| Abstract [eng] |
The use and overdose of opioids have become an increasingly significant problem in Europe and worldwide in recent years. Long-term opioid therapy can lead to addiction and often results in side effects for patients. The biggest problem with opioid use is currently in the United States, but an increase in the use of these drugs is also being observed in Europe and Lithuania. Opioids act on three different types of receptors (Mu, Kappa, Delta) located in various parts of the body. Opioids can act on these receptors as agonists, antagonists, or partial agonists, resulting in either the desired effect, usually analgesia, or one of the side effects. The most common side effect of chronic opioid use is gastrointestinal dysfunction, manifested as constipation. Opioid-induced respiratory depression, is the most common cause of death due to opioid overdose. Naloxone infusion is the first-choice antagonistic treatment for life-threatening respiratory depression. Opioids can also cause upper gastrointestinal tract symptoms, most commonly nausea and vomiting. Tolerance develops due to misuse, long-term opioid use or abuse, which can be complicated by hyperalgesia. Due to a lowered pain threshold, patients take higher doses of these drugs, experience chronic pain, and their quality of life decreases, which can lead to suicidal attemps. Opioids can cause endocrinopathy by affecting the hormonal systems, with impotence being the most common manifestation in men and menstrual cycle disorders and infertility in women. Additionally, opioid preparations can cause bradycardia and Torsade de Pointes tachycardia due to parasympathetic stimulation, which results in death in approximately one in five patients with this condition In this article, we will review two clinical cases of opioid overdose, in which spontaneous detoxification occurred after stabilizing the patients' vital condition, as well as opioid-induced side effects. |
