Less Well-Known Consequences of the Long-Term Use of Opioid Analgesics: A Comprehensive Literature Review.

Background: The adverse effects of short-term opioid analgesics are well known and acknowledged; however, the spectrum of the sequelae of long-term use seems less clear. Some effects may remain undetected but still have the potential to cause harm and reduce patients' quality of life.

Objective: To review the literature on the adverse effects of long-term opioid therapy.

Paraneoplastic itch: an expert position statement from the Special Interest Group (SIG) of the International Forum on the Study of Itch (IFSI).

In clinical practice, the term "paraneoplastic itch" is used to describe itch in patients with cancer. Patients with hematological or solid tumor malignancies can be affected. In general, paraneoplastic itch is considered a rare disorder.

Dynorphin expression, processing and receptors in the alveolar macrophages, cancer cells and bronchial epithelium of lung cancer patients.

Functional evidence suggests that opioid peptides such as dynorphin are involved in the regulation of airway macrophage functions and of human cancer growth. However, anatomical evidence for components of a putative dynorphin network within lung cancer patients is scarce. Tissue from lung cancer patients was examined immunohistochemically for all components of a local dynorphin (DYN) network.

Local pulmonary opioid network in patients with lung cancer: a putative modulator of respiratory function.

Recently, there has been growing interest in the opioid regulation of physiological respiratory function. However, evidence for a local opioid network that includes endogenous opioid peptides and their receptors is scarce. Tissue samples from patients with lung cancer were examined by immunohistochemistry to identify the components of the opioid network: beta-endorphin (END); its precursor, proopiomelanocortin (POMC); the key processing enzymes prohormone convertase 1 and 2; carboxypeptidase E; and END's corresponding opioid receptor, the mu-opioid receptor (MOR).

Enkephalin, its precursor, processing enzymes, and receptor as part of a local opioid network throughout the respiratory system of lung cancer patients.

Evidence is accumulating regarding the local opioid regulation of physiologic respiratory functions. However, anatomical evidence for a local opioid network of the respiratory system is scarce. In this study, tissue samples from 12 lung cancer patients undergoing lobectomy or pneumonectomy were examined immunohistochemically for the expression of the opioid network components met-enkephalin, the respective precursor proenkephalin, the key processing enzymes prohormone convertases 1 and 2, carboxypeptidase E, and the delta opioid receptor in different areas of human lung.

Morphine inhalation by cancer patients: a comparison of different nebulization techniques using pharmacokinetic, spirometric, and gasometric parameters.

Despite numerous case reports suggesting the value of morphine (M) nebulization in the treatment of breathlessness, only a few clinical trials have been able to support this. The reason for this could lie in the lack of understanding of the localization of opioid receptors in the airways and the biopharmaceutics and pharmacokinetics of nebulized morphine. In the present study, we compared two different methods of pneumodosimetric nebulization: the Bronchial Control Treatment System-Sidestream (BCTS-S) and the Bronchial Control Treatment System-Micro Cirrus (BCTS-MC).

Air humidity may influence the aerosol distribution of normal saline administered by closed or vented nebulizers operated continuously or dosimetrically.

In clinical practice the majority of inhaled agents require deposition in the most distant regions of the bronchial tree. Contrary to this, it is likely that morphine delivery in breathlessness and chronic cough should be directed to the tracheobronchial area. The aim of the present study was to assess how an environmental condition such as air humidity might influence the particle distribution of normal saline administered by closed or vented nebulizers operated continuously or dosimetrically.

Severe pruritus of cholestasis in disseminated cancer: developing a rational treatment strategy. A case report.

Severe pruritus is a frequent complication of cholestasis. Both serotonin and opioids play an important role in the development of this symptom. Guidelines to provide rational management of pruritus of cholestasis do not exist.

What has dry cough in common with pruritus? Treatment of dry cough with paroxetine.

Distressing persistent dry cough is commonly the consequence of sensitization of the cough reflex. A slight and transient peripheral nociceptive impulse, such as bronchitis, may be perpetuated for weeks because of sensitization of the cough reflex. Cough usually can be inhibited by opioids, but some types of cough can be out of opioid control or even be induced by opioids.

Paroxetine in the treatment of severe non-dermatological pruritus: a randomized, controlled trial.

Severe pruritus may be an idiopathic phenomenon or associated with advanced systemic disease. It is one of the most distressing and difficult to treat symptoms. Uncontrolled studies have suggested that, in patients experiencing severe pruritus, paroxetine appeared to have a rapid anti-pruritic effect.