title: Pharmacotherapy of opioids: present and future developments.
abstract: The clinically available opioids have different physicochemical properties, resulting in differences in clinical profile with regard to potency, onset, and duration of activity. However, they all have comparable side-effects after acute systemic application. Several approaches can be used to overcome these side-effects. The following approaches, with special emphasis on the perioperative use of the opioids, are discussed: (1) the use of alternative routes of administration, such as via the spine (epidurally and intrathecally); (2) optimization of opioid delivery by means of slow-release preparations, chronic infusions with indwelling catheters, and transdermal delivery systems; (3) use of additional agents to potentiate the analgesic properties of the opioids so that the dose of opioid can be reduced; and (4) searching for new analgesics on the basis of knowledge of the pain-transmission system and the different opioid receptors with their functional interactions.
authors.affiliation: Department of Neuropsychopharmacology, Janssen Research Foundation, Beerse, Belgium.
authors.forename: T F
authors.initials: TF
authors.lastname: Meert
mesh_terms: D000279:Administration, Cutaneous; D015360:Analgesia, Epidural; D000758:Anesthesia / Q000639:trends; D018849:Controlled Clinical Trials as Topic; D003692:Delayed-Action Preparations; D016503:Drug Delivery Systems / Q000592:standards; D015195:Drug Design; D004347:Drug Interactions; D004357:Drug Synergism; D006801:Humans; D007278:Injections, Spinal; D009294:Narcotics / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use; D011957:Receptors, Opioid / Q000187:drug effects* / Q000378:metabolism; D013329:Structure-Activity Relationship
chemical_list: D003692:Delayed-Action Preparations; D009294:Narcotics; D011957:Receptors, Opioid