Review article

Variability in the response to opioid therapy

Nevenka Krčevski-Škvarč ; Department of Anesthesiology, Intensive Care and Pain Treatment, University Clinical Centre Maribor, Maribor, Slovenia

Abstract

Opioids are main drugs for the treatment of moderate and severe pain. Successful opioid treatment depends on achieving a favorable balance between analgesia and adverse effects. The effective opioid dose and adverse events may vary greatly across patients. Opioid analgesic efficacy is not always sustained during continuous and long term treatment. Decreased opioid analgesic efficacy could be the main problem, which can potentially arise from multiple mechanisms. Decreased opioid analgesic efficacy can be the result of opioid tolerance, opioid–induced hyperalgesia, psychological factors and advancement of the disease. The mechanisms involved in variability in the response to opioid therapy could be the result of changes in drug pharmacology and interactions or changes in nociception because of adaptive changes and genetic constellation and mutation. It is important to distinguish the clinical manifestations of decreased opioid efficacy which differ in their mechanisms and the efforts to assure treatment efficacy.

Keywords

opioid efficacy; quality of pain; adaptive nociceptive changes; genetic factors; drug interactions

Hrčak ID:

278797

URI

https://hrcak.srce.hr/278797

Publication date:

30.11.2009.

Article data in other languages: croatian

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