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  4. Iatrogenic Side Effects of Pain Therapies

Iatrogenic Side Effects of Pain Therapies

Cureus, 2023 · DOI: 10.7759/cureus.44583 · Published: September 2, 2023

PharmacologyPain Management

Simple Explanation

Pain treatments, especially for long-lasting pain, need to carefully balance the benefits of easing pain against the risks of side effects. Many common pain treatments can cause unwanted side effects. Even common over-the-counter pain relievers can have side effects, and stronger medications like opioids can cause constipation. It's important for doctors to check what medicines older patients are taking, because taking many medicines at once can be risky. Sometimes, stopping certain medicines may be a good idea, but this should be done carefully with a doctor's help. The goal is to make sure pain relief doesn't cause more problems than it solves.

Study Duration
Not specified
Participants
Not specified
Evidence Level
Review Article

Key Findings

  • 1
    Interventional pain procedures can lead to nerve or vascular injuries, spinal cord trauma, and epidural abscesses, though these are rare.
  • 2
    Opioids, while effective for pain relief, commonly cause constipation due to their action on opioid receptors in the gut.
  • 3
    Polypharmacy in geriatric patients is a significant concern, increasing the risk of drug interactions and adverse effects.

Research Summary

Interventional procedures and drug therapy to reduce pain may introduce iatrogenic side effects. These adverse events range from those that are merely bothersome to those that reduce the quality of life or even pose threats to life. Drug therapy may cause serious side effects, such as opioid-induced constipation which requires judicious management, ideally with a PAMORA product. Geriatric patients and those with complex conditions may require periodical medication reviews to avoid complications associated with polypharmacy, prescribing cascades, and the use of contraindicated or suboptimal drugs.

Practical Implications

Careful Assessment of Risks vs Benefits

Weigh potential benefits against risks of pain treatments for each patient.

Judicious Opioid Management

Consider PAMORAs for opioid-induced constipation to preserve analgesia without severe gastrointestinal side effects.

Medication Review for Geriatric Patients

Regularly review medications in elderly patients to avoid polypharmacy and prescribing cascades, considering deprescribing when appropriate.

Study Limitations

  • 1
    Rare iatrogenic events in interventional pain treatments can occur.
  • 2
    Opioid-induced constipation requires careful management.
  • 3
    Polypharmacy complications need medication reviews and deprescribing strategies.

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