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Opioids for refractory dyspnea.

Donald A Mahler1

  • 1Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA. donald.a.mahler@hitchcock.org

Expert Review of Respiratory Medicine
|April 4, 2013
PubMed
Summary
This summary is machine-generated.

Opioids can help manage refractory dyspnea, a persistent breathing difficulty. Low, titrated doses are recommended, but further research is needed to optimize their use.

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Area of Science:

  • Pulmonary Medicine
  • Pharmacology

Background:

  • Refractory dyspnea is persistent breathing difficulty unresponsive to standard treatments.
  • Opioid receptors are involved in modulating the perception of breathlessness.

Purpose of the Study:

  • To explore the role of opioids in managing refractory dyspnea.
  • To discuss proposed mechanisms of opioid action and clinical application.

Main Methods:

  • Literature review of opioid mechanisms and clinical use in dyspnea.
  • Discussion of proposed pathways including central and peripheral effects.

Main Results:

  • Opioids, both endogenous and exogenous, modulate dyspnea perception via opioid receptors.
  • Mechanisms include decreased respiratory drive, altered central perception, peripheral lung effects, and reduced anxiety.

Conclusions:

  • Opioid therapy for refractory dyspnea requires careful initial low-dose titration based on patient-reported outcomes.
  • Further research is essential to address clinical uncertainties and explore genetic factors for personalized treatment.