American Board of Family Medicine (ABFM) Practice Exam

Which complication is possibly associated with the use of opioids for dyspnea?

1. Psychological dependence

2. Sleep disturbances

3. Increased delirium

4. Respiratory depression

The correct answer is: Respiratory depression

The use of opioids for managing dyspnea is often effective due to their ability to relieve breathlessness by acting on the central nervous system. However, one of the most significant risks associated with opioid therapy is respiratory depression. This condition refers to a decrease in the rate and depth of breathing, which can lead to inadequate oxygenation of the body and a buildup of carbon dioxide. Respiratory depression occurs because opioids bind to specific receptors in the brain that control the respiratory drive. This interaction can slow down the respiratory rate, particularly in sensitive populations such as the elderly or those with pre-existing respiratory conditions. Therefore, while opioids can provide relief for patients suffering from dyspnea, their administration must be carefully monitored for signs of reduced respiratory function. In contrast, psychological dependence and sleep disturbances are related to chronic opioid use but are not immediate nor specific complications of using opioids for palliation in dyspnea. Increased delirium can be a side effect, especially in elderly patients, but it is not the most pressing or immediate risk compared to the life-threatening possibility of respiratory depression. Thus, among the complications of opioid use for dyspnea, respiratory depression stands out as the most critical concern that necessitates vigilant monitoring.