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Opioid analgesia and opioid-induced adverse effects: A review

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journal contribution
posted on 2021-10-27, 00:00 authored by A K Paul, Craig SmithCraig Smith, M Rahmatullah, V Nissapatorn, P Wilairatana, M Spetea, N Gueven, N Dietis
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.

History

Journal

Pharmaceuticals

Volume

14

Issue

11

Article number

ARTN 1091

Pagination

1 - 22

Publisher

MDPI / MDPI AG (Multidisciplinary Digital Publishing Institute)

Location

Basel, Switzerland

ISSN

1424-8247

eISSN

1424-8247

Language

English

Publication classification

C1 Refereed article in a scholarly journal