[Opioids for noncancer XXXX in the elderly].

@entity1 @entity8 @entity1286 @entity158
BACKGROUND: Opioids are increasingly used in the elderly. Side effects differ compared to other analgesics. PURPOSE: In this review article, special aspects about using opioids for noncancer @entity158 in older @entity1 and in geriatric @entity1 are identified. CURRENT SITUATION: So far randomized controlled trials for the indication of and comparison between various opioids have been performed in middle-aged @entity1 and not exclusively in geriatric @entity1 or elderly (>   75  years). Furthermore, the evidence for multimorbid elderly @entity1 with respect to side effects is also very poor. RECOMMENDATIONS: The indication for opioid therapy should be narrow. The @entity1 and their caregivers must be provided @entity1 information regarding opioid therapy. The principle "start low, go slow" is highly recommended. To reduce the risk of falls, longer acting opioids should be used and short acting opioids should be avoided. Everyday relevant negative effects on cognition are possible in opioid use and have to be observed. As recommended in the recently published German guideline for long-term use of opioids in noncancer @entity158 a critical check after 3  months and in case of dosing over 120  mg @entity1286 equivalents is advisable, especially for older @entity1 . @entity8 and drug interactions have to be taken into consideration like in every age group.
