Iatrogenic Side Effects of Pain Therapies.
| Autor: | Gharibo C; Pain Management, NYU Langone Health, New York City, USA., Drewes AM; Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, DNK., Breve F; Pharmacy, Temple University, Philadelphia, USA., Rekatsina M; Anesthesia and Pain Management, University of Athens, Athens, GRC., Narvaez Tamayo MA; Pain Medicine, Hospital Obrero, La Paz, BOL., Varrassi G; Pain Medicine, Paolo Procacci Foundation, Rome, ITA., Paladini A; Life, Health and Environmental Sciences (MESVA), University of L'Aquila, L'Aquila, ITA. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2023 Sep 02; Vol. 15 (9), pp. e44583. Date of Electronic Publication: 2023 Sep 02 (Print Publication: 2023). |
| DOI: | 10.7759/cureus.44583 |
| Abstrakt: | Pain regimens, particularly for chronic cancer and noncancer pain, must balance the important analgesic benefits against potential risks. Many effective and frequently used pain control regimens are associated with iatrogenic adverse events. Interventional procedures can be associated with nerve injuries, vascular injuries, trauma to the spinal cord, and epidural abscesses. Although rare, these adverse events are potentially catastrophic. Pharmacologic remedies for pain must also consider potential side effects that can occur even at therapeutic doses of over-the-counter remedies such as paracetamol (acetaminophen) or nonsteroidal anti-inflammatory drugs. Opioids are effective pain relievers but are associated with many side effects, some of which can be treatment limiting. A prevalent and distressing side effect of opioid therapy is constipation. Opioid-induced constipation is caused by binding to opioid receptors in the gastrointestinal system, making conventional laxatives ineffective. Peripherally acting mu-opioid receptor antagonists are a new drug class that offers the benefits of preserving opioid analgesia without side effects in the gastrointestinal system. An important safety concern, particularly among geriatric patients is the increasingly prevalent condition of polypharmacy. Many senior patients take five or more medications, including some that may be contraindicated in geriatric patients, duplicative of other drugs, have potential pharmacokinetic drug-drug interactions, or may not be the optimal choice for the patient's age and condition. Careful assessment of medications in the elderly, including possibly deprescribing with tapering of certain drugs, may be warranted but should be done systematically and under clinical supervision. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, Gharibo et al.) |
| Databáze: | MEDLINE |
| Externí odkaz: |
|