Pathophysiology of opioid tolerance and clinical approach to the opioid-tolerant patient.
The physiologic basis for opioid tolerance has been elucidated, resulting in a better understanding of this problem. As a result of this ongoing effort, patients exhibiting opioid tolerance can now expect better pain management both in the postoperative period and during the course of their treatment. This article outlines the pathophysiology of opioid tolerance and a practical clinical approach to this problem.
de Leon-Casasola
O
O
Department of Anesthesiology, Pain, and Critical Care Medicine, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA.
Yarussi
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A
D000701:Analgesics, Opioid / Q000494:pharmacology*; D004361:Drug Tolerance / Q000502:physiology; D006801:Humans; D007430:Intraoperative Care; D010146:Pain / Q000503:physiopathology*; D059408:Pain Management; D011182:Postoperative Care; D011493:Protein Kinase C / Q000187:drug effects; D011953:Receptors, Cyclic AMP / Q000187:drug effects; D016194:Receptors, N-Methyl-D-Aspartate / Q000187:drug effects / Q000502:physiology
D000701:Analgesics, Opioid; D011953:Receptors, Cyclic AMP; D016194:Receptors, N-Methyl-D-Aspartate; D011493:Protein Kinase C