TY - JOUR
KW - adverse effect
KW - Aging
KW - older persons
KW - Opioids
KW - pain
KW - polypharmacy
AU - M. Prostran
AU - K. S. Vujovic
AU - S. Vuckovic
AU - B. Medic
AU - D. Srebro
AU - N. Divac
AU - R. Stojanovic
AU - A. Vujovic
AU - L. Jovanovic
AU - A. Jotic
AU - N. Cerovac
A1 - 
AB - Pain is a common symptom in older people. It is possible that pain is underreported in older persons due to an incorrect belief that it is an inevitable part of aging. Opioid analgesics are potent medications, with confirmed efficacy for the treatment of moderate to severe pain. These drugs are commonly used in older persons. However, there is insufficient evidence regarding safety of opioids in older patients. One of the reasons for this is the lack of randomized, controlled clinical trials. People of advanced age often have comorbidites and use other prescription drugs, as well as over-the-counter (OTC) compounds, thus making them more suceptible to the risk of interactions with opioids. Significant pharmacokinetic and pharmacodynamic changes that occur with advancing age increase the risk of adverse effects of opioids. There are also some discrepancies between guidelines, which recommend the use of lower doses of opioids in older patients, and the findings in the literature which suggest that pain is often undertreated in this age group. It seems that there are significant variations in the tolerability of different opioid analgesics in older people. Morphine, fentanyl, oxycodone, and buprenorphine are still the preferred evidence-based choices for add-on opioid therapy for these patients. However, the safety and efficacy of other opioids in older patients, especially if comorbidities and polypharmacy are present, is still questionable. This review addresses the most important aspects of the use of opioids in older persons, focusing on pharmacokinetics, pharmacodynamics, adverse effects, and interactions.
BT - Frontiers in aging neuroscience
C5 - Opioids & Substance Use; Healthcare Disparities
CY - Switzerland
DO - 10.3389/fnagi.2016.00144
JF - Frontiers in aging neuroscience
N2 - Pain is a common symptom in older people. It is possible that pain is underreported in older persons due to an incorrect belief that it is an inevitable part of aging. Opioid analgesics are potent medications, with confirmed efficacy for the treatment of moderate to severe pain. These drugs are commonly used in older persons. However, there is insufficient evidence regarding safety of opioids in older patients. One of the reasons for this is the lack of randomized, controlled clinical trials. People of advanced age often have comorbidites and use other prescription drugs, as well as over-the-counter (OTC) compounds, thus making them more suceptible to the risk of interactions with opioids. Significant pharmacokinetic and pharmacodynamic changes that occur with advancing age increase the risk of adverse effects of opioids. There are also some discrepancies between guidelines, which recommend the use of lower doses of opioids in older patients, and the findings in the literature which suggest that pain is often undertreated in this age group. It seems that there are significant variations in the tolerability of different opioid analgesics in older people. Morphine, fentanyl, oxycodone, and buprenorphine are still the preferred evidence-based choices for add-on opioid therapy for these patients. However, the safety and efficacy of other opioids in older patients, especially if comorbidities and polypharmacy are present, is still questionable. This review addresses the most important aspects of the use of opioids in older persons, focusing on pharmacokinetics, pharmacodynamics, adverse effects, and interactions.
PP - Switzerland
PY - 2016
SN - 1663-4365; 1663-4365
SP - 144
T1 - Pharmacotherapy of Pain in the Older Population: The Place of Opioids
T2 - Frontiers in aging neuroscience
TI - Pharmacotherapy of Pain in the Older Population: The Place of Opioids
U1 - Opioids & Substance Use; Healthcare Disparities
U2 - 27378916
U3 - 10.3389/fnagi.2016.00144
VL - 8
VO - 1663-4365; 1663-4365
Y1 - 2016
ER -