1279–1281

    Google Scholar 

  • Grond S, Zech D, Schug SA et al (1991) Validation of the World Health Organisation guidelines for cancer pain relief during the last days and hours of life. J Pain Sympt Manag 6/7: 411–412

    Article  CAS  Google Scholar 

  • HE L. Fong J, von Zastrow M, Whistler JL (2002) Regulation of opioid receptor trafficking and morphine tolerance by receptor oligomerisation Cell 25.108: 271–282

    CAS  Google Scholar 

  • Indelicato RA, Portenoy RK (2002) Opioid rotation in the management of refractory cancer pain. J Clin Oncol 20: 348–352

    PubMed  Google Scholar 

  • Itoh A, Noda Y, Mamiya T, Hasega. T, Nabeshima T (1998) A therapeutic strategy to prevent morphine dependence and tolerence by coadministration of cAMP-related reagents with morphine. Meth Find Exp Clin Pharmacol 20.7: 619–625

    Article  Google Scholar 

  • Lotsch J, Starke C, Grosch S et al. (2002) The polymorphism A118G of the human mu-opioid receptor gene decreases the pupil constrictory effect of morphine-6-glucuronide but not that of morphine. Pharmacogenetics 12.1: 3–9

    Article  Google Scholar 

  • Lotsch J, Zimmermann M, Darimont J et al (2002) Does the A118G polymoprhism at the mu-opioid receptor gene protect against moprhin-6-glucuronide toxicity? Anesthesiology 97.4: 814–819

    Article  Google Scholar 

  • Mao J, Backil S, RuRong J Grewo L (2002) Chronic morphine induces downregulation of spinal glutamate transporters: implications in morphine tolerance and abnormal pain sensation. J Neurosci 18: 8312–8323

    Google Scholar 

  • Menten J (2004) Opioid tolerance in advanced cancer patients: a selflimiting phenomen. Palliat Med 18.4: 310

    Google Scholar 

  • Pasternak GW (2003) Insights into the genetics of mu-opioid analgesics: lessons from the clinic. Eur J Palliat Care 10.2 (Suppl) 37–38

    Google Scholar 

  • Raith K, Hochhaus G (2003) Drugs used in the treatment of opioid tolerance and physical dependence: a review. Bull Cancer 90 (8-9) 795–806

    Google Scholar 

  • Thompson CM, Wojno H, Greiner E et al (2002) Activation of G-proteins by morphine and codeine congeners: insights to the relevance of O-and N-demethylated metabolites at mu-and delta-opioid receptors. J Pharmacol Exp Ther. 308.2: 547–554

    Google Scholar 

  • Ueda H, Inoue M. Mizuno K (2003) New approaches to study the developement of morphine tolerance and dependence. Life Sci 72: 313–320

    Article  Google Scholar 

  • Radbruch L, Loick G et al (2000) MIDOS. Elektronische Datenbank für Palliativstationen. Schmerz 214: 231–239

    Article  Google Scholar 

  • Rowbotham MC, Twillin L, Davies PS er al. (2003) Oral opioid therapy for chronic peripheral and central neuropathic pain. N Engl J Med 348: 1223–1232

    Article  PubMed  CAS  Google Scholar 

  • Tegeder I, Lotsch J, Geisslinger G (1999) Pharmacokinetics in liver disease. Clin Pharmacokinet 37.1: 17–40

    Article  Google Scholar 

  • Ventafridda V, Tamburini M, Caraceni A (1987) A validation study of the WHO method for cancer pain relief. Cancer 59: 850–856

    Article  PubMed  CAS  Google Scholar 

  • World Health Organisation. Cancer pain relief. 2nd edn. 1996. WHO, Geneva

    Google Scholar 

  • Zykicz Z: Opioids: are there any differences between them? Eur J Palliat Care 2003 Abstracts of the 8th Congress of the EAPC, p 57

    Google Scholar 

Literatur zu Kap. 12.3

  • Bennett M, Cresswell H (2003) Factors influencing constipation in advanced cancer patients: a prospective study of opioid dose, dantron dose and physical functioning. Palliat Med Jul 17(5) 418–22

    Article  Google Scholar 

  • Bruera E, Moyano JR, Sala R, Rico MA, Bosnjak S, Bertolino M, Willey J, Strasser F, Palmer JL (2004) Dexamethasone in addition to metoclopramide for chronic nausea in patients with advanced cancer: a randomized controlled trial. J Pain Symptom Manage 28(4) 381–388

    Article  PubMed  CAS  Google Scholar 

  • Davis MP, Walsh D (2000) Treatment of nausea and vomiting in advanced cancer. Support Care Cancer Nov 8(6): 444–452

    Article  CAS  Google Scholar 

  • Fine PG (2002) Analgesia issues in palliative care: bone pain, controlled release opioids, managing opioid-induced constipation and nifedipine as an analgesic. J Pain Palliat Care Pharmacother. 16(1): 93–97 Review

    Article  PubMed  Google Scholar 

  • Glare P, Pereira G, Kristjanson LJ, Stockler M, Tattersall M (2004) Systematic review of the efficacy of antiemetics in the treatment of nausea in patients with far-advanced cancer Support Care Cancer Jun 12(6): 432–40

    Google Scholar 

  • Muir JC, von Gunten CF (2001) Abdominal cancer, nausea, and vomiting. J Palliat Med Fall 4(3): 391–394

    CAS  Google Scholar 

  • Tamayo AC, Diaz-Zuluaga PA (2004) Management of opioid-induced bowel dysfunction in cancer patients. Support Care Cancer Sep; 12(9): 613–618

    Google Scholar 

  • Schwarzer A, Nauck F, Klaschik E (2003/2004) Strong opioids and constipation Schmerz 2004 Mar 5; Palliat Med 2003 Jul 17(5): 418–422

    Google Scholar 

Literatur zu Kap. 12.4

  • Ripamonti C, Fusco F (2002) Respiratory problems in advanced cancer, Support Care Cancer Apr 10(3) 204–216

    Google Scholar 

  • LeGrand SB, Khawam EA, Walsh D, Rivera NI. (2003) Opioids, respiratory function, and dyspnea. Am J Hosp Palliat Care Jan-Feb 20(1) 57–61

    Article  Google Scholar 

  • Dudgeon DJ. (2002) Managing dyspnea and cough. Hematol Oncol Clin North Am Jun 16(3) 557–77, viii

    Article  Google Scholar 

  • Booth S, Anderson H et al (2004) the use of oxygen in the palliation of breathlessness. A report of the expert working group of the scientific committee of the association of palliative care. Resp Med 98: 66–77

    Article  Google Scholar 

Literatur zu Kap. 12.5

  • Braun TC, Hagen NA, Clark T (2003) Development of a clinical practice guideline for palliative sedation. J Palliat Med 6: 345–427

    Article  PubMed  Google Scholar 

  • Chater S, Viola R, Paterson J, Jarvis (1998) Sedation for intractable distress in the dying-a survey of experts. Palliat Med 12: 255–269

    Article  PubMed  CAS  Google Scholar 

  • Cherny NI, Portenoy RK (1994) Sedation in the management of refractory symptoms: Guidelines for evaluation and treatment. J Palliat Care 10: 31–38

    PubMed  CAS  Google Scholar 

  • Materstvedt LJ, Clark D, Ellershaw J, Forde R, Gravgaard AM, Muller-Busch HC, Portai Sales J, Rapin CH. (2004) Euthanasie und ärztlich unterstützter Suizid: eine Stellungnahme der Ethics Task Force der European Association for Palliat Care. Z Palliativmed 5: 102–106

    Article  Google Scholar 

  • Müller-Busch HC (2004) Sterbende sedieren? DMW 129: 701–704

    Google Scholar 

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Authors and Affiliations

  1. Kliniken Essen-Mitte Evang, Huyssens-Stiftung Klinik für Innere Medizin IV Internistische Onkologie/Hämatologie, Henricistraße 92, 45136, Essen

    Dr. med. M. Kloke & Priv.-Doz. Dr. med. M. Stahl

  2. Innere Klinik und Poliklinik (Tumorforschung), Universitätsklinikum Essen, Hufelandstraße 55, 45122, Essen

    Dr. med. J. Hense

Authors
  1. Dr. med. M. Kloke
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  2. Dr. med. J. Hense
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  3. Priv.-Doz. Dr. med. M. Stahl
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Editors and Affiliations

  1. Universitätsklinikum Essen, Hufelandstraße 55, 45122, Essen

    Herbert Rübben (Direktor der Klinik und Poliklinik für Urologie) (Direktor der Klinik und Poliklinik für Urologie)

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Kloke, M., Hense, J., Stahl, M. (2007). Grundlagen der Palliativmedizin. In: Rübben, H. (eds) Uroonkologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-33848-2_12

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  • DOI: https://doi.org/10.1007/978-3-540-33848-2_12

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-33847-5

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