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2000, Number 2

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Rev Med Hosp Gen Mex 2000; 63 (2)

Possible mechanisms of the efficacy or non efficacy of the opioid compounds about chronic pain by deafferentation

Brito BF

Language: Spanish
References: 82
Page: 112-123
PDF size: 258.86 Kb.


ABSTRACT

Deaferentation pain is a clinical problem characterized by its persistence through time and its resistance to improve with either analgesic medication or any neuromodulator available. One of the main controversies in the treatment of chronic deaferentation pain, is the use of opioids, that is why in the article review, we do an analysis on the history of the opioid compounds, endogenous opioids peptides and its receptors, as well as the biochemistry aspects involved in the pathology of chronic deaferentation pain: central or peripheral, and which are related to neuronal plasticity, the sensory changes accompanied by pain, hyperestesia (decrease in pain threshold) and allodynia (pain induced by a non painful stimulus), and the interaction of opioid compounds with the N-metyl-D-aspartate (NMDA), kinase protein (CPK) and the nitric oxide (NO) in the development of tolerance to morphine. With the knowledge of the biochemistry events at an experimental level, pharmacological alternatives, which are currently tested in laboratories, have been proposed and it is expected that in a future they will appear as new drugs among which are: the NMDA antagonists (MK81 and LY274614), the CPK antagonist (ganglioside GM1) and the inhibitor of the synthesis of nitric oxide (NOARG)


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