Brigette Gertoberens and John Dunlop

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The Use of Opioids versus Traditional Concepts in the Treatment of Non-Cancer Pain

Managing chronic non-cancer pain states has always been a challenge and it continues to be.  The presentation will give a brief introduction into the size of the problem and the plethora of challenges health practitioners and patients are facing when dealing with chronic pain.  Pharmacological treatment is part of pain management, though effects often do not meet expectations.

NSAIDSs (Cox inhibitors) are widely used analgesics in non-malignant pain states (e.g. OA, musculoskeletal pain).   The presentation gives a refresher course for the experienced or an introduction for those who want to improve their knowledge about the pharmacology of NSAIDs.  The mode of action of Cox 1 and Cox 2 inhibitors, risks and side effects will be outlined.

Treatment with opioids is generally subject to concerns for health practitioners and for patients as well.  The mode of action of opioids, their potential risks and side effects will be shown, including opioid induced hyperalgesia.  Development of tolerance and opioid rotation will be discussed.  The talk intends to facilitate decision making about analgesic regimes and showing ways of a sensible use of opioids as an option.

Discussing the pros and cons with the audience will surely add interesting aspects.

Intended audience: Suitable for all health professionals involved in the care of chronic pain patients, but especially GP’s who are often struggling with the pharmacological regime in these patients.

Biography: Brigitte Gertoberens is a German trained Specialist Anaesthetist.  After graduating from the University of Duesseldorf Medical School in 1978, she started her training as an anaesthetic registrar and completed her training as a Specialist Anaesthetist in 1984.  Brigitte became a consultant and later, the  Clinical Director of the Anaesthetic Department in a 200 bed hospital.  A particular interest was the establishment of an acute pain service and facilities, both outpatient and inpatient, for patients with chronic pain. Following this she established a private practice specializing in chronic pain management and became one of the first Specialists to be recognized in the new specialty of Pain Medicine.  Bridget relocated to New Zealand in 1996 and works with the Auckland Regions Pain Service.

Biography:  John has extensive experience in community pharmacy, being a proprietor of a specialised service pharmacy for many years. This pharmacy did not have the traditional retailing component of community pharmacy, but specialised in prescription medicines and over-the-counter medicines and health advice.  Since 1993 John has moved out of community pharmacy, becoming principal pharmacist and then general manager of the National Preferred Medicines Centre (PreMeC).

John moved to the Pharmaceutical Society of New Zealand and became the Manager responsible for introducing Comprehensive Pharmaceutical Care® (CPC®) in 1996. This role expanded to becoming the Manager of Professional Pharmacy Development, and then General Manager of the New Zealand College of Pharmacists.

Wanting to implement the opportunities for primary care pharmacists, John formed a company, Comprehensive Pharmaceutical Solutions Ltd (CPSL) with other pharmacists who had postgraduate qualifications.

Currently, through CPSL, John works with both New Zealand’s largest Primary Health Organisation and four  smaller Primary Health Organisation of approximately 10,000 high-needs patients each,  as the Clinical Advisory Pharmacist. His role is to help general practitioners with their prescribing, undertake CPC® medication reviews, and liaise with community pharmacy, generating opportunities for them to provide enhanced services.  He is also a clinical lecturer for postgraduate students at Otago University and Auckland University.

John has a Masters in Pharmacy Practice and is currently completing his postgraduate Doctorate of Pharmacy through the University of Auckland Dept of General Practice and Primary Health Care, in the area of pharmacist prescribing for heart failure.