Avaliação da S(+) cetamina por via oral associada à morfina no tratamento da dor oncológica

Ishizuka, Pedro; Garcia, João Batista Santos; Sakata, Rioko Kimiko; Issy, Adriana Machado; Mülich, Sílvia Letícia

doi:10.1590/s0034-70942007000100003

Cited by 8 publications

(4 citation statements)

References 26 publications

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“…In a contradictory a review written by Jonkman et al [75], they summarized from four controlled trials that there is lack of evidence that ketamine provides opioid-sparing effect for cancer pain. However, they have also argued that the efficacy of ketamine as a treatment for cancer pain management was not completely ruled out [74,75,76,77,78].…”

Section: Adjuvant Analgesics In Cancermentioning

confidence: 99%

Molecular Basis of Cancer Pain Management: An Updated Review

2019

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Pain can have a significantly negative impact on the quality of life of patients. Therefore, patients may resort to analgesics to relieve the pain. The struggle to manage pain in cancer patients effectively and safely has long been an issue in medicine. Analgesics are the mainstay treatment for pain management as they act through various methods on the peripheral and central pain pathways. However, the variability in the patient genotypes may influence a drug response and adverse drug effects that follow through. This review summarizes the observed effects of analgesics on UDP-glucuronosyl (UGT) 2B7 isoenzyme, cytochrome P450 (CYP) 2D6, μ-opioid receptor μ 1 (OPRM1), efflux transporter P-glycoprotein (P-gp) and ATP-binding cassette B1 ABCB1/multiple drug resistance 1 (MDR1) polymorphisms on the mechanism of action of these drugs in managing pain in cancer. Furthermore, this review article also discusses the responses and adverse effects caused by analgesic drugs in cancer pain management, due to the inter-individual variability in their genomes.

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Section: Adjuvant Analgesics In Cancermentioning

confidence: 99%

Molecular Basis of Cancer Pain Management: An Updated Review

2019

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“…These findings led us to use molecular docking tests [ 13 ] to investigate whether there is an association between ascaridole and specific pain receptors, such as N-methyl-D-aspartate (NMDA). This receptor has been thought responsible for the processes of central sensitization and chronic pain [ 14 ]. Some NMDA receptor antagonists have demonstrated the capacities to reduce chronic pain and to prevent hyperalgesic phenomena.…”

Section: Introductionmentioning

confidence: 99%

Chenopodium ambrosioides L. Reduces Synovial Inflammation and Pain in Experimental Osteoarthritis

et al. 2015

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The chronicity of osteoarthritis (OA), characterized by pain and inflammation in the joints, is linked to a glutamate receptor, N-methyl-D-aspartate (NMDA). The use of plant species such as Chenopodium ambrosioides L. (Amaranthaceae) as NMDA antagonists offers a promising perspective. This work aims to analyze the antinociceptive and anti-inflammatory responses of the crude hydroalcoholic extract (HCE) of C. ambrosioides leaves in an experimental OA model. Wistar rats were separated into six groups (n = 24): clean (C), negative control (CTL-), positive control (CTL+), HCE0.5, HCE5 and HCE50. The first group received no intervention. The other groups received an intra-articular injection of sodium monoiodoacetate (MIA) (8 mg/kg) on day 0. After six hours, they were orally treated with saline, Maxicam plus (meloxicam + chondroitin sulfate) and HCE at doses of 0.5 mg/kg, 5 mg/kg and 50 mg/kg, respectively. After three, seven and ten days, clinical evaluations were performed (knee diameter, mechanical allodynia, mechanical hyperalgesia and motor activity). On the tenth day, after euthanasia, synovial fluid and draining lymph node were collected for cellular quantification, and cartilage was collected for histopathological analysis. Finally, molecular docking was performed to evaluate the compatibility of ascaridole, a monoterpene found in HCE, with the NMDA receptor. After the third day, HCE reduced knee edema. HCE5 showed less cellular infiltrate in the cartilage and synovium and lower intensities of allodynia from the third day and of hyperalgesia from the seventh day up to the last treatment day. The HCE5 and HCE50 groups improved in forced walking. In relation to molecular docking, ascaridole showed NMDA receptor binding affinity. C. ambrosioides HCE was effective in the treatment of OA because it reduced synovial inflammation and behavioral changes due to pain. This effect may be related to the antagonistic effect of ascaridole on the NMDA receptor.

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“…They evaluated the intensity of pain, the presence of side effects, and analgesics prescribed at each appointment. The conclusion was that oral S (+) ketamine was not superior to placebo in the treatment of patients with oncologic pain when associated with morphine [ 30 ].…”

Section: Resultsmentioning

confidence: 99%

The Role of Ketamine in the Treatment of Chronic Cancer Pain

Zgaia

Irimie

Săndesc

et al. 2015

Medicine and Pharmacy Reports

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Background and aimKetamine is a drug used for the induction and maintenance of general anesthesia, for the treatment of postoperative and posttraumatic acute pain, and more recently, for the reduction of postoperative opioid requirements. The main mechanism of action of ketamine is the antagonization of N-methyl-D-aspartate (NMDA) receptors that are associated with central sensitization. In the pathogenesis of chronic pain and particularly in neuropathic pain, an important role is played by the activation of NMDA receptors. Although ketamine is indicated and used for the treatment of chronic cancer pain as an adjuvant to opioids, there are few clinical studies that clearly demonstrate the effectiveness of ketamine in this type of pain.The aim of this study is to analyze evidence-based clinical data on the effectiveness and safety of ketamine administration in the treatment of chronic neoplastic pain, and to summarize the evidence-based recommendations for the use of ketamine in the treatment of chronic cancer pain.MethodWe reviewed the literature from the electronic databases of MEDLINE, COCHRANE, PUBMED, MEDSCAPE (1998–2014), as well as chapters of specialized books (palliative care, pain management, anesthesia).ResultsA number of studies support the effectiveness of ketamine in the treatment of chronic cancer pain, one study does not evidence clear clinical benefits for the use of ketamine, and some studies included too few patients to be conclusive.ConclusionsKetamine represents an option for neoplasic pain that no longer responds to conventional opioid treatment, but this drug should be used with caution, and the development of potential side effects should be carefully monitored.

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Avaliação da S(+) cetamina por via oral associada à morfina no tratamento da dor oncológica

Cited by 8 publications

References 26 publications

Molecular Basis of Cancer Pain Management: An Updated Review

Molecular Basis of Cancer Pain Management: An Updated Review

Chenopodium ambrosioides L. Reduces Synovial Inflammation and Pain in Experimental Osteoarthritis

The Role of Ketamine in the Treatment of Chronic Cancer Pain

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