Opioids in chronic non cancer pain: rational and selection criteria

Abstract

The therapeutic efficacy and appearance of side effects of opioid drugs is strongly conditioned by the patient’s individual characteristics. It is impossible to know the patient’s particular pharmacogenomic connotations which determine those phenotypic expressions that make the patient more or less sensitive to the administered drug, and that also determine the presence and signifi cance of side effects. Knowledge of the patient’s hepatic opioid metabolization can aid in the choice of a more personalised therapy. To reduce the unpredictability of favourable effects and side effects, it is preferable to choose drugs that are less affected by pharmacological interactions, and that can also compromise the efficacy of the many pharmacological associations that patients undergo, especially elderly patients, who often suffer from serious organ impairments.

Keywords

• Chronic nonmalignant pain
• Hepatic opioid metabolization
• Pharmacological interactions