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Pharmacological Strategies for Decreasing Opioid Therapy and Management of Side Effects from Chronic Use

As awareness increases about the side effects of opioids and risks of misuse, opioid use and appropriate weaning of opioid therapies have become topics of significant clinical relevance among pediatric populations. Critically ill hospitalized neonates, children, and adolescents routinely receive opi...

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Autores principales: D’Souza, Genevieve, Wren, Anava A., Almgren, Christina, Ross, Alexandra C., Marshall, Amanda, Golianu, Brenda
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306833/
https://www.ncbi.nlm.nih.gov/pubmed/30563157
http://dx.doi.org/10.3390/children5120163
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author D’Souza, Genevieve
Wren, Anava A.
Almgren, Christina
Ross, Alexandra C.
Marshall, Amanda
Golianu, Brenda
author_facet D’Souza, Genevieve
Wren, Anava A.
Almgren, Christina
Ross, Alexandra C.
Marshall, Amanda
Golianu, Brenda
author_sort D’Souza, Genevieve
collection PubMed
description As awareness increases about the side effects of opioids and risks of misuse, opioid use and appropriate weaning of opioid therapies have become topics of significant clinical relevance among pediatric populations. Critically ill hospitalized neonates, children, and adolescents routinely receive opioids for analgesia and sedation as part of their hospitalization, for both acute and chronic illnesses. Opioids are frequently administered to manage pain symptoms, reduce anxiety and agitation, and diminish physiological stress responses. Opioids are also regularly prescribed to youth with chronic pain. These medications may be prescribed during the initial phase of a diagnostic workup, during an emergency room visit; as an inpatient, or on an outpatient basis. Following treatment for underlying pain conditions, it can be challenging to appropriately wean and discontinue opioid therapies. Weaning opioid therapy requires special expertise and care to avoid symptoms of increased pain, withdrawal, and agitation. To address this challenge, there have been enhanced efforts to implement opioid-reduction during pharmacological therapies for pediatric pain management. Effective pain management therapies and their outcomes in pediatrics are outside the scope of this paper. The aims of this paper were to: (1) Review the current practice of opioid-reduction during pharmacological therapies; and (2) highlight concrete opioid weaning strategies and management of opioid withdrawal.
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spelling pubmed-63068332019-01-02 Pharmacological Strategies for Decreasing Opioid Therapy and Management of Side Effects from Chronic Use D’Souza, Genevieve Wren, Anava A. Almgren, Christina Ross, Alexandra C. Marshall, Amanda Golianu, Brenda Children (Basel) Review As awareness increases about the side effects of opioids and risks of misuse, opioid use and appropriate weaning of opioid therapies have become topics of significant clinical relevance among pediatric populations. Critically ill hospitalized neonates, children, and adolescents routinely receive opioids for analgesia and sedation as part of their hospitalization, for both acute and chronic illnesses. Opioids are frequently administered to manage pain symptoms, reduce anxiety and agitation, and diminish physiological stress responses. Opioids are also regularly prescribed to youth with chronic pain. These medications may be prescribed during the initial phase of a diagnostic workup, during an emergency room visit; as an inpatient, or on an outpatient basis. Following treatment for underlying pain conditions, it can be challenging to appropriately wean and discontinue opioid therapies. Weaning opioid therapy requires special expertise and care to avoid symptoms of increased pain, withdrawal, and agitation. To address this challenge, there have been enhanced efforts to implement opioid-reduction during pharmacological therapies for pediatric pain management. Effective pain management therapies and their outcomes in pediatrics are outside the scope of this paper. The aims of this paper were to: (1) Review the current practice of opioid-reduction during pharmacological therapies; and (2) highlight concrete opioid weaning strategies and management of opioid withdrawal. MDPI 2018-12-05 /pmc/articles/PMC6306833/ /pubmed/30563157 http://dx.doi.org/10.3390/children5120163 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
D’Souza, Genevieve
Wren, Anava A.
Almgren, Christina
Ross, Alexandra C.
Marshall, Amanda
Golianu, Brenda
Pharmacological Strategies for Decreasing Opioid Therapy and Management of Side Effects from Chronic Use
title Pharmacological Strategies for Decreasing Opioid Therapy and Management of Side Effects from Chronic Use
title_full Pharmacological Strategies for Decreasing Opioid Therapy and Management of Side Effects from Chronic Use
title_fullStr Pharmacological Strategies for Decreasing Opioid Therapy and Management of Side Effects from Chronic Use
title_full_unstemmed Pharmacological Strategies for Decreasing Opioid Therapy and Management of Side Effects from Chronic Use
title_short Pharmacological Strategies for Decreasing Opioid Therapy and Management of Side Effects from Chronic Use
title_sort pharmacological strategies for decreasing opioid therapy and management of side effects from chronic use
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306833/
https://www.ncbi.nlm.nih.gov/pubmed/30563157
http://dx.doi.org/10.3390/children5120163
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