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http://dx.doi.org/10.14475/kjhpc.2014.17.3.113

Opioids Use and Adrenal Insufficiency  

Jung, Ji Hoon (Department of Family Medicine, Korea University Guro Hospital)
Choi, Youn Seon (Department of Family Medicine, Korea University Guro Hospital)
Kim, Jung Eun (Department of Family Medicine, Korea University Guro Hospital)
Kim, E Yeon (Department of Family Medicine, Korea University Guro Hospital)
Publication Information
Journal of Hospice and Palliative Care / v.17, no.3, 2014 , pp. 113-121 More about this Journal
Abstract
The major symptoms of terminally ill cancer patients are fatigue, loss of energy, feeling of helplessness, poor appetite and pain as well as general weakness, which are very similar to symptoms of adrenal insufficiency. Adrenal insufficiency-induced symptoms widely vary from mild symptoms to life-threatening conditions and may be resulted from variable medical causes. For terminally ill cancer patients who are hospitalized for palliative care, opioid agents are prescribed to control moderate to severe pain. The use of acute or chronic opioid agents is believed to negatively affect adrenal gland function. In most studies of opioid effects (preclinical/clinical with animal subjects or and patients suffering non-malignant pain, adrenal insufficiency and hormonal abnormalities were observed as side effects. However, opioid-induced adrenal insufficiency has been rarely reported in studies with patients with malignant cancer pain. Relationship between the type, treatment period, dosage of opioid agents and hormonal abnormalities can be examined by measuring the functional level of the adrenal glands. We hope to improve patient's quality of life by indicating hormone substitution to treat symptoms of adrenal insufficiency.
Keywords
Adrenal insufficiency; Opioid analgesics; Dehydroepiandrosterone; Hydrocortisone;
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