Hidromorfona: una alternativa en el tratamiento del dolor

Abstract

The analgesics opioids are one of the fundamental props in the pharmacological treatment of the moderate and severe pain, particularly in chronic oncology pain. The hydromorphone molecule is structurally very similar to morphine and it may be administered enterally or parenterally. It binds mainly to μ opioid receptors and to a lesser extent to d receptors. The binding to the μ receptor is responsible for the analgesic effect as well as for the appearance of side effects. Hydromorphone is available in 12-hour and 24-hour slowrelease presentations. A 24-hour sustained release preparation has recently come available on the market in Spain which uses the OROS push-pull system. In the treatment of the acute pain, the clinical evidence demonstrates that hydromorphone has similar analgesic equivalence to other opioids. Treatment of oncological pain has been evaluated compared to other opioids and with different formulations, demonstrating it to be a drug equivalent to morphine as regards its analgesic effectiveness and side effects. There are no controlled clinical trials on the use of hydromorphone in the treatment of chronic nononcological pain. Conclusions, hydromorphone has a pharmacological profile, analgesic properties and side effects similar to morphine, but there is still controversy as regards hydromorphonemorphine equivalent doses and the oral-parenteral dose.