Opioid analgesics as noncompetitive N-methyl-d-aspartate (NMDA) antagonists

Ebert, Bjarke; Thorkildsen, Christian; Andersen, Steen; Christrup, Lona Louring; Hjeds, Hans

doi:10.1016/s0006-2952(98)00088-4

Cited by 152 publications

(73 citation statements)

References 50 publications

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“…93 However, its long half-life (24-36 hours) necessitates extremely careful dose titration. 94 Two small RCTs of methadone demonstrated benefit in managing neuropathic pain, 95,96 and open-label experience suggests promise in a wide variety of neuropathic pain conditions.…”

mentioning

confidence: 99%

Neuropathic pain: a practical guide for the clinician

Gilron

Watson²,

Cahill³

et al. 2006

Canadian Medical Association Journal

379

275

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mentioning

confidence: 99%

Neuropathic pain: a practical guide for the clinician

Gilron

Watson²,

Cahill³

et al. 2006

Canadian Medical Association Journal

379

275

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“…These multiple action mechanisms give it advantages over other opioids. NMDA antagonism is also believed to atenuate tolerance [12][13][14][15][16]. These combined mechanisms are the cause of its eicacy in chronic and neuropathic pain [17].…”

Section: Dual or Multimechanism Opioidsmentioning

confidence: 99%

Pharmacotherapy of Chronic Pain

Vázquez¹,

Fagiolino²

2017

Pain Relief - From Analgesics to Alternative Therapies

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In the past two decades, many preclinical works have been carried out assisting in our understanding of the underlying pathophysiological mechanisms that cause chronic pain. Chronic pain involves multiple pathophysiological mechanisms with peripheral and central components. This research in basic and clinical research has greatly expanded the options for analgesic pharmacotherapy. This chapter gives information regarding the major classes of medication used to assist in the management of chronic pain, including nonopioids analgesics such as NSAIDs and acetaminophen, opioids analgesics, antidepressants and anticonvulsants and an emerging area as the ield of cannabinoids is. Importantly, chronic pain treatment encompasses multiple agents to take advantage of synergistic mechanism of actions, but drug-drug interactions have to be taken into account in order to avoid lack of eicacy or toxicity.

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“…13 The degree of NMDA antagonism produced by methadone is similar to that of ketamine. 14 Methadone is characterized by its high inter-individual variability. A good understanding of the pharmacokinetics and pharmacodynamics is imperative to the safe use of this medication.…”

Section: Conclusion : La Méthadone Est Un Opiacé Aux Propriétés Complmentioning

confidence: 99%

Review article: Perioperative pain management of patients on methadone therapy

Peng

Tumber

Gourlay

2005

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : Methadone, an opioid traditionally associated with the management of opioid addictive disorders, has been prescribed increasingly as an analgesic for the management of various chronic pain conditions. Despite the increasing popularity of methadone, most anesthesiologists are not familiar with its complex pharmacology. The purpose of this article is to review the pharmacology of methadone and to suggest a management algorithm for the perioperative care of methadone patients.S So ou ur rc ce e: : A Medline search was performed to obtain the published literature on the pharmacology of methadone and its use perioperatively.P Pr ri in nc ci ip pa al l f fi in nd di in ng gs s: : The complexity of methadone's pharmacology is characterized by a high inter-individual variability, a potential for interaction with other medications, and a long elimination half-life. The postoperative management of methadone patients may be difficult as they are often 'opioid-tolerant' but may be 'pain-intolerant'. For those patients who are taking part in methadone-maintenance programs, there is a potential for the problematic use of opioids or other substances. The management plan for patients taking methadone may differ depending on the type of surgery and the associated perioperative differences in fasting status and gastrointestinal function. In consideration of all the factors listed above, a management algorithm is outlined for the perioperative care of methadone patients.C Co on nc cl lu us si io on n: : Methadone is an opioid with complex properties, and a patient that is taking methadone can represent a unique challenge to the anesthesiologist. A good understanding of the pharmacology of methadone and of the type of patients on this medication will help to improve their perioperative care. Objectif

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Opioid analgesics as noncompetitive N-methyl-d-aspartate (NMDA) antagonists

Cited by 152 publications

References 50 publications

Neuropathic pain: a practical guide for the clinician

Neuropathic pain: a practical guide for the clinician

Pharmacotherapy of Chronic Pain

Review article: Perioperative pain management of patients on methadone therapy

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