Buprenorphine: new tricks with an old molecule for pain management.
Sublingual buphrenorphine is a unique opioid medication based on its pharmacokinetics and pharmacodynamic properties. It may be used "on label" as an alternative choice to methadone for the treatment of opioid addiction or "off-label" for the treatment of both acute and chronic pain. Because of high mu receptor affinity and resultant blockade, it has been suggested that this might interfere with the management of moderate to severe pain in patients on opioid agonist treatment. The following article will offer strategies and approaches to address some of these real and perceived challenges.
Heit
Howard A
HA
Department of Medicine, Georgetown School of Medicine, Fairfax, VA 22031, USA. howard204@aol.com
Gourlay
Douglas L
DL
D000208:Acute Disease / Q000628:therapy; D000286:Administration, Sublingual; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D002047:Buprenorphine / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D002908:Chronic Disease / Q000628:therapy; D004357:Drug Synergism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D010148:Intractable Pain / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology; D011957:Receptors, Opioid / Q000187:drug effects / Q000378:metabolism
D000701:Analgesics, Opioid; D011957:Receptors, Opioid; D002047:Buprenorphine