{"title":"Complications of opiate pharmacotherapy","authors":"Peter R. Wilson MBBS, PhD","doi":"10.1016/j.spmd.2004.09.007","DOIUrl":null,"url":null,"abstract":"<div><p><span><span>Opioid therapy, both short- and long-term, has potential adverse effects related to: (1) occupancy of opioid receptors in the nociceptive system: analgesia (antinociception), biochemical tolerance, physical dependence and </span>hyperalgesia<span>; (2) occupancy of other opioid receptors—gastrointestinal slowing/constipation, nausea and vomiting, respiratory depression<span>, pruritus, reward behaviors, immunosuppression; (3) effects on cognitive and </span></span></span>psychomotor function<span>, sleep; (4) metabolic by-products (morphine-6-glucuronide, normeperidine); (5) drug interaction, especially with other centrally active agents; (6) method of delivery; and (7) social and legal factors. Management of complications is based on: (1) dose reduction of opioid; (2) optimization of adjuvants; (3) symptomatic management of adverse effects; (4) opioid rotation; and (5) switching route of administration.</span></p></div>","PeriodicalId":101158,"journal":{"name":"Seminars in Pain Medicine","volume":"2 4","pages":"Pages 228-232"},"PeriodicalIF":0.0000,"publicationDate":"2004-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.spmd.2004.09.007","citationCount":"4","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Seminars in Pain Medicine","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1537589704000813","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 4
Abstract
Opioid therapy, both short- and long-term, has potential adverse effects related to: (1) occupancy of opioid receptors in the nociceptive system: analgesia (antinociception), biochemical tolerance, physical dependence and hyperalgesia; (2) occupancy of other opioid receptors—gastrointestinal slowing/constipation, nausea and vomiting, respiratory depression, pruritus, reward behaviors, immunosuppression; (3) effects on cognitive and psychomotor function, sleep; (4) metabolic by-products (morphine-6-glucuronide, normeperidine); (5) drug interaction, especially with other centrally active agents; (6) method of delivery; and (7) social and legal factors. Management of complications is based on: (1) dose reduction of opioid; (2) optimization of adjuvants; (3) symptomatic management of adverse effects; (4) opioid rotation; and (5) switching route of administration.
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