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KMID : 0856920140170030113
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Journal of Hospice and Palliative Care
2014 Volume.17 No. 3 p.113 ~ p.121
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Opioids Use and Adrenal Insufficiency
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Jung Ji-Hoon
Choi Youn-Seon
Kim Jung-Eun
Kim E-Yeon
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Abstract
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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.
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KEYWORD
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Adrenal insufficiency, Opioid analgesics, Dehydroepiandrosterone, Hydrocortisone
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