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• W2498579620 abstract "Opioids are among the most potent analgesic agents available for acute and post-surgical analgesia. Despite a lack of efficacy in many pain syndromes, their use in the treatment of chronic pain has increased dramatically. Long-term analgesia for those patients for whom opioids are initially effective is limited by side effects. Short-term side effects include respiratory depression, constipation, nausea and vomiting, urinary retention, pruritus, and myoclonus. These side effects range from mild, as with constipation, which can lead to poor patient compliance but can be mitigated pharmacologically, to severe, as with respiratory depression, which is the leading cause of death in opioid toxicity. Long-term side effects include analgesic tolerance, hyperalgesia (enhanced pain perception), hormonal imbalance, and immune modulation (Ballantyne and Mao 2003). It is now the standard of care to prescribe testosterone replacement for male patients and monitor all patients for immune suppression throughout long-term opioid therapy. Currently there are no effective strategies to reduce tolerance and opioid-induced hyperalgesia, which are thought to be the cause of failed long-term analgesia (Ballantyne 2007).The clinical use of opioids has increased dramatically over the past 20 years with increased recognition of the under-treatment of chronic pain and better marketing by pharmaceutical companies (Cicero, Inciardi, and Munoz 2005; Joranson et al. 2000). A salient example of this trend was the increase in the off-label use of the non-opioid gabapentin (Neurontin) for chronic pain treatment, which was driven by misinformation and false claims (Landefeld and Steinman 2009). Portenoy and Foley (1986) were the first to report on the efficacy of opioid therapy for chronic, non-malignant pain. Their retrospective case study of 38 patients found that low-dose ( 6 months) treatment. Much of this variability is due to the differences in the pain populations studied, the wide dosage ranges of opioids currently being prescribed for chronic pain (from 20 to >100 mg morphine equivalents per day), and non-uniformity in the outcomes measured (Ballantyne and Shin 2008). Limited opioid efficacy, increasing diversion and misuse, and side effects are key problems in the treatment of chronic pain. These clinical realities and insights from preclinical investigation highlight the need for the development of new analgesic agents that target non-opioid based mechanisms that include other cell types and interactions beyond neuronal actions." @default.
• W2498579620 created "2016-08-23" @default.
• W2498579620 creator A5012117352 @default.
• W2498579620 creator A5019847663 @default.
• W2498579620 creator A5061857298 @default.
• W2498579620 date "2010-01-01" @default.
• W2498579620 modified "2023-09-23" @default.
• W2498579620 title "Glial Modulation in Pain States: Translation into Humans" @default.
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