Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1590/S0034-70942008000500011
Brazilian Journal of Anesthesiology
Miscellaneous

O papel dos antagonistas periféricos dos opióides no tratamento da dor e nos cuidados perioperatórios

The role of peripheral opiate antagonists in pain medicine and perioperative care

Pedro Paulo Tanaka; Jonathan Moss

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Resumo

JUSTIFICATIVA E OBJETIVOS: Estudos clínicos e pré-clínicos sobre os antagonistas periféricos dos opióides aumentaram nosso conhecimento sobre os efeitos dos opióides exógenos e endógenos. CONTEÚDO: Este artigo faz uma revisão dos estudos clínicos e pré-clínicos sobre a disfunção intestinal secundária ao uso de opióides. CONCLUSÕES: Se forem aprovados, esses fármacos podem representar soluções importantes para os problemas encontrados na prática médica com relação ao tratamento da dor.

Palavras-chave

ANALGÉSICOS, Opióides, COMPLICAÇÕES

Abstract

BACKGROUND AND OBJECTIVES: Pre-clinical and clinical trials of peripheral opiate antagonists have shed new light on the effects of exogenous and endogenous opioids. CONTENTS: This article review preclinical studies and clinical opioid bowel disfunction trials. CONCLUSIONS: If approved these drugs may offer potential solutions to important clinical problems in pain management.

Keywords

ANALGESICS, Opioids, COMPLICATIONS

References

Hughes J, Kosterlitz HW, Smith TW. The distribution of methionine-enkephalin and leucine-enkephalin in the brain and peripheral tissues. Br J Pharmacol. 1977;61:639-647.

Manara L, Bianchetti A. The central and peripheral influences of opioids on gastrointestinal propulsion. Annu Rev Pharmacol Toxicol. 1985;25:249-273.

Walsh TD. Oral morphine in chronic cancer pain. Pain. 1984;18:1-11.

McCaffrey M, Beebe A. Managing your patients' adverse reactions to narcotics. Nursing. 1989;19:166-168.

Cameron JC. Constipation related to narcotic therapy: A protocol for nurses and patients. Cancer Nurs. 1992;15:372-377.

Glare P, Lickiss JN. Unrecognized constipation in patients with advanced cancer: a recipe for therapeutic disaster. J Pain Symptom Manage. 1992;7:369-371.

Kurz A, Sessler DI. Opioid-induced bowel dysfunction: pathophysiology and potential new therapies. Drugs. 2003;63:649-671.

Fallon MT, Hanks GW. Morphine, constipation and performance status in advanced cancer patients. Palliat Med. 1999;13:159-160.

Palmer CS, Ingham M, Schmier J. Utility Assessments of Opioid Treatment for Patients with Chronic Non-Cancer Pain. . 2001.

Shook JE, Pelton JT, Hruby VJ. Peptide opioid antagonist separates peripheral and central opioid antitransit effects. J Pharmacol Exp Ther. 1987;243:492-500.

Manara L, Bianchi G, Ferretti P. Inhibition of gastrointestinal transit by morphine in rats results primarily from direct drug action on gut opioid sites. J Pharmacol Exp Ther. 1986;237:945-949.

Sykes NP. An investigation of the ability of oral naloxone to correct opioid-related constipation in patients with advanced cancer. Palliat Med. 1996;10:135-144.

Culpepper-Morgan JA, Inturrisi CE, Portenoy RK. Treatment of opioid-induced constipation with oral naloxone: a pilot study. Clin Pharmacol Ther. 1992;52:90-95.

Latasch L, Zimmermann M, Eberhardt B. Treatment of morphine-induced constipation with oral naloxone. Anaesthesist. 1997;46:191-194.

Cheskin LJ, Chami TN, Johnson RE. Assessment of nalmefene glucuronide as a selective gut opioid antagonist. Drug Alcohol Depend. 1995;39:151-154.

Maxwell LG, Kaufmann SC, Bitzer S. The effects of a small-dose naloxone infusion on opioid-induced side effects and analgesia in children and adolescents treated with intravenous patient-controlled analgesia: a double-blind, prospective, randomized, controlled study. Anesth Analg. 2005;100:953-958.

Yuan CS, Foss JF, Moss J. Effects of methylnaltrexone on morphine-induced inhibition of contraction in isolated guinea-pig ileum and human intestine. Eur J Pharmacol. 1995;276:107-11.

Yuan CS, Foss JF, O'Connor M. Methylnaltrexone prevents morphine-induced delay in oral-cecal transit time without affecting analgesia: a double-blind randomized placebo-controlled trial. Clin Pharmacol Ther. 1996;59:469-475.

Yuan CS, Foss JF, Osinski J. The safety and efficacy of oral methylnaltrexone in preventing morphine-induced delay in oral-cecal transit time. Clin Pharmacol Ther. 1997;61:467-475.

Yuan CS, Foss JF, O'Connor M. Effects of enteric-coated methylnaltrexone in preventing opioid-induced delay in oral-cecal transit time. Clin Pharmacol Ther. 2000;67:398- 404.

Yuan CS, Foss JF, O'Connor M. Gut motility and transit changes in patients receiving long-term methadone maintenance. J Clin Pharmacol. 1998;38:931-935.

Yuan CS, Foss JF, O'Connor M. Methylnaltrexone for reversal of constipation due to chronic methadone use. JAMA. 2000;283:367-372.

Yuan CS, Foss JF. Oral methylnaltrexone for opioid-induced constipation. JAMA. 2000;284:1383-1384.

Yuan CS, Wei G, Foss JF. Effects of subcutaneous methylnaltrexone on morphine-induced peripherally mediated side effects: a double-blind randomized placebo-controlled trial. J Phrmacol Exp Ther. 2002;300:118-123.

Russel K, Portenoy R, Thomas . Subcutaneous methylnaltrexone for the treatment opioid-induced constipation in patients with advanced illness: A double-blind, randomized, parallel group, dose-ranging study. J Pain Symptom Manage. 2008;35:458-468.

Thomas J, Karver S, Slatkin N. Methylnaltrexone for opioid-induced constipation in advanced illness. N Engl J Med. 2008;358:2332-2343.

McCarthy RN, Jeffcott LB, Clarke IJ. Preliminary studies on the use of plasma b-endorphin in horses as an indicator of stress and pain. J Equine Vet Sci. 1993;13:216-219.

Stewart JJ, Weisbrodt NW, Burks TF. Central and peripheral actions of morphine on intestinal transit. J Pharmacol Exp Ther. 1978;205:547-555.

Galligan JJ, Burks TF. - Centrally mediated inhibition of small intestinal transit and motility by morphine in the rat. J Pharmacol Exp Ther. 1983;226:356-361.

Daniel EE, Sutherland WH, Bogoch A. Effects of morphine and other drugs on motility of the terminal ileum. Gastroenterology. 1959;36:510-523.

Burks TF. Mediation by 5-hydroxytryptamine of morphine stimulant actions in dog intestine. J Pharmacol Exp Ther. 1973;185:530-539.

Kehlet H, Holte K. Multimodal strategies to improve surgical outcome. Am J Surg. 2002;183:630-641.

Taguchi A, Sharma N, Saleem RM. Selective postoperative inhibition of gastrointestinal opioid receptors. N Engl J Med. 2001;345:935-940.

Delaney CP, Wolff BG, Viscusi ER. Alvimopan, for postoperative ileus following bowel resection: a pooled analysis of phase III studies. Ann Surg. 2007;245:355-363.

Weese JL, Du W, Techner L. Effect of Alvimopan (ALV) on Gastrointestinal (GI) Recovery, Length of Hospital Stay (LOS), and Postoperative Ileus (POI)-Related Morbidity in Patients (PTS) Undergoing Bowel Resection (BR) for Colon or Rectal Cancer (CRC). Proceedings. 2007.

Viscuzi E, Rathmell J, Fichera A. A Double-Blind, Randomized, Placebo-Controlled Trial of Methylnaltrexone (MNTX) for Post-Operative Bowel Dysfunction in Segmenta. .

Yuan CS, Foss JF. Gastric effects of methylnaltrexone on mu, kappa, and delta opioid agonists induced brainstem unitary responses. Neuropharmacology. 1999;38:425-432.

Rosow CE, Gomery P, Chenl TY. Reversal of Opioid-Induced Bladder Dysfunction by Intravenous Naloxone and Methylnaltrexone. Clin Farmacol Ther. 2007.

Yuan CS, Foss JF, O'Connor M. Efficacy of orally administered methylnaltrexone in decreasing subjective effects after intravenous morphine. Drug Alcohol Depend. 1998;52:161-165.

Li Y, Wang X, Tian S. Methadone enhances human immunodeficiency virus infection of human immune cells. J Infect Dis. 2002;185:118-122.

Ho WZ, Guo CJ, Yuan CS. Methylnaltrexone antagonizes opioid-mediated enhancement of HIV infection of human blood mononuclear phagocytes. J Pharmacol Exp Ther. 2003;307:1158-1162.

Gupta K, Kshirsagar S, Chang L. Morphine stimulates angiogenesis by activating proangiogenic and survival-promoting signaling and promotes breast tumor growth. Cancer Res. 2002;62:4491-4498.

Singleton PA, Lingen MW, Fekete MJ. Methylnaltrexone inhibits opiate and VEGF-induced angiogenesis: role of receptor transactivation. Microvascular Res. 2006;72:3-11.

Exadaktylos AK, Buggy DJ, Moriarty DC. Can anesthetic technique for primary breast cancer surgery affect recurrence or metastasis?. Anesthesiology. 2006;105:660-664.

Singleton P, Garcia JGN, Moss J. Synergistic effects of methylnaltrexone with 5-fluorouracil and bevacizumab on inhibition of vascular endothelial growth factor-induced angiogenesis. Mol Cancer Ther. 2008;7:1669-1679.

Moss J, Zaborina O, Alverdy J. Methylnaltrexone inhibis morphine induced activation of pseudomonas aeruginosa virulence. Anesthesiology. 2006;105:A697.

Moss J, Yuan CS. Selective postoperative inhibition of gastrointestinal opioid receptors. N Engl J Med. 2002;346:455.

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