Related Experiment Video
Updated: Jan 31, 2026
07:23
Assessment of Morphine-induced Hyperalgesia and Analgesic Tolerance in Mice Using Thermal and Mechanical Nociceptive Modalities
Published on: July 29, 2014
34.1K
A Case of Opioid-Induced Hyperalgesia
Journal of Pain & Palliative Care Pharmacotherapy
|December 29, 2018
Summary
Opioid-induced hyperalgesia (OIH) can cause severe pain and delirium in cancer patients. Reducing opioid dosage significantly improved a patient
Area of Science:
- Palliative Care
- Oncology
- Pain Management
Background:
- Metastatic breast cancer patients often experience severe pain requiring opioid analgesia.
- Uncontrolled pain and opioid escalation can lead to complex clinical presentations.
- Opioid-induced hyperalgesia (OIH) is a potential, yet under-recognized, complication of long-term opioid therapy.
Observation:
- A 76-year-old female patient with metastatic breast cancer presented with severe pain, hypersensitivity, and delirium.
- Her symptoms worsened despite increased opioid dosage, suggesting a paradoxical effect.
- The clinical picture was highly suggestive of opioid-induced hyperalgesia.
Findings:
- Opioid dose reduction led to significant improvement in the patient's pain and overall condition.
- The patient's symptoms resolved sufficiently for her to be discharged home.
- This case highlights the importance of recognizing OIH in patients with advanced cancer.
Implications:
- Increased clinical awareness and recognition of OIH are crucial for effective pain management in oncology.
- Consideration of OIH should prompt opioid dose reduction or rotation.
- Further research is needed to better understand and manage OIH in clinical practice.
Related Concept Videos
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
1.1K
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
1.1K
01:22Opioid Receptors: Overview
4.3K
Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2,...
4.3K
01:20Opioid Analgesics: Morphine and Other Natural Cogeners
1.0K
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
1.0K
01:17Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents
675
Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
675
01:13Induced-fit Model
89.2K
Most chemical reactions in cells require enzymes—biological catalysts that speed up the reaction without being consumed or permanently changed. They reduce the activation energy needed to convert the reactants into products. Enzymes are proteins, that usually work by binding to a substrate—a reactant molecule that they act upon.
Enzymes exhibit substrate specificity, meaning that they can only bind to certain substrates. This is mainly determined by the shape and chemical...
Enzymes exhibit substrate specificity, meaning that they can only bind to certain substrates. This is mainly determined by the shape and chemical...
89.2K
01:13Induced Pluripotent Stem Cells
28.0K
Stem cells are undifferentiated cells that divide and produce different types of cells. Ordinarily, cells that have differentiated into a specific cell type are post-mitotic—that is, they no longer divide. However, scientists have found a way to reprogram these mature cells so that they “de-differentiate” and return to an unspecialized, proliferative state. These cells are also pluripotent like embryonic stem cells—able to produce all cell types—and are therefore...
28.0K