New Opioid Formulations and Delivery Systems

With the exception of tramadol, there have been no new opioid compounds added to the pain management armamentarium in the last 15 to 20 years. Yet, an array of new drug formulations and delivery systems have been developed that may help further individualize analgesic regimens for those patients who have acute and chronic pain. It is important to be aware of the full range of analgesic options available to best address a patient’s specific needs. Until recently, pain management pharmacotherapies were primarily limited to short-acting opioid formulations or only those opioids with inherently longer durations of action. The development of technologies that can control the release and slow absorption of a drug to provide an extended duration of action has led to significant potential benefits for patients with chronic pain who require continuous around-the-clock analgesia. Drugs with the lowest side effect profile for each individual and a formulation that best matches the pattern of pain should be given preference. An understanding of the indications, contraindications, onset, peak, and duration of action of specific drug formulations and delivery systems, as well as differences in individual opioids, is essential for providing effective pain control. Nurses play a pivotal role in counseling and patient education, as well as the ongoing reassessments to check how the patient is actually taking the medicine, the effectiveness of the agent, and the side effects. It is critical that nurses keep up to date with information on emerging formulations and opioid delivery technologies to administer safe and effective analgesia.