JPET

Home Help [Feedback] [For Subscribers] [Archive] [Search] [Contents]
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Martin, T. J.
Right arrow Articles by Eisenach, J. C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Martin, T. J.
Right arrow Articles by Eisenach, J. C.

Vol. 299, Issue 3, 811-817, December 2001

Pharmacology of Opioid and Nonopioid Analgesics in Chronic Pain States

Thomas J. Martin and James C. Eisenach

Departments of Physiology and Pharmacology, and Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina

Chronic pain represents a mixture of pathophysiologic mechanisms, a complex assortment of spontaneous and elicited pain states, and a somewhat unpredictable response to analgesics. Opioids remain the mainstay of treatment of moderate to severe chronic pain, although there is little systematic examination to guide drug selection. Cyclooxygenase inhibitors play primarily an adjunctive role in chronic pain treatment. Agents with little activity in the treatment of acute pain, such as antidepressants, antiepileptics, and i.v. administered local anesthetics, are initiated in many patients and have significant long-term efficacy in some patients with chronic pain. The N-methyl-D-aspartate antagonist ketamine and the alpha 2-adrenergic agonist clonidine exhibit activity in patients with acute or chronic pain and reduce opioid consumption, but are often poorly tolerated due to side effects. Topical treatment with capsaicin or lidocaine exhibits efficacy in a subset of patients, and invasive intrathecal treatment with opioids as well as clonidine, neostigmine, and adenosine may have advantages in some patients. Several laboratory models have been developed to mimic chronic pain states found in humans. Nerve injury has been induced in rats by a variety of means, resulting in mechanical allodynia and thermal hyperalgesia. A number of arthritic states have also been produced by means of chronic joint inflammation in rats. The pharmacology of these neuropathic and arthritic pain models generally resembles that found in the respective human conditions. Additional models of chronic pain, particularly visceral pain, have been developed; however, the pharmacology of these models is not well established at this time.

0022-3565/01/2993-0811$03.00/0
THE JOURNAL OF PHARMACOLOGY AND EXPERIMENTAL THERAPEUTICS
Copyright © 2001 by The American Society for Pharmacology and Experimental Therapeutics


This article has been cited by other articles:


Home page
 J. Pharmacol. Exp. Ther.Home page
N. P. Lapointe, R.-V. Ung, P. Rouleau, and P. A. Guertin
Effects of Spinal {alpha}2-Adrenoceptor and I1-Imidazoline Receptor Activation on Hindlimb Movement Induction in Spinal Cord-Injured Mice
J. Pharmacol. Exp. Ther., June 1, 2008; 325(3): 994 - 1006.
[Abstract] [Full Text] [PDF]

Home page
 J. Pharmacol. Exp. Ther.Home page
T. M. Tzschentke, T. Christoph, B. Kogel, K. Schiene, H.-H. Hennies, W. Englberger, M. Haurand, U. Jahnel, T. I. F. H. Cremers, E. Friderichs, et al.
( )-(1R,2R)-3-(3-Dimethylamino-1-ethyl-2-methyl-propyl)-phenol Hydrochloride (Tapentadol HCl): a Novel {micro}-Opioid Receptor Agonist/Norepinephrine Reuptake Inhibitor with Broad-Spectrum Analgesic Properties
J. Pharmacol. Exp. Ther., October 1, 2007; 323(1): 265 - 276.
[Abstract] [Full Text] [PDF]

Home page
 J. Pharmacol. Exp. Ther.Home page
S. S. Negus, T. W. Vanderah, M. R. Brandt, E. J. Bilsky, L. Becerra, and D. Borsook
Preclinical Assessment of Candidate Analgesic Drugs: Recent Advances and Future Challenges
J. Pharmacol. Exp. Ther., November 1, 2006; 319(2): 507 - 514.
[Abstract] [Full Text] [PDF]

Home page
 J Am Board Fam MedHome page
R. Sinatra
Opioid Analgesics in Primary Care: Challenges and New Advances in the Management of Noncancer Pain
J Am Board Fam Med, March 1, 2006; 19(2): 165 - 177.
[Abstract] [Full Text] [PDF]

Home page
 J. Pharmacol. Exp. Ther.Home page
J. De Vry, D. Denzer, E. Reissmueller, M. Eijckenboom, M. Heil, H. Meier, and F. Mauler
3-[2-Cyano-3-(trifluoromethyl)phenoxy]phenyl-4,4,4-trifluoro-1-butanesulfonate (BAY 59-3074): A Novel Cannabinoid CB1/CB2 Receptor Partial Agonist with Antihyperalgesic and Antiallodynic Effects
J. Pharmacol. Exp. Ther., August 1, 2004; 310(2): 620 - 632.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
G. Schechtmann, J. Wallin, B. A. Meyerson, and B. Linderoth
Intrathecal Clonidine Potentiates Suppression of Tactile Hypersensitivity by Spinal Cord Stimulation in a Model of Neuropathy
Anesth. Analg., July 1, 2004; 99(1): 135 - 139.
[Abstract] [Full Text] [PDF]

Home page
 Journal of Pharmacy PracticeHome page
P. J. S. Koo
Acute Pain Management
Journal of Pharmacy Practice, August 1, 2003; 16(4): 231 - 248.
[Abstract] [PDF]


Home Help [Feedback] [For Subscribers] [Archive] [Search] [Contents]
All ASPET Journals Molecular Pharmacology Pharmacological Reviews
Molecular Interventions Drug Metabolism and Disposition

Copyright © 2001 by the American Society for Pharmacology and Experimental Therapeutics.