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J Palliat Med. 2009 Nov;12(11):1043-50. doi: 10.1089/jpm.2009.0127.

Pharmacokinetic drug interactions in palliative care: focus on opioids.

Author information

1
Department of Psychiatry and Biobehavioral Science, David Geffen-UCLA School of Medicine, Los Angeles, California, USA.

Abstract

Opioid analgesics are crucial for pain management in most patients receiving palliative care. Contemporary models advocate for the provision of palliative care services as early as possible in a course of illness, suggesting that many patients will receive palliative care services, and opioids, concurrent with complex disease-modifying therapies. This article reviews the metabolic pathways of commonly prescribed opioid analgesics and provides a survey of what is known about how disease-modifying therapies alter the pharmacokinetics and pharmacodynamics of opioids. Existing treatment guidelines are reviewed. Practical suggestions are offered.

PMID:
19694525
DOI:
10.1089/jpm.2009.0127
[Indexed for MEDLINE]

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