Opioids: a pharmacologist's delight!

Clinical and Experimental Pharmacology & Physiology
L E Mather

Abstract

1. Opioids, in one form or another, have been used for their pain-relieving properties from prehistoric times: they are still the first line medication for the treatment of severe nociceptive pain and are likely to remain so for the foreseeable future. 2. The therapeutic index of opioids used for pain management is low: opioid side effects are essentially extensions of therapeutic effects and no available agent has a marked advantage over the others. When used for opioid 'anaesthesia', differences in therapeutic index are more obvious due to differences in non-opioid effects. 3. Opioid receptors in brain and spinal cord periphery are the main 'therapeutic targets' and clinical dosage strategies have been derived using a variety of systemic (indirect or blood-borne) methods as well as intraspinal and intracerebroventricular (direct) methods: no method, however, is without potential side effects. Peripheral opioid effects are now being exploited with intra-articular injection. 4. Opioid pharmacokinetics and pharmacodynamics are characterized by high inter-subject variability: accordingly, patient-controlled dosage strategies are found to be more successful for pain control than deterministic recipes.

References

Mar 10, 1979·Lancet·M BeharJ T Davidson
May 26, 1979·Lancet·M J CousinsJ R Graham
Feb 1, 1979·Anesthesiology·J K WangJ E Thomas
Jun 25, 1976·Science·T L Yaksh, T A Rudy
Aug 1, 1992·British Journal of Clinical Pharmacology·R OsborneM Slevin
Jun 1, 1991·British Journal of Anaesthesia·L M MorrisonG B Drummond
Jul 1, 1990·Anesthesiology·C C Hug
Aug 1, 1989·British Journal of Anaesthesia·R W Mitchell, G Smith
Aug 1, 1989·British Journal of Anaesthesia·K Budd
Dec 1, 1988·Brain Research Bulletin·M Kavaliers
Jul 1, 1993·British Journal of Anaesthesia·B J Pleuvry
Mar 1, 1994·Anesthesia and Analgesia·Y F HuangL E Mather
Jan 1, 1993·Anesthesia and Analgesia·C Stein
Mar 1, 1993·Anesthesia and Analgesia·S L Shafer
Feb 1, 1993·Clinical Pharmacokinetics·H F Hill, L E Mather
Dec 1, 1954·The Journal of Pharmacy and Pharmacology·A H BECKETT, A F CASY

❮ Previous
Next ❯

Citations

Dec 1, 2009·Forensic Science, Medicine, and Pathology·Danielle M Butzbach
Nov 18, 1998·International Journal of Immunopharmacology·J L TangS Specter
Apr 22, 1999·Journal of Veterinary Pharmacology and Therapeutics·J D Harkins, T Tobin
May 13, 2014·Best Practice & Research. Clinical Anaesthesiology·Pamela P PalmerRonald D Miller
Jan 23, 2016·Expert Opinion on Drug Metabolism & Toxicology·Rovnat Babazade, Alparslan Turan
Nov 13, 2014·Expert Opinion on Drug Delivery·Harold S Minkowitz, Keith Candiotti
Aug 27, 2014·Pain Practice : the Official Journal of World Institute of Pain·Timothy I MelsonPamela P Palmer
Nov 1, 2016·Expert Opinion on Pharmacotherapy·Rovnat Babazade, Alparslan Turan
Nov 12, 2016·Expert Review of Neurotherapeutics·Susanna Porela-TiihonenHannu Kokki
Aug 28, 2014·The Journal of Trauma and Acute Care Surgery·Neil K SinglaPamela P Palmer
Dec 29, 2012·Regional Anesthesia and Pain Medicine·Harold S MinkowitzPamela P Palmer
Mar 20, 2019·Clinical Drug Investigation·Emma D Deeks
Nov 17, 2019·Journal of Perianesthesia Nursing : Official Journal of the American Society of PeriAnesthesia Nurses·Jacob L HutchinsPamela P Palmer
Nov 11, 2017·The American Journal of Emergency Medicine·James R MinerPamela P Palmer
Nov 16, 2010·Anesthesiology Clinics·Pamela P Palmer, Ronald D Miller

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.