Recent Advances in the Pharmacological Management of Pain

Abstract

Pain is an unpleasant sensation that originates from ongoing or impending tissue damage. Management of different types of pain (acute, postoperative, inflammatory, neuropathic or cancer) is the most frequent issue encountered by clinicians and pharmacological therapy is the first line of approach for the treatment of pain. This review presents and discusses recent clinical advances regarding both the improvements in delivery of analgesic drugs and improvements in the design of analgesic molecules. The new modalities of administration of analgesics used in the clinic are reviewed, including skin patches, oral and mucosal sprays, transdermal delivery systems and intranasal administration. New insights are then presented on standard drugs used to relieve pain, such as opioids (including tramadol), NSAIDs including selective cyclo-oxygenase-2 inhibitors, paracetamol (acetaminophen), local anaesthetics and adjuvant analgesics such as antidepressants, anticonvulsants (gabapentin and pregabalin), cannabinoids, ketamine and others (e.g. nefopam). Although the understanding of pain mechanisms has improved significantly recently, much more is yet to be discovered and awaited. Broadening of our knowledge is needed to improve basic and clinical research in this field in order to better alleviate pain in millions of people.

Polymeric Matrix System for Prolonged Delivery of Tramadol Hydrochloride, Part II: Biological Evaluation

“…Many treatment approaches are being used to reduce and alleviate pain, but unfortunately, there are still many unmet goals (1).…”

First in Vivo Evidence for a Functional Interaction between Chemokine and Cannabinoid Systems in the Brain

“…The pathogenesis of pain states is immensely complex, involving structural, physiological, and pharmacological changes throughout the neuroaxis. Multiple pharmacological agents have been used to treat diverse pathological pain states, including opiates, nonsteroidal, anti-inflammatory drugs, anticonvulsants, antidepressants, and others (Guindon et al, 2007).…”

Antidepressiva in der Schmerztherapie

“…Diese Nebenwirkungen, die über muskarinische, H 1 -histaminische und α 1 -adrenerge Rezeptoren vermittelt werden, können das Absetzen der Antidepressiva notwendig machen. 6 Während die Wirksamkeit von trizyklischen Antidepressiva bei neuropathischen Schmerzen in zahlreichen randomisierten und kontrollierten Studien hinlänglich gezeigt wurde, ist die diesbezügliche Datenlage für selektive Serotonin Reuptake Inhibitoren (SSRI) unklar. 11 Venlafaxin (Efectin ® ), ein Antagonist der Serotonin und Noradrenalin Wiederaufnahme, ist ein wirksamer Hemmer von Schmerzen im Rahmen einer Polyneuropathie ohne unerwünschte Wirkungen wie antimuskarinische, histaminerge oder α1-adrenerg blockierende Effekte zu verursachen.…”