Side effects of morphine administration in cancer patients

Abstract

According to the World Health Organization (WHO) guidelines, oral morphine is the first choice drug for treating moderate to severe cancer-related pain. The fear of the side effects caused by this drug and the scarce information about prevention and management of these effects are the main reasons for the underuse of morphine. The aim of this paper is to provide a review of the literature on the side effects most frequently present both in the titration phase and during chronic administration of oral morphine and to describe the appropriate treatment.

Constipation in cancer patients on morphine

“…Although there have been a number of papers examining the effects of morphine in cancer patients in terms of analgesia and side effects [20,32], there have been few studies specifically focusing on the constipating effects of opioids in cancer patients. The numbers of patients included in these studies have tended to be small [1,5,25].…”

Effect of Naloxone-3-Glucuronide and N-Methylnaloxone on the Motility of the Isolated Rat Colon After Morphine

“…Opioid therapy is the mainstay of treatment for cancer-related pain affecting approximately 9 million people worldwide annually [1], and 55 to 95% of patients with advanced cancer have severe pain [2]. Morphine (MO) is the drug of choice for the management of moderate to severe chronic cancer pain because of its effectiveness, tolerability, ease of use, and low cost [3].…”

Management of opioid-induced bowel dysfunction in cancer patients

“…This produces gastric fullness, nausea, vomiting, hiccups, constipation, overflow diarrhea, and in some case mental confusion and delirium. Of these series of symptoms, constipation is the most frequent among patients treated with opioids [59] and is present in more than 50% of opiate-treated [55] patients. These series of GI symptoms constitute what is called opioid-induced bowel dysfunction (OBD) [36].…”