Opioid insights:opioid-induced hyperalgesia and opioid rotation.
Opioid analgesics are an irreplaceable component of pharmacotherapy of numerous pain-producing conditions. Clinicians and patients must contend with the imperfect nature of this class of drugs, trying to balance benefits and burdens on a continual basis. New literature related to evidence-based selection of opioids and the neurobiological phenomenon of opioid induced hyperalgesia are reviewed. A matrix describing critical elements in the selection of opioid analgesics, both for initial therapy and for opioid rotation, is presented.
Fine
Perry G
PG
School of Medicine, Pain Management Center, University of Utah Health Sciences Center, Salt Lake City, UT, USA. fine@aros.net
D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D003657:Decision Making; D004334:Drug Administration Schedule; D019317:Evidence-Based Medicine; D006801:Humans; D006930:Hyperalgesia / Q000139:chemically induced*; D010166:Palliative Care
D000701:Analgesics, Opioid