Respiratory Depression Associated with Opioids: A Narrative Review.

IF 3.8 2区 医学 Q2 ONCOLOGY Current Treatment Options in Oncology Pub Date : 2024-11-01 Epub Date: 2024-10-21 DOI:10.1007/s11864-024-01274-5
Mellar P Davis, Sandra DiScala, Amy Davis
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Abstract

Opinion: All opioids have a risk of causing respiratory depression and reduced cerebral circulation. Fentanyl has the greatest risk of causing both. This is particularly a concern when combined with illicit opioids such as diamorphine (also known as heroin). Fentanyl should not be used as a frontline potent opioid due its significant risks. Buprenorphine, a schedule III opioid, morphine, or hydromorphone is preferred, followed by oxycodone, which has a significant risk of abuse relative to buprenorphine and morphine. Although all opioids were equally effective in producing analgesia, the relative safety of each opioid is no longer a secondary concern when prescribing. In the face of an international opioid epidemic, clinicians need to choose opioid analgesics safely, wisely, and carefully.

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与阿片类药物相关的呼吸抑制:叙述性综述。
意见:所有阿片类药物都有导致呼吸抑制和脑循环减弱的风险。芬太尼导致这两种情况的风险最大。当与非法阿片类药物如二羟吗啡(又称海洛因)合用时,这种风险尤其令人担忧。由于芬太尼具有重大风险,因此不应将其作为一线强效阿片类药物使用。丁丙诺啡(第三类阿片)、吗啡或氢吗啡酮是首选,其次是羟考酮,相对于丁丙诺啡和吗啡,羟考酮有很大的滥用风险。尽管所有阿片类药物在产生镇痛效果方面具有同等效力,但在开处方时,每种阿片类药物的相对安全性已不再是次要考虑因素。面对阿片类药物的国际流行,临床医生需要安全、明智、谨慎地选择阿片类镇痛药。
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来源期刊
CiteScore
7.10
自引率
0.00%
发文量
113
审稿时长
>12 weeks
期刊介绍: This journal aims to review the most important, recently published treatment option advances in the field of oncology. By providing clear, insightful, balanced contributions by international experts, the journal intends to facilitate worldwide approaches to cancer treatment. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as endocrine tumors, lymphomas, neuro-oncology, and cancers of the breast, head and neck, lung, skin, gastrointestinal tract, and genitourinary region. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. We also provide commentaries from well-known oncologists, and an international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research.
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