Side effect of opioids

Co-codamol is a combination of paracetamol (nonnapioid analgesic) and codeine (opioid analgesic). One of the side-effects of opioids is constipation. Naprosyn is a proprietary (trade name) preparation of the non-steroidal antiinflammatory drug naproxen Adalat is a proprietary preparation of the calcium-channel blocker nifedipine Amoxil is a proprietary preparation of the beta-lactam amoxicillin and Dulco-lax is the brand name of the stimulant laxative bisacodyl. 

Suboxone is a combination of buprenorphine (opioid partial agonist) and naloxone. It is presented as sublingual tablets and is used as an adjunct in the treatment of opioid dependence and in premedication or perioperative analgesia. A side-effect of opioids is drowsiness. 

One of the main side-effects of opioid analgesics, such as codeine and tramadol, is constipation. Amitriptyline (tricyclic antidepressant) and orphenadrine tend to have antimuscarinic properties, resulting in side-effects such as constipation. Senna is a stimulant laxative indicated in constipation. 

Gastrointestinal side-effects of opioids are used for treatment of diarrhea... 

Nausea and emesis are common unpleasant side-effects of opioids (Campora et al., 1991 Aparasu et al., 1999). They are most intensively experienced at the beginning of the treatment. During chronic administration, tolerance may occur, which reduces the emetic sequelae. Nausea and emesis are induced via activation of chemoreceptors which are located in the trigger zone of the area postema of the formatio reticularis. The receptors are at the tissue surface and in contact with the circulating blood. Thus the emetic effect of opioids is not mediated centrally, i.e. after penetration of the blood-brain barrier, but rather peripherally via the amount of the compound, which is distributed in the circulating blood. 

Side effects typically seen when opioids are used for PCA include sedation, pruritus, and gastrointestinal problems (nausea, vomiting). The incidence of these side effects, however, is not significantly increased during PCA versus more traditional methods of opioid administration such as intermittent intramuscular dosing.18 Respiratory depression is another common side effect of opioid use, but again, there is no increased incidence of this problem when appropriate amounts... 

Cepeda MS, Farrar JT, Baumgarten M, Boston R, Carr DB, Strom BL. Side effects of opioids during short-term administration Effect of age, gender, and race. Clin Pharmacol Ther 2003 74 102-12. 

Patients on morphine and related agonists must be monitored for signs of CNS-mediated respiratory depression, which is the dose-limiting side effect of opioid agonists. 

The concerns about addiction and the potential for adverse side effects of opioid analgesics influence how the medication is administered. Patients may avoid or postpone taking pain medication until the pain is unbearable for fear of becoming addicted or developing a tolerance for the medication. This is especially true with patients who suffer chronic debilitating diseases. They realize pain increases as the disease progresses and they are fearful that the medication will lose its effectiveness. 

The most significant and concerning side effect of opioids is respiratory depression. This effect of morphine was quickly recognized, with Sertiimer himself reporting in 1827 the death of a dog he had injected with morphine. He and several human volunteers also suffered respiratory depression in the course of their experimentation [12]. 

American College of Physicians. Common side effects of opioids. In ACP Observer. American College of Physicians, 2004. 

Nausea and vomiting are common side effects of opioids and volatile anesthetics. Opioid use is identified as one of the four major anesthetic risk factors (female gender, non-smoker, history of PONV and postoperative opioids) for post-operative nausea and vomiting (PONV). It is estimated as many as one-third of... 

M6G possesses many morphine-like properties, and several preliminary studies suggest it may provide analgesia comparable to morphine with similar onset and longer duration of action. It appears to induce less nausea and respiratory suppression, two of the most troublesome side effects of opioid analgesia, than... 

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