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Opioid Analgesia and Opioid-Induced Adverse Effects: A Review

Opioids are widely used as therapeutic agents against moderate to severe acute and chronic pain. Still, these classes of analgesic drugs have many potential limitations as they induce analgesic tolerance, addiction and numerous behavioural adverse effects that often result in patient non-compliance....

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Autores principales: Paul, Alok K., Smith, Craig M., Rahmatullah, Mohammed, Nissapatorn, Veeranoot, Wilairatana, Polrat, Spetea, Mariana, Gueven, Nuri, Dietis, Nikolas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8620360/
https://www.ncbi.nlm.nih.gov/pubmed/34832873
http://dx.doi.org/10.3390/ph14111091
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author Paul, Alok K.
Smith, Craig M.
Rahmatullah, Mohammed
Nissapatorn, Veeranoot
Wilairatana, Polrat
Spetea, Mariana
Gueven, Nuri
Dietis, Nikolas
author_facet Paul, Alok K.
Smith, Craig M.
Rahmatullah, Mohammed
Nissapatorn, Veeranoot
Wilairatana, Polrat
Spetea, Mariana
Gueven, Nuri
Dietis, Nikolas
author_sort Paul, Alok K.
collection PubMed
description Opioids are widely used as therapeutic agents against moderate to severe acute and chronic pain. Still, these classes of analgesic drugs have many potential limitations as they induce analgesic tolerance, addiction and numerous behavioural adverse effects that often result in patient non-compliance. As opium and opioids have been traditionally used as painkillers, the exact mechanisms of their adverse reactions over repeated use are multifactorial and not fully understood. Older adults suffer from cancer and non-cancer chronic pain more than younger adults, due to the physiological changes related to ageing and their reduced metabolic capabilities and thus show an increased number of adverse reactions to opioid drugs. All clinically used opioids are μ-opioid receptor agonists, and the major adverse effects are directly or potentially connected to this receptor. Multifunctional opioid ligands or peripherally restricted opioids may elicit fewer adverse effects, as shown in preclinical studies, but these results need reproducibility from further extensive clinical trials. The current review aims to overview various mechanisms involved in the adverse effects induced by opioids, to provide a better understanding of the underlying pathophysiology and, ultimately, to help develop an effective therapeutic strategy to better manage pain.
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spelling pubmed-86203602021-11-27 Opioid Analgesia and Opioid-Induced Adverse Effects: A Review Paul, Alok K. Smith, Craig M. Rahmatullah, Mohammed Nissapatorn, Veeranoot Wilairatana, Polrat Spetea, Mariana Gueven, Nuri Dietis, Nikolas Pharmaceuticals (Basel) Review Opioids are widely used as therapeutic agents against moderate to severe acute and chronic pain. Still, these classes of analgesic drugs have many potential limitations as they induce analgesic tolerance, addiction and numerous behavioural adverse effects that often result in patient non-compliance. As opium and opioids have been traditionally used as painkillers, the exact mechanisms of their adverse reactions over repeated use are multifactorial and not fully understood. Older adults suffer from cancer and non-cancer chronic pain more than younger adults, due to the physiological changes related to ageing and their reduced metabolic capabilities and thus show an increased number of adverse reactions to opioid drugs. All clinically used opioids are μ-opioid receptor agonists, and the major adverse effects are directly or potentially connected to this receptor. Multifunctional opioid ligands or peripherally restricted opioids may elicit fewer adverse effects, as shown in preclinical studies, but these results need reproducibility from further extensive clinical trials. The current review aims to overview various mechanisms involved in the adverse effects induced by opioids, to provide a better understanding of the underlying pathophysiology and, ultimately, to help develop an effective therapeutic strategy to better manage pain. MDPI 2021-10-27 /pmc/articles/PMC8620360/ /pubmed/34832873 http://dx.doi.org/10.3390/ph14111091 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Paul, Alok K.
Smith, Craig M.
Rahmatullah, Mohammed
Nissapatorn, Veeranoot
Wilairatana, Polrat
Spetea, Mariana
Gueven, Nuri
Dietis, Nikolas
Opioid Analgesia and Opioid-Induced Adverse Effects: A Review
title Opioid Analgesia and Opioid-Induced Adverse Effects: A Review
title_full Opioid Analgesia and Opioid-Induced Adverse Effects: A Review
title_fullStr Opioid Analgesia and Opioid-Induced Adverse Effects: A Review
title_full_unstemmed Opioid Analgesia and Opioid-Induced Adverse Effects: A Review
title_short Opioid Analgesia and Opioid-Induced Adverse Effects: A Review
title_sort opioid analgesia and opioid-induced adverse effects: a review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8620360/
https://www.ncbi.nlm.nih.gov/pubmed/34832873
http://dx.doi.org/10.3390/ph14111091
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