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2000, Número 2

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Rev Med Hosp Gen Mex 2000; 63 (2)


Posibles mecanismos de la eficacia o falta de eficacia de los compuestos opioides sobre el dolor crónico por deaferentación

Brito BF

Idioma: Español
Referencias bibliográficas: 82
Paginas: 112-123
Archivo PDF: 258.86 Kb.


RESUMEN

El dolor crónico por deaferentación constituye un problema clínico que se caracteriza por su persistencia y resistencia a mejorar con cualquiera de los analgésicos y neuromoduladores actuales. Una de las principales controversias en el tratamiento del dolor crónico por deaferentación es el uso de los opioides. Por este motivo, en esta revisión se hace un análisis sobre la historia de los compuestos opioides, de los péptidos opioides endógenos y de sus receptores, así como de los aspectos bioquímicos en la patología del dolor crónico por deaferentación periférico y central relacionados con la plasticidad neuronal e involucrados en la alodinia e hiperalgesia y la interacción de los compuestos opioides con el N-metil-D-aspartato (NMDA), la proteína cinasa C (CPK) y el óxido nítrico en la tolerancia a la morfina. Con el conocimiento de los eventos bioquímicos a nivel experimental se han iniciado las opciones farmacológicas en el tratamiento del dolor crónico y en un futuro aparecerán nuevos fármacos que actualmente existen en experimentación, los antagonistas NMDA (MK81 y LY274614), el antagonista de la CPK (gangliósido GM1) y el inhibidor de la enzima de la síntesis de óxido nítrico NOARG.


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