Abstract
In recent years, there are more frequently used new pathophysiological and pharmacological evidence for the introduction of new drugs and treatments. They are either completely new drugs or drugs already used in the new application forms.
Above all, the new molecule ziconotide, which was isolated from marine shellfish Conus Magus and has profound effects on chronic pain, which are resistant to treatment with opioids especially with morphine. Unfortunately, it has also significant side effects.
But according to current clinical experience the positive effects dominate, and therefore it is introduced into medical practice in the Czech Republic. A substance whose formation was conditioned by long-term basic research of pain receptors, particularly capsaicin receptors TRPV is 8% capsaicin, which is now used in a patch for the treatment of local pain.
It is quite an excellent treatment for postherpetic neuralgia, as well as other types of neuralgia. Its application is more complex, but very well manageable after short training.
The substances which have been already used and now appeared on the market are transmucosal fentanyls in various applications. They are primarily submucosal fentanyl tablets (transbuccal fentanyl and sublingual fentanyl tablets) and fentanyl nasal spray.
These treatment is used mainly for breakthrough pain, especially where it is not administered by other routes. There mainly useful in oncological patients and their breakthrough pain.
The article describes the pathophysiological and pharmacological mechanisms and clinical experience and possibilities for use.