Problems

Prolonged administration of opioids and high dosages are frequently associated with tolerance, which often becomes noticeable after about a week. Drug-specific differences appear to exist. Typical predisposing factors for the development of tolerance are systemic inflammatory response syndrome and tetanus. The underlying pathophysiological and pharmacological mechanisms have not been clarified in detail. During weaning from long-term mechanical ventilation, withdrawal symptoms due to dosage reduction of analgesics and sedatives become dominant, complicating and extending the weaning phase.

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