Adjuvant analgesic drugs


September 6, 2013 – 11:05

Prognostic and predictive markers in colorectal cancer

Essential drugs are those drugs that satisfy the health care needs of the majority of the population; they should therefore be available at all times in adequate amounts and in the appropriate dosage forms, at a price that individuals and the community can afford.

--WHO Expert Committee on the Selection and Use of Essential Medicines

The meaning of essential drugs

The World Health Organization (WHO) Model List of Essential Drugs is a selection of a limited range of essential medicines intended to provide a high quality of care and a cost-effective use of health resources.

The WHO Essential Drugs List (EDL) has been updated every two years since 1977 by the WHO Expert Committee on the Selection and Use of Essential Medicines which includes scientists and clinicians from all regions of the world. The current version, the 12th list, dates from April 2002 and includes 325 drugs (see Resources).

Although it was not designed as a global standard, the WHO EDL has led to the global acceptance of the concept of essential medicines and as a means to promote health equity. The EDL has served as a guide for the development of national essential medicines lists which 156 countries currently have.

National lists of essential medicines are generally developed in conjunction with clinical practice guidelines to guide the training of health workers in a country. The medicines on national lists are selected on the basis of efficacy, safety and quality and after a comparison of the value they give in relation to their cost.

Essential drugs and WHO guidelines

The WHO guidelines on cancer pain, symptom control and palliative care recommend that physicians and other health professionals know how to use a few drugs well. The basic drug list recommended by WHO since the publication of the first cancer pain relief guidelines in 1986 includes: non opioids, weak opioids, strong opioids and adjuvants.

Adjuvants can be divided into those that are used to treat the side effects of opioids (e.g., antiemetics and laxatives) or to treat symptoms associated with pain (anxiolytics) and agents used to enhance pain relief (e.g., a corticosteroid for nerve compression pain).

This issue of Cancer Pain Release reviews adjuvant agents that enhance the relief of neuropathic pain and are considered essential medicines by the WHO.

The role of adjuvant analgesics


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