J Pharm Pharmacogn Res 2(Suppl. 1): S28, 2014
Special supplement with the abstract book of LATINFARMA 2013
CO 051: OPIOIDS UPDATE IN 2013. PAIN FREE HOSPITALS, IMPORTANCE OF ITS DEVELOPMENT IN CUBA
Yera-Nadal JL.Clínica del Dolor Hospital Hermanos Ameijeiras, La Habana, Cuba. E-mail: email@example.com
Opioids are still important analgesics in the management of acute and chronic pain. They can be very effective and also safe if used wisely, with a thorough understanding of their pharmacology. Opioids often cause adverse effects; respiratory depression and nausea are important adverse effects when opioids are used to treat acute pain, whereas constipation, cognitive impairment, hormonal effects, addiction and tolerance are relevant concerns in chronic administration. However, nothing like nonsteroidal anti-inflammatory drugs, there are not evidences of severe injury on vital organs as heart, liver and kidney by its long term use. In the present review it discussed the use of opioids in acute and chronic pain, with focus in MOR agonists as morphine, oxycodone, fentanyl, methadone, hydromorphone and buprenorphine, particularly in the news special routes and modes of administration. We also analyzed the importance of nonopioid effects that are relevant for its analgesic profile. For example, racemic methadone and its ability by binding to N-methyl–D aspartate (NMDA) receptor, that exhibit noncompetitive antagonism. As well as, tramadol and tapentadol, which also inhibit the reuptake of monoamines. Moreover, it will provide up to date information regarding the pharmacokinetic and pharmacogenetic differences among opioids. On the other hand we are considering about the importance of accepting pain as a vital sign and then develop pain free hospitals in our country. This information can be used to improve the effective and safe use of available opioids in the management of pain and it also offers possibilities for improving opioid efficacy and reversing opioid tolerance.