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Published in: Drugs 16/2007

01-11-2007 | Therapy In Practice

Pathophysiology and Management of Opioid-Induced Pruritus

Authors: Arjunan Ganesh, Lynne G. Maxwell

Published in: Drugs | Issue 16/2007

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Abstract

Pruritus occurs frequently following opioid use, particularly after neuraxial administration. Although not life threatening, pruritus is discomforting and may decrease patient satisfaction. Even though the mechanism of opioid-induced pruritus is not yet fully understood, there is increasing evidence of the important role played by μ opioid receptors. Animal experiments pointing to the role of the μ opioid receptor and the efficacy of μ opioid receptor antagonists for opioid adverse effect prophylaxis and treatment have been replicated in several studies. Serotonin and dopamine D2 receptors, prostaglandins and spinal inhibitory pathways may also be involved in the genesis of pruritus.
Several pharmacological agents have been used both for the treatment of established pruritus and in its prevention. Of these, μ opioid receptor antagonists have been most consistent in terms of attenuating opioid-induced pruritus but present problems in dose and administration. Other drugs, including mixed opioid receptor agonist-antagonists, serotonin 5-HT3 receptor antagonists, propofol, NSAIDs and D2 receptor antagonists, have also been demonstrated to be useful.
This review summarises the current understanding of the mechanisms causing opioid-induced pruritus and the pharmacological therapies available to prevent and/or manage this disorder.
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Metadata
Title
Pathophysiology and Management of Opioid-Induced Pruritus
Authors
Arjunan Ganesh
Lynne G. Maxwell
Publication date
01-11-2007
Publisher
Springer International Publishing
Published in
Drugs / Issue 16/2007
Print ISSN: 0012-6667
Electronic ISSN: 1179-1950
DOI
https://doi.org/10.2165/00003495-200767160-00003

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