Symptoms And Treatment Of Opioid Therapy

1226 WordsJan 16, 20155 Pages
Introduction In the United States alone it has been estimated that nearly 50 million people suffer from chronic pain. However, chronic pain continues to be undermanaged with as many as 41% of patients reporting uncontrolled pain 1. Poor pain management outcomes are due in large part to a lack of a pharmacological intervention that is both efficacious for moderate-to-severe chronic pain and widely tolerable. Currently, the most efficacious treatment for moderate-to-severe chronic pain is the use of opioid agonists. Despite the efficacy of opioid therapy, in one survey 68% of physicians cited concerns about adverse events as a barrier to prescription of opioids for the maintenance of chronic pain1. Systemically delivered opioid agonists…show more content…
This brief review will focus on one such drug, tapentadol, and how a unique mechanism of action may provide similar analgesia to classical opioids with a more tolerable adverse event profile. Tapentadol: a novel therapeutic with a unique mechanism of action Tapentadol has a unique dual mechanism of action; acting not only as an agonist at μ-opioid receptors but additionally acting to inhibit norepinephrine reuptake1. Previous studies using preclinical models have shown that the addition of norepinephrine reuptake inhibitors can supplement the analgesic potential of morphine2. Consistently, preclinical studies of tapentadol have shown analgesic efficacy that is comparable to morphine with a 50-fold decrease in binding affinity to μ-opioid receptors1. The ability of tapentadol to produce analgesia similar to that seen with classical opioids with considerably lower binding affinity for µ-opioid receptors at off-target sites suggests that tapentadol treatment could provide effective pain management while limiting adverse events. Clinical efficacy of tapentadol for chronic pain management The etiology of chronic pain is complex and may be due to a number of different factors. Current therapeutics often fail to produce adequate analgesia for moderate-to-severe pain
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