Opioids
Opioid analgesics are used to relieve moderate to severe pain. They can be used in the acute setting and are also appropriate for the treatment of certain cases of persistent non-cancer pain. It is recommended that treatment is supervised by a pain specialist (physicians who have undergone additional training and gained additional expertise in pain management) and the patient is assessed at regular intervals.
Although side effects are similar across the opioid class, there are qualitative and quantitative differences in side effect profiles between opioid drugs. The most common side effects include nausea, vomiting, constipation and drowsiness.
For drug interactions, specialist literature, such as the prescribing information or Summary of Product Characteristics, should be consulted.
The dose of opioid should be titrated according to the individual's response, carefully weighing up the degree of analgesia required against the possible side effects. It should be remembered that patients' responses to opioids varies widely.
The opioid class includes:
- Buprenorphine
- Codeine
- Diamorphine
- Fentanyl
- Hydromorphone
- Methadone
- Morphine
- Oxycodone
These molecules come in a range of formulations and methods of administration. The choice of opioid will depend on a number of factors such as route of administration, duration of onset, patient pathology and any concomitant medication, physician preference and familiarity, patient preference, availability, accessibility, cost, previous analgesic/opioid history. It is paramount to treat the patient on an individualised basis and take into careful consideration patient preference and the impact that the medication regimen will have on patient lifestyle.