Paliatívna medicína a liečba bolesti 3/2012

Possible side effects of long-term opioids therapy

Opioids are cornstone of the severe acute and chronic cancer pain treatment. The use of strong opioids for treatment of noncancer chronic pain has increased, but it has limitations of side effects. Besides well kown side efects such as nausea, vomiting, pruritus, respiratory depression, constipation, urinary retention, sedation and addiction, there are newer side effects, which are being reported with long-term opioid treatment. These side effects include tolerance, hyperalgesia, syndrom opioid-induced neurotoxicity, disturbancies in endocrine, immunologic and musculosceletal system, rarely also cardio-vascular and pulmonary system and so on. It is important to be aware of side effects of long-term opioid treatment, to diagnose them early, if it is possible to change the treatment or arrange hormons substitution in cooperation with endocrinologist.

Keywords: opioids, long-term treatment, tolerance, hyperalgesia, hypogonadism, imunosupresion.