[Opioids for refractory dyspnoea in palliation]

Area of Science:

• Palliative Care
• Respiratory Medicine
• Pharmacology

Background:

• Dyspnoea is a primary symptom in chronic obstructive lung disease and advanced cancer.
• Low-dose opioids are often used off-label to manage refractory dyspnoea.
• Evidence for efficacy and safety of low-dose opioids for dyspnoea requires comprehensive review.

Purpose of the Study:

• To review the evidence, safety, administration, and pharmacokinetics of low-dose opioids for dyspnoea.
• To assess the clinical utility of low-dose opioids in palliative care settings.
• To provide recommendations for the use of low-dose morphine in refractory dyspnoea.

Main Methods:

• Systematic literature review of studies on low-dose opioid use for dyspnoea.
• Analysis of evidence regarding efficacy, safety, pharmacokinetics, and administration routes.
• Examination of data from palliative care and chronic disease populations.

Main Results:

• Low-dose opioids demonstrate clinical efficacy in managing refractory dyspnoea.
• Evidence suggests a favorable safety profile when used appropriately.
• Pharmacokinetic data supports the use of specific administration forms.

Conclusions:

• Low-dose opioids are a viable option for managing refractory dyspnoea in palliative care.
• Further clinical studies are warranted to solidify evidence and guide practice.
• Regulatory consideration for low-dose morphine in refractory dyspnoea is recommended.