Vol 12, No 3 (2018)
Review paper
Published online: 2018-10-25
Opioids for the treatment of breathlessness. Are all opioids equally efficacious?
Palliat Med Pract 2018;12(3):151-155.
Abstract
Morfina jest uznanym lekiem do leczenia objawowego duszności w opiece paliatywnej, choć dowody na
jej działanie są ograniczone. Podana systemowo (doustnie, podskórnie i dożylnie) oraz drogą wziewną do
drzewa oskrzelowego, gdzie znajdują się receptory opioidowe, znacząco zmniejsza nasilenie duszności.
Efekt ten związany jest między innymi z obwodowym działaniem morfiny, która jest hydrofilnym opioidem.
Dowody na skuteczność w leczeniu objawowym duszności lipofilnych opioidów takich jak: fentanyl, są co
najmniej kontrowersyjne. Oprócz domniemanego działania przeciw duszności, fentanyl może spowodować
sztywność mięśni klatki piersiowej, co utrudnia oddychanie i zwiększa poczucie duszności.
Palliat Med Pract 2018; 12, 3: 151–155
Keywords: breathlessnessmorphinefentanylpathophysiology of dyspnea
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