{"id":3303,"date":"2021-06-10T14:41:29","date_gmt":"2021-06-10T11:41:29","guid":{"rendered":"https:\/\/www.esrahellas.gr\/?page_id=3303"},"modified":"2021-07-16T11:51:15","modified_gmt":"2021-07-16T08:51:15","slug":"opioids-primary-and-secondary-outcomes","status":"publish","type":"page","link":"https:\/\/www.esrahellas.gr\/en\/interesting-reviews\/opioids-primary-and-secondary-outcomes\/","title":{"rendered":"OPIOIDS: PRIMARY AND SECONDARY OUTCOMES"},"content":{"rendered":"  <div id=\"page-header-1038263769\" class=\"page-header-wrapper\">\n  <div class=\"page-title dark featured-title\">\n\n    \n    <div class=\"page-title-inner container align-center flex-row medium-flex-wrap\" >\n              <div class=\"title-wrapper flex-col text-left medium-text-center\">\n          <h1 class=\"entry-title mb-0\">\n            OPIOIDS: PRIMARY AND SECONDARY OUTCOMES          <\/h1>\n        <\/div>\n                    <div class=\"title-content flex-col flex-right text-right medium-text-center\">\n        <div class=\"title-share pt-half pb-half\"><div class=\"social-icons share-icons share-row relative icon-style-fill\" ><a href=\"https:\/\/www.facebook.com\/sharer.php?u=https:\/\/www.esrahellas.gr\/en\/interesting-reviews\/opioids-primary-and-secondary-outcomes\/\" data-label=\"Facebook\" onclick=\"window.open(this.href,this.title,'width=500,height=500,top=300px,left=300px'); return false;\" target=\"_blank\" class=\"icon primary button circle tooltip facebook\" title=\"Share on Facebook\" aria-label=\"Share on Facebook\" rel=\"noopener nofollow\"><i class=\"icon-facebook\" aria-hidden=\"true\"><\/i><\/a><a href=\"https:\/\/twitter.com\/share?url=https:\/\/www.esrahellas.gr\/en\/interesting-reviews\/opioids-primary-and-secondary-outcomes\/\" onclick=\"window.open(this.href,this.title,'width=500,height=500,top=300px,left=300px'); return false;\" target=\"_blank\" class=\"icon primary button circle tooltip twitter\" title=\"Share on Twitter\" aria-label=\"Share on Twitter\" rel=\"noopener nofollow\"><i class=\"icon-twitter\" aria-hidden=\"true\"><\/i><\/a><a href=\"mailto:?subject=OPIOIDS%3A%20PRIMARY%20AND%20SECONDARY%20OUTCOMES&body=Check%20this%20out%3A%20https%3A%2F%2Fwww.esrahellas.gr%2Fen%2Finteresting-reviews%2Fopioids-primary-and-secondary-outcomes%2F\" class=\"icon primary button circle tooltip email\" title=\"Email to a Friend\" aria-label=\"Email to a Friend\" rel=\"nofollow\"><i class=\"icon-envelop\" aria-hidden=\"true\"><\/i><\/a><a href=\"https:\/\/www.linkedin.com\/shareArticle?mini=true&url=https:\/\/www.esrahellas.gr\/en\/interesting-reviews\/opioids-primary-and-secondary-outcomes\/&title=OPIOIDS%3A%20PRIMARY%20AND%20SECONDARY%20OUTCOMES\" onclick=\"window.open(this.href,this.title,'width=500,height=500,top=300px,left=300px'); return false;\" target=\"_blank\" class=\"icon primary button circle tooltip linkedin\" title=\"Share on LinkedIn\" aria-label=\"Share on LinkedIn\" rel=\"noopener nofollow\"><i class=\"icon-linkedin\" aria-hidden=\"true\"><\/i><\/a><\/div><\/div>      <\/div>\n    <\/div>\n\n     \n<style>\n#page-header-1038263769 {\n  margin-bottom: 20px;\n}\n<\/style>\n  <\/div>\n    <\/div>\n  \n<div class=\"row align-middle\"  id=\"row-375712312\">\n\n\t<div id=\"col-211655834\" class=\"col medium-3 small-12 large-3\"  >\n\t\t\t\t<div class=\"col-inner\"  >\n\t\t\t\n\t\t\t\n\t<div class=\"img has-hover x md-x lg-x y md-y lg-y\" id=\"image_2040958555\">\n\t\t\t\t\t\t\t\t<div class=\"img-inner dark\" >\n\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"399\" height=\"300\" src=\"https:\/\/www.esrahellas.gr\/wp-content\/uploads\/2021\/06\/opioids.jpg\" class=\"attachment-large size-large\" alt=\"\" \/>\t\t\t\t\t\t\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\n<style>\n#image_2040958555 {\n  width: 100%;\n}\n<\/style>\n\t<\/div>\n\t\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\n\n\t<div id=\"col-1426541647\" class=\"col medium-9 small-12 large-9\"  >\n\t\t\t\t<div class=\"col-inner\"  >\n\t\t\t\n\t\t\t\n<h3>Interesting Reviews<\/h3>\n<p><strong>OPIOIDS: PRIMARY AND SECONDARY OUTCOMES<\/strong><\/p>\n<p><strong>Giustino Varrassi<\/strong><\/p>\n<p>Professor of Anaesthesiology and Pain Medicine<\/p>\n<p>Italy<\/p>\n<p>Presented at:<strong> 11th Panhellenic Congress of Regional Anaesthesia, Pain Therapy and Palliative Care<\/strong>, Hotel Doryssa Bay, Samos, September 23 &#8211; 26, 2010<\/p>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\n<\/div>\n<div class=\"row\"  id=\"row-1865601472\">\n\n\t<div id=\"col-1806616555\" class=\"col small-12 large-12\"  >\n\t\t\t\t<div class=\"col-inner text-left\"  >\n\t\t\t\n\t\t\t\n<p>for the full text in pdf form click <a href=\"https:\/\/www.esrahellas.gr\/wp-content\/uploads\/2021\/06\/VARRASSI-SAMOS.pdf\" target=\"_blank\">here<\/a>.<\/p>\n<p>\u00a0<\/p>\n<p>The primary outcome for the opioids is pain control, primarily related to interaction with specific opioid receptors, not forgetting the importance of avoiding opioid-induced side effects. The characteristics that identify the primary outcome of an &#8220;ideal opioid analgesic&#8221; are: pure \u00b5 agonistic action, l\u03bfw tolerance potential, reduced side effects and adverse events, minimal risk of abuse, poor development of hyperalgesia and long duration of action. \u0391 pure \u00b5 agonist must ensure maximal action on all types of pain syndromes and types of pain. Currently, there isn&#8217;t a molecule that fully satisfies the relationship analgesia \/ side effects, because it is closely dependent on the genetics of the individual, since it determines affinity receptor, then the number of available sites.<\/p>\n<p>Another character of an ideal opioid is reduced tolerance that allows to maintain efficacy without the need to increase the dosage. The drugs with scarce tolerance are at the same time those with higher risk of addiction. The use of opioids, with strict selection of patients is not associated with a significant risk of abuse.<\/p>\n<p>Adverse events may occur with normal doses of opiates and these conditions may be related to an underlying condition of altered biotransformation of the drug. The long duration of action is essential to patient adherence to therapy.<\/p>\n<p>The characteristics that identify the secondary outcome of an analgesic ideal, are: high bioavailability after oral administration, reduced drug interactions, reduced protein binding, absence of active metabolites, l\u03afnear kinetics and hydrolysis of compounds to inactive metabolites. According to several guidelines, the approach with opioids must be done with oral formulations that ensure a good bioavailability. The drug combination with opioids should not be burdened by significant interactions because the frequency of Adverse Drug Reactions (ADRs) increases exponentially when the patient takes four or more drugs. The risk of drug interactions of opiate use is determined largely by the enzyme system that metabolizes the specific opioid.<\/p>\n<p>In patients with a complex therapeutic regimen, physician may consider initiating treatment with an opioid drug that is not metabolized by cytochrome. Physicians should be aware that some opioids have active metabolites which may become clinically important, for e\u03c7ample in case of liver or renal disease, drug interactions and genetic polymorphisms of enzymes that metabolize drugs. Metabolites are generally considered a clinical problem only when their concentration in the blood undergoes a fluctuation different of the parent compounds, Iike in renal failure.<\/p>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\n\t\n<\/div>\n\t<div id=\"gap-1636436676\" class=\"gap-element clearfix\" style=\"display:block; height:auto;\">\n\t\t\n<style>\n#gap-1636436676 {\n  padding-top: 30px;\n}\n<\/style>\n\t<\/div>\n\t\n<div class=\"social-icons share-icons share-row relative full-width text-center\" ><a href=\"https:\/\/www.facebook.com\/sharer.php?u=https:\/\/www.esrahellas.gr\/en\/interesting-reviews\/opioids-primary-and-secondary-outcomes\/\" data-label=\"Facebook\" onclick=\"window.open(this.href,this.title,'width=500,height=500,top=300px,left=300px'); return false;\" target=\"_blank\" class=\"icon primary button circle tooltip facebook\" title=\"Share on Facebook\" aria-label=\"Share on Facebook\" rel=\"noopener nofollow\"><i class=\"icon-facebook\" aria-hidden=\"true\"><\/i><\/a><a href=\"https:\/\/twitter.com\/share?url=https:\/\/www.esrahellas.gr\/en\/interesting-reviews\/opioids-primary-and-secondary-outcomes\/\" onclick=\"window.open(this.href,this.title,'width=500,height=500,top=300px,left=300px'); return false;\" target=\"_blank\" class=\"icon primary button circle tooltip twitter\" title=\"Share on Twitter\" aria-label=\"Share on Twitter\" rel=\"noopener nofollow\"><i class=\"icon-twitter\" aria-hidden=\"true\"><\/i><\/a><a href=\"mailto:?subject=OPIOIDS%3A%20PRIMARY%20AND%20SECONDARY%20OUTCOMES&body=Check%20this%20out%3A%20https%3A%2F%2Fwww.esrahellas.gr%2Fen%2Finteresting-reviews%2Fopioids-primary-and-secondary-outcomes%2F\" class=\"icon primary button circle tooltip email\" title=\"Email to a Friend\" aria-label=\"Email to a Friend\" rel=\"nofollow\"><i class=\"icon-envelop\" aria-hidden=\"true\"><\/i><\/a><a href=\"https:\/\/www.linkedin.com\/shareArticle?mini=true&url=https:\/\/www.esrahellas.gr\/en\/interesting-reviews\/opioids-primary-and-secondary-outcomes\/&title=OPIOIDS%3A%20PRIMARY%20AND%20SECONDARY%20OUTCOMES\" onclick=\"window.open(this.href,this.title,'width=500,height=500,top=300px,left=300px'); return false;\" target=\"_blank\" class=\"icon primary button circle tooltip linkedin\" title=\"Share on LinkedIn\" aria-label=\"Share on LinkedIn\" rel=\"noopener nofollow\"><i class=\"icon-linkedin\" aria-hidden=\"true\"><\/i><\/a><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":3297,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page-blank.php","meta":{"footnotes":"","_links_to":"","_links_to_target":""},"class_list":["post-3303","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.0 - 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