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阿片类镇痛药的不良反应:硬币的另一面。

Opioid Analgesics Adverse Effects: The Other Side of the Coin.

机构信息

Main Regional Center for Pain Relief and Supportive/palliative Care, La Maddalena Cancer Center, Palermo, Italy.

出版信息

Curr Pharm Des. 2019;25(30):3197-3202. doi: 10.2174/1381612825666190717152226.

Abstract

BACKGROUND

Opioids are the cornerstone of the management of cancer pain. However, the development of adverse effects may compromise the opioid response. They include nausea and vomiting, constipation, drowsiness, sleep disorders, cognitive dysfunction, myoclonus, pruritus, dysuria, dependence and the development of aberrant behaviors, respiratory depression, and some endocrine responses.

METHODS

The goal of this paper is to identify the most common opioid-related adverse effects, their pathophysiology, and proposing the possible treatments. This narrative review will describe how these adverse effects may develop and how to prevent or to treat.

CONCLUSION

Intensity of adverse effects tend to decrease with continuous use. However, they may be persistent and may require symptomatic treatment or more complex treatment including alternative strategies for pain management.

摘要

背景

阿片类药物是癌症疼痛管理的基石。然而,不良反应的发展可能会影响阿片类药物的反应。这些不良反应包括恶心和呕吐、便秘、嗜睡、睡眠障碍、认知功能障碍、肌阵挛、瘙痒、排尿困难、依赖和异常行为的发展、呼吸抑制以及一些内分泌反应。

方法

本文的目的是确定最常见的阿片类药物相关不良反应、它们的病理生理学,并提出可能的治疗方法。本叙述性综述将描述这些不良反应如何发展以及如何预防或治疗。

结论

不良反应的强度随着连续使用而降低。然而,它们可能是持续性的,可能需要对症治疗或更复杂的治疗,包括疼痛管理的替代策略。

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