alexa Opioid-Induced Hyperalgesia | OMICS International | Abstract
ISSN: 2167-0846

Journal of Pain & Relief
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Review Article

Opioid-Induced Hyperalgesia

Fady Youssef1, Alan Pater2 and Marlene Shehata3*
1Carleton University, Ottawa, ON, Canada
2Memorial University of Newfoundland, NL, Canada
3Marlene Shehata Pharmaceuticals, Ottawa, ON, Canada
Corresponding Author : Shehata M
Clinical Pharmacist Consultant/Cardiovascular Geneticist
Marlene Shehata Pharmaceuticals, Ottawa, Ontario, Canada
Tel: 613-890-5476
Fax: 347-710-5334
E-mail: [email protected]
Received March 16, 2015; Accepted May 19, 2015; Published May 21, 2015
Citation: Youssef F, Pater A, Shehata M (2015) Opioid-Induced Hyperalgesia. J Pain Relief 4:183. doi: 10.4172/2167-0846.1000183
Copyright: © 2015 Youssef F, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Opioid-induced hyperalgesia (OIH) is a state of sensitization of pain receptors caused by opioid use. In OIH, there is a paradoxical response to opioids, in which opioids that are used to produce analgesia will instead induce sensitization to certain painful stimuli. The resulting pain might be similar or different from the original pain for which the opioids were taken. OIH is a characteristic phenomenon that could explain the loss of opioid effectiveness in many patients. The exact molecular mechanism for OIH is not yet fully understood. However, four proposed mechanisms are being considered in the present review to explain OIH including; N-methyl-D-aspartate (NMDA) receptor activation; spinal dynorphin; descending facilitation; and finally decreased reuptake and enhanced nociceptive response. It is important for clinicians to consider OIH in opioid-treated patients, particularly for any new appearance of unexplained pain, or when increasing the opiate dose results in worsening of the pain. OIH is managed by reducing opioid dosage, tapering opiods off, and adding NMDA receptor antagonists.

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