The current literature describes the possible risks for bone fracture in chronic analgesics users. There are three main hypotheses that could explain the increased risk of fracture associated with central analgesics, such as opioids: 1) the increased risk of falls caused by central nervous system effects, including sedation and dizziness; 2) reduced bone mass density caused by the direct opioid effect on osteoblasts; and 3) chronic opioid-induced hypogonadism. The impact of opioids varies by sex and among the type of opioid used (less, for example, for tapentadol and buprenorphine). Opioid-associated androgen deficiency is correlated with an increased risk of osteoporosis; thus, despite that standards have not been established for monitoring and treating opioid-induced hypogonadism or hypoadrenalism, all patients chronically taking opioids (particularly at doses ≥100 mg morphine daily) should be monitored for the early detection of hormonal impairment and low bone mass density.

The unsolved case of “bone-impairing analgesics”. The endocrine effects of opioids on bone metabolism / Coluzzi, Flaminia; Pergolizzi, Joseph; Raffa, Robert B; Mattia, Consalvo. - In: THERAPEUTICS AND CLINICAL RISK MANAGEMENT. - ISSN 1176-6336. - ELETTRONICO. - 11:(2015), pp. 515-523. [10.2147/TCRM.S79409]

The unsolved case of “bone-impairing analgesics”. The endocrine effects of opioids on bone metabolism

COLUZZI, FLAMINIA;MATTIA, Consalvo
2015

Abstract

The current literature describes the possible risks for bone fracture in chronic analgesics users. There are three main hypotheses that could explain the increased risk of fracture associated with central analgesics, such as opioids: 1) the increased risk of falls caused by central nervous system effects, including sedation and dizziness; 2) reduced bone mass density caused by the direct opioid effect on osteoblasts; and 3) chronic opioid-induced hypogonadism. The impact of opioids varies by sex and among the type of opioid used (less, for example, for tapentadol and buprenorphine). Opioid-associated androgen deficiency is correlated with an increased risk of osteoporosis; thus, despite that standards have not been established for monitoring and treating opioid-induced hypogonadism or hypoadrenalism, all patients chronically taking opioids (particularly at doses ≥100 mg morphine daily) should be monitored for the early detection of hormonal impairment and low bone mass density.
2015
bone metabolism; chronic pain; endocrine system; fractures; OPIAD; opioids side effects; pharmacology (medical); medicine (all); pharmacology, toxicology and pharmaceutics (all); safety research; chemical health and safety
01 Pubblicazione su rivista::01a Articolo in rivista
The unsolved case of “bone-impairing analgesics”. The endocrine effects of opioids on bone metabolism / Coluzzi, Flaminia; Pergolizzi, Joseph; Raffa, Robert B; Mattia, Consalvo. - In: THERAPEUTICS AND CLINICAL RISK MANAGEMENT. - ISSN 1176-6336. - ELETTRONICO. - 11:(2015), pp. 515-523. [10.2147/TCRM.S79409]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/891235
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