Opioids

Class at a glance

• Mu-opioid agonism → analgesia + reward

Pharmacology

• Full agonists differ mainly in PK/potency

Clinical role

• Reserve for pain when benefits exceed harms

Safety / monitoring

• Respiratory depression is lethal toxicity
• Constipation + tolerance + dependence expected
• Fentanyl/methadone have major special risks
• Do not equate physical dependence with OUD

Pearls

• Opioids: tolerance to sedation and nausea, not constipation
• Opioid hyperalgesia: reduce or rotate, don't escalate
• Opioid dependence can begin within days; taper gradually
• Chronic opioids: hypogonadism, bone loss, adrenal insufficiency
• Start IR opioids; convert to ER only after titration

Self-check

• Does physical opioid dependence necessarily mean OUD?
  No.
• What is the lethal toxicity of opioids?
  Respiratory depression.

Drugs in this class (45)

All drug classes · Open Opioids in the interactive console ↗