Opioid use in palliative care: new developments and guidelines

Bemand‐Qureshi, Lucy; Gishen, Faye; Tookman, Adrian

doi:10.1002/psb.1755

Cited by 4 publications

(6 citation statements)

References 2 publications

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“…There are some myths and misconceptions about morphine and other opioids, for instance that they cause addiction or hasten death ( 8 ). A properly titrated dose of morphine does not cause respiratory depression, the most concerning side effect of opioid drugs.…”

Section: Discussionmentioning

confidence: 99%

Ethics and palliative care: a case of patient’s autonomy

Tahmasebi¹

2023

jmehm

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Section: Discussionmentioning

confidence: 99%

Ethics and palliative care: a case of patient’s autonomy

Tahmasebi¹

2023

jmehm

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“…General strategies for avoiding or reducing the incidence and severity of side effects include dose reduction, opioid rotation, changing the route of administration, and symptomatic management, although not all strategies apply to all side effects [2, 17,18]. Opioid-related adverse effects are discussed below, and those for which frequencies have been reported are shown in Table 1.…”

Section: Management Of Opioid-related Adverse Effectsmentioning

confidence: 99%

“…Methadone is known to prolong the QT interval with standard dosing [18,44] through its inhibition of the cardiac potassium ion channel, KCNH2, to block the rapid delayed rectifier potassium current [45]. The management of patients initiating methadone involves careful monitoring and adherence to expert guidelines to reduce the risk of torsade de pointes [17,45].…”

Section: Cardiac Effectsmentioning

confidence: 99%

Safe Management of Adverse Effects Associated with Prescription Opioids in the Palliative Care Population: A Narrative Review

Zimmerman,

Laitman

2024

JCM

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In the palliative care population, prescription opioids are often considered viable pain relief options. However, in this complex patient population, the adverse effects of opioid medications should be identified and managed without delay. Common adverse effects can include constipation, nausea, somnolence, dizziness, vomiting, and pruritus. Less common adverse effects can include potentially lethal respiratory depression and cardiovascular effects. Critical aspects of safe opioid prescribing are recognition of side effects and knowledge of effective management strategies; prompt management is necessary for uninterrupted pain relief. Most complications are managed with general approaches such as dose reduction, opioid rotation, alternate routes of administration, and symptomatic management. The only opioid-induced complication for which US Food and Drug Administration-approved treatments currently exist is constipation. Treating laxative-refractory opioid-induced constipation (OIC) with peripherally acting mu-opioid receptor antagonists (PAMORAs), which block gastrointestinal opioid receptors, can restore gastrointestinal motility and fluid secretion. This narrative review discusses key complications of prescription opioid treatment and their management in the palliative care setting.

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“…Although there is no evidence that the use of opioids for the management of cancer pain negatively impacts survival, it remains a subject of intense discussion. Concern over opioids' side effects and the common practice of prescribing morphine to dying patients, 11 explains why opioids are often misconstrued as the cause of death. Studies demonstrate that good pain management is beneficial for sleep and appetite, and as a consequence, improves the quality of life and even survival.…”

Section: Hastening Deathmentioning

confidence: 99%