Title |
The unsolved case of “bone-impairing analgesics”: the endocrine effects of opioids on bone metabolism
|
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Published in |
Therapeutics and Clinical Risk Management, March 2015
|
DOI | 10.2147/tcrm.s79409 |
Pubmed ID | |
Authors |
Flaminia Coluzzi, Joseph Pergolizzi, Robert B Raffa, Consalvo Mattia |
Abstract |
The current literature describes the possible risks for bone fracture in chronic analgesics users. There are three main hypotheses that could explain the increased risk of fracture associated with central analgesics, such as opioids: 1) the increased risk of falls caused by central nervous system effects, including sedation and dizziness; 2) reduced bone mass density caused by the direct opioid effect on osteoblasts; and 3) chronic opioid-induced hypogonadism. The impact of opioids varies by sex and among the type of opioid used (less, for example, for tapentadol and buprenorphine). Opioid-associated androgen deficiency is correlated with an increased risk of osteoporosis; thus, despite that standards have not been established for monitoring and treating opioid-induced hypogonadism or hypoadrenalism, all patients chronically taking opioids (particularly at doses ≥100 mg morphine daily) should be monitored for the early detection of hormonal impairment and low bone mass density. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 5 | 63% |
Unknown | 3 | 38% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 2 | 25% |
Science communicators (journalists, bloggers, editors) | 2 | 25% |
Practitioners (doctors, other healthcare professionals) | 2 | 25% |
Scientists | 2 | 25% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Germany | 1 | 1% |
Unknown | 72 | 99% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 10 | 14% |
Student > Master | 8 | 11% |
Student > Ph. D. Student | 6 | 8% |
Student > Doctoral Student | 6 | 8% |
Student > Bachelor | 4 | 5% |
Other | 15 | 21% |
Unknown | 24 | 33% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 22 | 30% |
Pharmacology, Toxicology and Pharmaceutical Science | 5 | 7% |
Social Sciences | 5 | 7% |
Nursing and Health Professions | 4 | 5% |
Agricultural and Biological Sciences | 2 | 3% |
Other | 4 | 5% |
Unknown | 31 | 42% |