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Adverse effects of systemic opioid analgesics
1Department of Pharmacology and Clinical Pharmacology, School of Medicine, University of Auckland, New Zealand.
Drug Safety
|May 1, 1992
Summary
Opioids have multiple adverse effects, primarily respiratory depression and CNS effects. However, long-term opioid use for pain management shows a good safety record with minimal addiction risks.
Area of Science:
- Pharmacology
- Clinical Medicine
- Pain Management
Background:
- Opioids are widely used for pain relief but are associated with various adverse effects.
- Understanding these effects is crucial for safe and effective clinical practice.
Purpose of the Study:
- To provide a comprehensive overview of the adverse effects of opioids.
- To evaluate the safety profile of opioids, particularly in long-term pain management.
Main Methods:
- Review of receptor-mediated effects.
- Analysis of central nervous system, cardiovascular, and gastrointestinal effects.
- Assessment of endocrine, immunological, and haematological impacts.
- Evaluation of long-term use, addiction, and withdrawal.
Main Results:
- Opioid adverse effects are diverse, including respiratory depression, CNS effects (e.g., cough suppression, nausea, vomiting, rigidity, pruritus, miosis), cardiovascular effects (histamine release-related), and gastrointestinal issues (constipation, reflux).
- Allergic reactions are rare; endocrine, immunological, and haematological effects are possible.
- Long-term use adverse effects are often overestimated, with negligible systemic toxicity and minimal tolerance development in pain management.
- Addiction and withdrawal are not significant problems in clinical pain control settings.
Conclusions:
- Opioids possess a generally good safety record when used appropriately for pain control.
- Unfounded fears should not limit opioid use; instead, focus should be on anticipating and preventing adverse effects.
- Potential effects on the unborn child warrant consideration.