Differences between and combinations of opiods re-visited

Smith, Maree T. (2008) Differences between and combinations of opiods re-visited. Current Opinion in Anaesthesiology, 21 5: 596-601. doi:10.1097/ACO.0b013e32830a4c4a

Author Smith, Maree T.
Title Differences between and combinations of opiods re-visited
Journal name Current Opinion in Anaesthesiology   Check publisher's open access policy
ISSN 0952-7907
Publication date 2008-10-01
Year available 2008
Sub-type Article (original research)
DOI 10.1097/ACO.0b013e32830a4c4a
Open Access Status Not yet assessed
Volume 21
Issue 5
Start page 596
End page 601
Total pages 6
Editor H. Van Aken
P. G. Brarsh
Place of publication London, U. K.
Publisher Lippincott Williams & Wilkins
Language eng
Subject C1
111501 Basic Pharmacology
920111 Nervous System and Disorders
1102 Cardiovascular Medicine and Haematology
1103 Clinical Sciences
1117 Public Health and Health Services
111502 Clinical Pharmacology and Therapeutics
Abstract Purpose of review
Formatted abstract
Purpose of review: Recent studies highlighting between-opioid differences in patient outcomes, opioid receptor interactions and animal study findings implicating a 'fine control' mechanism underpinning potential diversity in opioid receptor signalling that could potentially be exploited to develop novel opioid analgesics with improved tolerability are reviewed.

Recent findings:
Recent clinical trials confirm the success of 'opioid rotation' for improving opioid tolerability and restoring analgesia in most patients who would otherwise experience intolerable side effects and poor pain relief. These findings suggest that individual strong opioids may interact, at least in part, with different opioid receptor sub-populations or modulate μ opioid receptor signalling in subtly different ways. Identification of novel μ opioid splice variants with different intron 1 sizes that heterodimerize with, and modulate the function of, native μ opioid receptors provide insight into potential diversity in opioid signalling. Oxycodone, unlike other strong opioids, does not cause potassium current desensitization nor does it displace [3H]-morphine binding, consistent with its different in-vivo pharmacological profile to morphine. Opioid analgesic combinations administered as tethered bivalent ligands or admixture demonstrate good pain relief with improved side effect profiles.

Enhanced understanding of diversity in opioid signalling has the potential to produce novel strong opioid analgesics with improved tolerability.
© 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins
Keyword Between-opioid differences
G protein-activated inwardly rectifying potassium current desensitization
Opioid combinations
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2009 Higher Education Research Data Collection
School of Pharmacy Publications
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Citation counts: TR Web of Science Citation Count  Cited 25 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 28 times in Scopus Article | Citations
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Created: Thu, 16 Apr 2009, 20:39:59 EST by Elizabeth Pyke on behalf of School of Pharmacy