Pharmacology of Opioids

OpioidsOpioids are the most effective analgesic used to manage acute and chronic painChronic pain. In general, the selection of opioids should be reserved for patients with acute moderate-to-severe postoperative pain or chronic malignant pain. It is anticipated that non-opioid therapy will not provide adequate treatment. When deciding which type of opioid is most appropriate for patients, one should consider the route of administration, pharmacokineticsPharmacokinetics/pharmacodynamicsPharmacodynamics, patient’s comorbidities, patient’s individual needs, and most importantly, the clinical risk and benefits. For this, the fundamental understanding of the clinical pharmacologyPharmacology of opioidsOpioids is paramount since opioids are associated with short- and long-term adverse events, including tolerance, addiction, and misuse. Opioid-based analgesia does not have a dose-related ceiling effect, but rather the severity of adverse events limits the escalation dose. Therefore, individual titration and combination with non-opioid analgesia should be considered to maximize the analgesic effect of opioids while reducing their adverse effects.