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Related Experiment Videos

Opiate antagonists in shock and trauma.

J W Holaday

    The American Journal of Emergency Medicine
    |January 1, 1984
    PubMed
    Summary

    Endogenous opioid systems contribute to circulatory shock after trauma. Naloxone, an opiate antagonist, reverses shock in animal models but has limitations; novel antagonists and thyrotropin-releasing hormone offer potential solutions.

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    Area of Science:

    • Neuroscience
    • Pharmacology
    • Critical Care Medicine

    Background:

    • Historically, pain and circulatory shock were common surgical/trauma outcomes before anesthesia.
    • Endogenous opioid systems are now understood to link pain and circulatory shock.
    • Opioid system involvement in pain relief (analgesia) is well-documented.

    Purpose of the Study:

    • To review evidence linking endogenous opioid systems to circulatory shock pathophysiology.
    • To explore the therapeutic potential of opioid antagonists like naloxone.
    • To discuss limitations and alternative strategies for managing shock.

    Main Methods:

    • Review of experimental animal studies on circulatory shock.
    • Investigation of endogenous opioid system activation in shock models (endotoxemia, hemorrhage, spinal cord trauma).
    • Evaluation of naloxone's effects on shock sequelae and spinal cord injury.

    Main Results:

    • Endogenous opioid systems contribute to shock pathophysiology from various causes.
    • Naloxone (Narcan) rapidly reverses shock's hemodynamic, metabolic, and biochemical effects in animal models.
    • Naloxone also prevents paralysis after cervical spinal cord injury.

    Conclusions:

    • Naloxone's clinical utility in shock is limited by factors like acidosis, hypothermia, and steroid interactions.
    • Specific opioid-receptor antagonists may reverse shock without compromising analgesia.
    • Thyrotropin-releasing hormone (TRH) offers an alternative, opioid-independent approach to reversing shock.

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