How do opioids work in dyspnoea?

Małgorzata Krajnik; Zbigniew Żylicz; Anna Adamczyk

Vol 2, No 3 (2003): Polish Palliative Medicine

Artykuły poglądowe

Published online: 2003-05-29

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How do opioids work in dyspnoea?

Małgorzata Krajnik, Zbigniew Żylicz, Anna Adamczyk

Advances in Palliative Medicine 2003;2(3):183-190.

Vol 2, No 3 (2003): Polish Palliative Medicine

Artykuły poglądowe

Published online: 2003-05-29

Abstract

Opioids are commonly used to treat dyspnoea in advanced cancer. The place of opioids for COPD patients in dyspnoea is still discussed. Morphine is an opioid of choice for treatment of breathlessness. Its efficacy mostly depends on reduction of the ventilatory response to hypercapnia, hypoxia and exercise. Other mechanisms due to the action on opioid receptors in alveoli, in the wall of trachea and bronchi, systemic venodilatation, analgesia, or reduction of enhanced peripheral chemosensitivity, may be also important in specific clinical situations. Recent systematic review concluded that oral and parenteral but not nebulised opioids improved breathlessness.