Opioids - no effect without side effect

Plasters containing the potent opiate fentanyl are now standard on chronic pain. How the patient tolerates and accepts the therapy, however, depends essentially on whether side effects are treated. Nausea, constipation and dizziness are the most common side effects of opioids. Especially patients who are prescribed these drugs for the first time, sometimes sensitive: The body needs a hiring phase. These side effects are normal and not dangerous, they do not occur in any case. However, many patients are insecure and anxious if they have not been adequately informed by the attending physician prior to initiating therapy.

Nausea, constipation, dizziness

The nausea arises because opioids irritate the vomiting center in the brain, and not because the stomach is strained, as many patients fear. If the active ingredients metoclopramide or domperidone concomitantly prescribed and taken in time, it does not even come to a nausea. In many cases, the nausea disappears after a hiring phase of two to three weeks.

The reason for the constipation is the effect of opioids on the intestinal musculature, whose activity is reduced. However, numerous studies have shown that the Fentanyl patch offers advantages here: The active ingredient is not absorbed as in the case of tablet intake via the gastrointestinal tract. The influence on the intestinal musculature is therefore lower. If constipation persists, a laxative must be prescribed.

Dizziness and dizziness occur because opioids act in the central nervous system. This side effect often disappears after one to two days. If this does not happen or if the feeling of dizziness worsens, the doctor will reduce the dose or discontinue the medication.

Benefits of therapy

Despite these symptoms, which sometimes occur, treatment with opioids in severe chronic pain has many advantages over simple analgesics such as ibuprofen or diclofenac. Liver, kidneys and stomach are not burdened and the effect is much higher. A life with normal everyday activities is so often only possible again. The widespread fear of dependency is unfounded if delayed, ie long-acting, remedies are given.

Tips for dealing

In order to make pain therapy with opioids as successful and tolerable as possible, those affected can do a lot themselves:

  • Take Opioide strictly according to the doctor's instructions.
  • Change your diet. High-fiber diet, plenty of hydration and sufficient exercise help against constipation.
  • If you get a pain patch, stick this on a hairless body site. It is best to clean the area first with lukewarm water, but never with moisturizing washing lotions or disinfectant sprays. The plaster then does not stick properly. Dab the area gently dry and press the plaster firmly for 30 seconds.
  • Do not overstrain yourself at the beginning of the therapy. Watch out for a relaxed daily routine and do not put a lot of stress on the first two weeks. If you suffer from side effects such as dizziness or nausea, you should not drive a car. After the adjustment phase, this is possible again, if you dare and feel fit. Watch for any side effects, but do not focus too much on them. Meet dizziness with serenity: they are not a disease symptom.
  • Ask your doctor if you are unsure.
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