Opioid-induced hyperalgesia a practical problem in the treatment of pain in patients with a cancer

Michał Walter Magiera; Leszek Strzelecki

eISSN: 2081-2833
ISSN: 2081-0016

Medycyna Paliatywna/Palliative Medicine

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3/2013
vol. 5

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abstract:

Review paper

Opioid-induced hyperalgesia a practical problem in the treatment of pain in patients with a cancer

Michał Walter Magiera

,

Leszek Strzelecki

Medycyna Paliatywna 2013; 5(3): 88–92

Online publish date: 2013/11/08

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A complication of the opioid-based treatment of pain in patients with a cancer could be opioid-induced hyperalgesia. This phenomenon is paradoxical occurrence of pain or exacerbation of pain during the use of opioid analgetics. Opioid-induced hyperalgesia is associated with changes in the conformation of the opioid receptors. In this paper based on the literature presens 6 mechanisms of this phenomenon. These are: stimulation of NMDA receptors, opioid receptors desensitization, the effect of dynorphin A, descending impulse control pain associated with activation of On-Off cells, increasing the level of cAMP and genetic changes involving the substitution of methionine by valine affecting neurotransmission of dopamine/norepinephrine. In the following section describes the proposed method of treatment of opioid-induced hyperalgesia.

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Opioid-induced hyperalgesia a practical problem in the treatment of pain in patients with a cancer

Michał Walter Magiera , Leszek Strzelecki

opioid-induced hyperalgesia, cancer-releated pain

Michał Walter Magiera

,

Leszek Strzelecki