@Article{Magiera2013,
journal="Medycyna Paliatywna/Palliative Medicine",
issn="2081-0016",
volume="5",
number="3",
year="2013",
title="Opioid-induced hyperalgesia a practical problem in the treatment of pain in patients with a cancer",
abstract="A complication of the opioid-based treatment of pain in patients with a cancer could be opioid-induced hyperalgesia. This phenomenon is paradoxical occurrence of pain or exacerbation of pain during the use of opioid analgetics. Opioid-induced hyperalgesia is associated with changes in the conformation of the opioid receptors. In this paper based on the literature presens 6 mechanisms of this phenomenon. These are: stimulation of NMDA receptors, opioid receptors desensitization, the effect of dynorphin A, descending impulse control pain associated with activation of On-Off cells, increasing the level of cAMP and genetic changes involving the substitution of methionine by valine affecting neurotransmission of dopamine/norepinephrine. In the following section describes the proposed method of treatment of opioid-induced hyperalgesia.",
author="Magiera, Michał Walter
and Strzelecki, Leszek",
pages="88--92",
url="https://www.termedia.pl/Opioid-induced-hyperalgesia-a-practical-problem-in-the-treatment-of-pain-in-patients-with-a-cancer,59,21719,1,1.html"
}