Skip to main content
Erschienen in: Der Anaesthesist 11/2017

02.10.2017 | Opioide | Leitthema

Differenzialindikation von Opioiden in der Schmerztherapie

verfasst von: Dr. J. Heyn, Prof. Dr. S. C. Azad

Erschienen in: Die Anaesthesiologie | Ausgabe 11/2017

Einloggen, um Zugang zu erhalten

Zusammenfassung

Aufgrund ihrer hohen analgetischen Potenz haben Opioide bis zum heutigen Tag einen großen Stellenwert in der Behandlung von akuten und insbesondere tumorbedingten chronischen Schmerzen. Da sich die einzelnen Opioide mitunter erheblich in ihren pharmakokinetischen und physikochemischen Eigenschaften unterscheiden, können sie nicht alle bei jedem Patienten gleichermaßen eingesetzt werden. Insbesondere bei Patienten mit Organfunktionsstörungen ist Vorsicht geboten. Darüber hinaus kann der Abbau der Opioide oder die Entstehung aktiver Metabolite durch genetische Faktoren oder Medikamenteninteraktionen maßgeblich beeinflusst werden. Die Kenntnis der Abbauwege sowie der pharmakologischen Besonderheiten einzelner Opioide kann daher helfen, Komplikationen zu vermeiden. Dieser Artikel widmet sich Pharmakologie, Anwendungsgebieten und Abbauwegen von Opioiden, die einen hohen Stellenwert in der Schmerztherapie haben.
Literatur
1.
Zurück zum Zitat Agundez JA, Ledesma MC, Ladero JM et al (1995) Prevalence of CYP2D6 gene duplication and its repercussion on the oxidative phenotype in a white population. Clin Pharmacol Ther 57:265–269CrossRefPubMed Agundez JA, Ledesma MC, Ladero JM et al (1995) Prevalence of CYP2D6 gene duplication and its repercussion on the oxidative phenotype in a white population. Clin Pharmacol Ther 57:265–269CrossRefPubMed
2.
Zurück zum Zitat Aklillu E, Persson I, Bertilsson L et al (1996) Frequent distribution of ultrarapid metabolizers of debrisoquine in an ethiopian population carrying duplicated and multiduplicated functional CYP2D6 alleles. J Pharmacol Exp Ther 278:441–446PubMed Aklillu E, Persson I, Bertilsson L et al (1996) Frequent distribution of ultrarapid metabolizers of debrisoquine in an ethiopian population carrying duplicated and multiduplicated functional CYP2D6 alleles. J Pharmacol Exp Ther 278:441–446PubMed
3.
Zurück zum Zitat Al-Hasani R, Bruchas MR (2011) Molecular mechanisms of opioid receptor-dependent signaling and behavior. Anesthesiology 115:1363–1381PubMedPubMedCentral Al-Hasani R, Bruchas MR (2011) Molecular mechanisms of opioid receptor-dependent signaling and behavior. Anesthesiology 115:1363–1381PubMedPubMedCentral
4.
Zurück zum Zitat Arbaiza D, Vidal O (2007) Tramadol in the treatment of neuropathic cancer pain: a double-blind, placebo-controlled study. Clin Drug Investig 27:75–83CrossRefPubMed Arbaiza D, Vidal O (2007) Tramadol in the treatment of neuropathic cancer pain: a double-blind, placebo-controlled study. Clin Drug Investig 27:75–83CrossRefPubMed
5.
Zurück zum Zitat Bosilkovska M, Walder B, Besson M et al (2012) Analgesics in patients with hepatic impairment: pharmacology and clinical implications. Drugs 72:1645–1669CrossRefPubMed Bosilkovska M, Walder B, Besson M et al (2012) Analgesics in patients with hepatic impairment: pharmacology and clinical implications. Drugs 72:1645–1669CrossRefPubMed
6.
Zurück zum Zitat Bradford LD (2002) CYP2D6 allele frequency in European Caucasians, Asians, Africans and their descendants. Pharmacogenomics 3:229–243CrossRefPubMed Bradford LD (2002) CYP2D6 allele frequency in European Caucasians, Asians, Africans and their descendants. Pharmacogenomics 3:229–243CrossRefPubMed
7.
Zurück zum Zitat Brockmoller J, Kirchheiner J, Meisel C et al (2000) Pharmacogenetic diagnostics of cytochrome P450 polymorphisms in clinical drug development and in drug treatment. Pharmacogenomics 1:125–151CrossRefPubMed Brockmoller J, Kirchheiner J, Meisel C et al (2000) Pharmacogenetic diagnostics of cytochrome P450 polymorphisms in clinical drug development and in drug treatment. Pharmacogenomics 1:125–151CrossRefPubMed
8.
Zurück zum Zitat Coller JK, Christrup LL, Somogyi AA (2009) Role of active metabolites in the use of opioids. Eur J Clin Pharmacol 65:121–139CrossRefPubMed Coller JK, Christrup LL, Somogyi AA (2009) Role of active metabolites in the use of opioids. Eur J Clin Pharmacol 65:121–139CrossRefPubMed
9.
Zurück zum Zitat Dahl ML, Johansson I, Bertilsson L et al (1995) Ultrarapid hydroxylation of debrisoquine in a Swedish population. Analysis of the molecular genetic basis. J Pharmacol Exp Ther 274:516–520PubMed Dahl ML, Johansson I, Bertilsson L et al (1995) Ultrarapid hydroxylation of debrisoquine in a Swedish population. Analysis of the molecular genetic basis. J Pharmacol Exp Ther 274:516–520PubMed
10.
Zurück zum Zitat Dai X, Brunson CD, Rockhold RW et al (2008) Gender differences in the antinociceptive effect of tramadol, alone or in combination with gabapentin, in mice. J Biomed Sci 15:645–651CrossRefPubMed Dai X, Brunson CD, Rockhold RW et al (2008) Gender differences in the antinociceptive effect of tramadol, alone or in combination with gabapentin, in mice. J Biomed Sci 15:645–651CrossRefPubMed
11.
Zurück zum Zitat Daly AK, Brockmoller J, Broly F et al (1996) Nomenclature for human CYP2D6 alleles. Pharmacogenetics 6:193–201CrossRefPubMed Daly AK, Brockmoller J, Broly F et al (1996) Nomenclature for human CYP2D6 alleles. Pharmacogenetics 6:193–201CrossRefPubMed
12.
Zurück zum Zitat Depriest AZ, Miller K (2014) Oxycodone/Naloxone: role in chronic pain management, opioid-induced constipation, and abuse deterrence. Pain Ther 3:1–15CrossRefPubMedPubMedCentral Depriest AZ, Miller K (2014) Oxycodone/Naloxone: role in chronic pain management, opioid-induced constipation, and abuse deterrence. Pain Ther 3:1–15CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Dieterich M, Muller-Jordan K, Stubert J et al (2012) Pain management after cesarean: a randomized controlled trial of oxycodone versus intravenous piritramide. Arch Gynecol Obstet 286:859–865CrossRefPubMed Dieterich M, Muller-Jordan K, Stubert J et al (2012) Pain management after cesarean: a randomized controlled trial of oxycodone versus intravenous piritramide. Arch Gynecol Obstet 286:859–865CrossRefPubMed
14.
Zurück zum Zitat Dobe M, Hechler T, Behlert J et al (2011) Pain therapy with children and adolescents severely disabled due to chronic pain: long-term outcome after inpatient pain therapy. Schmerz 25:411–422CrossRefPubMed Dobe M, Hechler T, Behlert J et al (2011) Pain therapy with children and adolescents severely disabled due to chronic pain: long-term outcome after inpatient pain therapy. Schmerz 25:411–422CrossRefPubMed
15.
Zurück zum Zitat Droney J, Levy J, Quigley C (2007) Prescribing opioids in renal failure. J Opioid Manag 3:309–316PubMed Droney J, Levy J, Quigley C (2007) Prescribing opioids in renal failure. J Opioid Manag 3:309–316PubMed
16.
17.
Zurück zum Zitat Engeser P, Kuate Fokan E, Laux G et al (2016) Care of patients with cancer pain in general practices in Germany. Schmerz 30:266–272CrossRefPubMed Engeser P, Kuate Fokan E, Laux G et al (2016) Care of patients with cancer pain in general practices in Germany. Schmerz 30:266–272CrossRefPubMed
18.
Zurück zum Zitat JANSSEN-CILAG (2014) Fachinformation zu Piritramid JANSSEN-CILAG (2014) Fachinformation zu Piritramid
19.
Zurück zum Zitat Finnerup NB, Attal N, Haroutounian S et al (2015) Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. Lancet Neurol 14:162–173CrossRefPubMedPubMedCentral Finnerup NB, Attal N, Haroutounian S et al (2015) Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. Lancet Neurol 14:162–173CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Flockhart DA (2007) Drug interactions: cytochrome P450 drug interaction TAble. Indiana University School of Medicine, Indianapolis (/clinpharm/ddis/Clinical-table/) Flockhart DA (2007) Drug interactions: cytochrome P450 drug interaction TAble. Indiana University School of Medicine, Indianapolis (/clinpharm/ddis/Clinical-table/)
21.
Zurück zum Zitat Fukushima-Uesaka H, Saito Y, Watanabe H et al (2004) Haplotypes of CYP3A4 and their close linkage with CYP3A5 haplotypes in a Japanese population. Hum Mutat 23:100CrossRefPubMed Fukushima-Uesaka H, Saito Y, Watanabe H et al (2004) Haplotypes of CYP3A4 and their close linkage with CYP3A5 haplotypes in a Japanese population. Hum Mutat 23:100CrossRefPubMed
22.
Zurück zum Zitat Greenspan JD, Craft RM, Leresche L et al (2007) Studying sex and gender differences in pain and analgesia: a consensus report. Pain 132(Suppl 1):S26–S45CrossRefPubMedPubMedCentral Greenspan JD, Craft RM, Leresche L et al (2007) Studying sex and gender differences in pain and analgesia: a consensus report. Pain 132(Suppl 1):S26–S45CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Grond S, Radbruch L (1998) Weak opioids. Meta-analysis for the therapy of chronic pain. Schmerz 12:142–155CrossRefPubMed Grond S, Radbruch L (1998) Weak opioids. Meta-analysis for the therapy of chronic pain. Schmerz 12:142–155CrossRefPubMed
24.
Zurück zum Zitat Grond S, Sablotzki A (2004) Clinical pharmacology of tramadol. Clin Pharmacokinet 43:879–923CrossRefPubMed Grond S, Sablotzki A (2004) Clinical pharmacology of tramadol. Clin Pharmacokinet 43:879–923CrossRefPubMed
25.
Zurück zum Zitat Grun B, Merkel U, Riedel KD et al (2012) Contribution of CYP2C19 and CYP3A4 to the formation of the active nortilidine from the prodrug tilidine. Br J Clin Pharmacol 74:854–863CrossRefPubMedPubMedCentral Grun B, Merkel U, Riedel KD et al (2012) Contribution of CYP2C19 and CYP3A4 to the formation of the active nortilidine from the prodrug tilidine. Br J Clin Pharmacol 74:854–863CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Guttler K (2012) Opioid effects – galenics make the difference. Anasthesiol Intensivmed Notfallmed Schmerzther 47:224–230CrossRefPubMed Guttler K (2012) Opioid effects – galenics make the difference. Anasthesiol Intensivmed Notfallmed Schmerzther 47:224–230CrossRefPubMed
27.
Zurück zum Zitat Hauser W, Bock F, Engeser P et al (2015) Recommendations of the updated LONTS guidelines. Long-term opioid therapy for chronic noncancer pain. Schmerz 29:109–130CrossRefPubMed Hauser W, Bock F, Engeser P et al (2015) Recommendations of the updated LONTS guidelines. Long-term opioid therapy for chronic noncancer pain. Schmerz 29:109–130CrossRefPubMed
28.
Zurück zum Zitat Hohne C, Donaubauer B, Kaisers U (2004) Opioids during anesthesia in liver and renal failure. Anaesthesist 53:291–303CrossRefPubMed Hohne C, Donaubauer B, Kaisers U (2004) Opioids during anesthesia in liver and renal failure. Anaesthesist 53:291–303CrossRefPubMed
29.
Zurück zum Zitat Jage J, Laufenberg-Feldmann R, Heid F (2008) Drugs for postoperative analgesia: routine and new aspects: Part 2: opioids, ketamine and gabapentinoids. Anaesthesist 57:491–498CrossRefPubMed Jage J, Laufenberg-Feldmann R, Heid F (2008) Drugs for postoperative analgesia: routine and new aspects: Part 2: opioids, ketamine and gabapentinoids. Anaesthesist 57:491–498CrossRefPubMed
30.
Zurück zum Zitat Karlsson M, Berggren AC (2009) Efficacy and safety of low-dose transdermal buprenorphine patches (5, 10, and 20 microg/h) versus prolonged-release tramadol tablets (75, 100, 150, and 200 mg) in patients with chronic osteoarthritis pain: a 12-week, randomized, open-label, controlled, parallel-group noninferiority study. Clin Ther 31:503–513CrossRefPubMed Karlsson M, Berggren AC (2009) Efficacy and safety of low-dose transdermal buprenorphine patches (5, 10, and 20 microg/h) versus prolonged-release tramadol tablets (75, 100, 150, and 200 mg) in patients with chronic osteoarthritis pain: a 12-week, randomized, open-label, controlled, parallel-group noninferiority study. Clin Ther 31:503–513CrossRefPubMed
31.
Zurück zum Zitat King S, Forbes K, Hanks GW et al (2011) A systematic review of the use of opioid medication for those with moderate to severe cancer pain and renal impairment: a European Palliative Care Research Collaborative opioid guidelines project. Palliat Med 25:525–552CrossRefPubMed King S, Forbes K, Hanks GW et al (2011) A systematic review of the use of opioid medication for those with moderate to severe cancer pain and renal impairment: a European Palliative Care Research Collaborative opioid guidelines project. Palliat Med 25:525–552CrossRefPubMed
32.
Zurück zum Zitat Kruger R, Meissner W, Zimmer A (2014) Misuse of opioid analgesics. An internet analysis. Schmerz 28:473–482CrossRefPubMed Kruger R, Meissner W, Zimmer A (2014) Misuse of opioid analgesics. An internet analysis. Schmerz 28:473–482CrossRefPubMed
33.
Zurück zum Zitat Kullgren J, Le V, Wheeler W (2013) Incidence of hydromorphone-induced neuroexcitation in hospice patients. J Palliat Med 16:1205–1209CrossRefPubMed Kullgren J, Le V, Wheeler W (2013) Incidence of hydromorphone-induced neuroexcitation in hospice patients. J Palliat Med 16:1205–1209CrossRefPubMed
34.
Zurück zum Zitat Lauche R, Klose P, Radbruch L et al (2015) Opioids in chronic noncancer pain-are opioids different? A systematic review and meta-analysis of efficacy, tolerability and safety in randomized head-to-head comparisons of opioids of at least four week’s duration. Schmerz 29:73–84CrossRefPubMed Lauche R, Klose P, Radbruch L et al (2015) Opioids in chronic noncancer pain-are opioids different? A systematic review and meta-analysis of efficacy, tolerability and safety in randomized head-to-head comparisons of opioids of at least four week’s duration. Schmerz 29:73–84CrossRefPubMed
35.
Zurück zum Zitat Law PY, Wong YH, Loh HH (2000) Molecular mechanisms and regulation of opioid receptor signaling. Annu Rev Pharmacol Toxicol 40:389–430CrossRefPubMed Law PY, Wong YH, Loh HH (2000) Molecular mechanisms and regulation of opioid receptor signaling. Annu Rev Pharmacol Toxicol 40:389–430CrossRefPubMed
36.
Zurück zum Zitat Lindena G, Arnau H, Liefhold J (1998) Hydromorphone – review of pharmacological properties and therapeutic efficacy with special regard to a controlled release preparation. Schmerz 12:195–204CrossRefPubMed Lindena G, Arnau H, Liefhold J (1998) Hydromorphone – review of pharmacological properties and therapeutic efficacy with special regard to a controlled release preparation. Schmerz 12:195–204CrossRefPubMed
37.
Zurück zum Zitat Marschall U, L’hoest H, Radbruch L et al (2016) Long-term opioid therapy for chronic non-cancer pain in Germany. Eur J Pain 20:767–776CrossRefPubMed Marschall U, L’hoest H, Radbruch L et al (2016) Long-term opioid therapy for chronic non-cancer pain in Germany. Eur J Pain 20:767–776CrossRefPubMed
38.
39.
Zurück zum Zitat Messerer B, Grogl G, Stromer W et al (2014) Pediatric perioperative systemic pain therapy: Austrian interdisciplinary recommendations on pediatric perioperative pain management. Schmerz 28:43–64CrossRefPubMed Messerer B, Grogl G, Stromer W et al (2014) Pediatric perioperative systemic pain therapy: Austrian interdisciplinary recommendations on pediatric perioperative pain management. Schmerz 28:43–64CrossRefPubMed
40.
Zurück zum Zitat Michel-Lauter B, Maier C, Schwarzer A (2012) Accidental levomethadone intoxication in a palliative patient. Schmerz 26:721–723CrossRefPubMed Michel-Lauter B, Maier C, Schwarzer A (2012) Accidental levomethadone intoxication in a palliative patient. Schmerz 26:721–723CrossRefPubMed
41.
Zurück zum Zitat Minoia P, Sciorsci RL (2001) Metabolic control through L calcium channel, PKC and opioid receptors modulation by an association of naloxone and calcium salts. Curr Drug Targets Immune Endocr Metabol Disord 1:131–137CrossRefPubMed Minoia P, Sciorsci RL (2001) Metabolic control through L calcium channel, PKC and opioid receptors modulation by an association of naloxone and calcium salts. Curr Drug Targets Immune Endocr Metabol Disord 1:131–137CrossRefPubMed
42.
Zurück zum Zitat Moody DE, Fang WB, Morrison J et al (2011) Gender differences in pharmacokinetics of maintenance dosed buprenorphine. Drug Alcohol Depend 118:479–483CrossRefPubMedPubMedCentral Moody DE, Fang WB, Morrison J et al (2011) Gender differences in pharmacokinetics of maintenance dosed buprenorphine. Drug Alcohol Depend 118:479–483CrossRefPubMedPubMedCentral
43.
Zurück zum Zitat Murthy KS, Makhlouf GM (1996) Opioid mu, delta, and kappa receptor-induced activation of phospholipase C‑beta 3 and inhibition of adenylyl cyclase is mediated by Gi2 and G(o) in smooth muscle. Mol Pharmacol 50:870–877PubMed Murthy KS, Makhlouf GM (1996) Opioid mu, delta, and kappa receptor-induced activation of phospholipase C‑beta 3 and inhibition of adenylyl cyclase is mediated by Gi2 and G(o) in smooth muscle. Mol Pharmacol 50:870–877PubMed
45.
Zurück zum Zitat Nelson DR, Koymans L, Kamataki T et al (1996) P450 superfamily: update on new sequences, gene mapping, accession numbers and nomenclature. Pharmacogenetics 6:1–42CrossRefPubMed Nelson DR, Koymans L, Kamataki T et al (1996) P450 superfamily: update on new sequences, gene mapping, accession numbers and nomenclature. Pharmacogenetics 6:1–42CrossRefPubMed
46.
Zurück zum Zitat Ninke T, Thoma-Jennerwein S, Blunk J et al (2015) Anesthesia and pain management during pregnancy. Anaesthesist 64:347–356CrossRefPubMed Ninke T, Thoma-Jennerwein S, Blunk J et al (2015) Anesthesia and pain management during pregnancy. Anaesthesist 64:347–356CrossRefPubMed
47.
Zurück zum Zitat Niscola P, Scaramucci L, Vischini G et al (2010) The use of major analgesics in patients with renal dysfunction. Curr Drug Targets 11:752–758CrossRefPubMed Niscola P, Scaramucci L, Vischini G et al (2010) The use of major analgesics in patients with renal dysfunction. Curr Drug Targets 11:752–758CrossRefPubMed
48.
Zurück zum Zitat Omura T, Sato R (1964) The carbon monoxide-binding pigment of liver microsomes. I. evidence for its hemoprotein nature. J Biol Chem 239:2370–2378PubMed Omura T, Sato R (1964) The carbon monoxide-binding pigment of liver microsomes. I. evidence for its hemoprotein nature. J Biol Chem 239:2370–2378PubMed
49.
Zurück zum Zitat Omura T, Sato R (1964) The carbon monoxide-binding pigment of liver microsomes. Ii. solubilization, purification, and properties. J Biol Chem 239:2379–2385PubMed Omura T, Sato R (1964) The carbon monoxide-binding pigment of liver microsomes. Ii. solubilization, purification, and properties. J Biol Chem 239:2379–2385PubMed
50.
Zurück zum Zitat Ostgathe C, Voltz R, Van Aaaken A et al (2012) Practicability, safety, and efficacy of a “German model” for opioid conversion to oral levo-methadone. Support Care Cancer 20:2105–2110CrossRefPubMed Ostgathe C, Voltz R, Van Aaaken A et al (2012) Practicability, safety, and efficacy of a “German model” for opioid conversion to oral levo-methadone. Support Care Cancer 20:2105–2110CrossRefPubMed
51.
Zurück zum Zitat Pergolizzi J, Boger RH, Budd K et al (2008) Opioids and the management of chronic severe pain in the elderly: consensus statement of an International Expert Panel with focus on the six clinically most often used World Health Organization Step III opioids (buprenorphine, fentanyl, hydromorphone, methadone, morphine, oxycodone). Pain Pract 8:287–313CrossRefPubMed Pergolizzi J, Boger RH, Budd K et al (2008) Opioids and the management of chronic severe pain in the elderly: consensus statement of an International Expert Panel with focus on the six clinically most often used World Health Organization Step III opioids (buprenorphine, fentanyl, hydromorphone, methadone, morphine, oxycodone). Pain Pract 8:287–313CrossRefPubMed
52.
Zurück zum Zitat Pleym H, Spigset O, Kharasch ED et al (2003) Gender differences in drug effects: implications for anesthesiologists. Acta Anaesthesiol Scand 47:241–259CrossRefPubMed Pleym H, Spigset O, Kharasch ED et al (2003) Gender differences in drug effects: implications for anesthesiologists. Acta Anaesthesiol Scand 47:241–259CrossRefPubMed
53.
Zurück zum Zitat Riley J, Eisenberg E, Muller-Schwefe G et al (2008) Oxycodone: a review of its use in the management of pain. Curr Med Res Opin 24:175–192CrossRefPubMed Riley J, Eisenberg E, Muller-Schwefe G et al (2008) Oxycodone: a review of its use in the management of pain. Curr Med Res Opin 24:175–192CrossRefPubMed
54.
Zurück zum Zitat Sachse C, Brockmoller J, Bauer S et al (1997) Cytochrome P450 2D6 variants in a Caucasian population: allele frequencies and phenotypic consequences. Am J Hum Genet 60:284–295PubMedPubMedCentral Sachse C, Brockmoller J, Bauer S et al (1997) Cytochrome P450 2D6 variants in a Caucasian population: allele frequencies and phenotypic consequences. Am J Hum Genet 60:284–295PubMedPubMedCentral
55.
Zurück zum Zitat Schopper M, Fleckenstein J, Irnich D (2013) Gender differences in acute and chronic pain conditions. Implications for diagnosis and therapy. Schmerz 27:456–466CrossRefPubMed Schopper M, Fleckenstein J, Irnich D (2013) Gender differences in acute and chronic pain conditions. Implications for diagnosis and therapy. Schmerz 27:456–466CrossRefPubMed
56.
Zurück zum Zitat Schuler M, Griessinger N (2015) Opioids for noncancer pain in the elderly. Schmerz 29:380–401CrossRefPubMed Schuler M, Griessinger N (2015) Opioids for noncancer pain in the elderly. Schmerz 29:380–401CrossRefPubMed
57.
Zurück zum Zitat Scordo MG, Caputi AP, D’arrigo C et al (2004) Allele and genotype frequencies of CYP2C9, CYP2C19 and CYP2D6 in an Italian population. Pharmacol Res 50:195–200CrossRefPubMed Scordo MG, Caputi AP, D’arrigo C et al (2004) Allele and genotype frequencies of CYP2C9, CYP2C19 and CYP2D6 in an Italian population. Pharmacol Res 50:195–200CrossRefPubMed
58.
Zurück zum Zitat Stamer UM, Stuber F (2007) Genetic factors in pain and its treatment. Curr Opin Anaesthesiol 20:478–484CrossRefPubMed Stamer UM, Stuber F (2007) Genetic factors in pain and its treatment. Curr Opin Anaesthesiol 20:478–484CrossRefPubMed
60.
Zurück zum Zitat Tafelski S, Beutlhauser T, Bellin F et al (2016) Incidence of constipation in patients with outpatient opioid therapy. Schmerz 30:158–165CrossRefPubMed Tafelski S, Beutlhauser T, Bellin F et al (2016) Incidence of constipation in patients with outpatient opioid therapy. Schmerz 30:158–165CrossRefPubMed
61.
Zurück zum Zitat Turolo S, Tirelli AS, Ferraresso M et al (2010) Frequencies and roles of CYP3A5, CYP3A4 and ABCB1 single nucleotide polymorphisms in Italian teenagers after kidney transplantation. Pharmacol Rep 62:1159–1169CrossRefPubMed Turolo S, Tirelli AS, Ferraresso M et al (2010) Frequencies and roles of CYP3A5, CYP3A4 and ABCB1 single nucleotide polymorphisms in Italian teenagers after kidney transplantation. Pharmacol Rep 62:1159–1169CrossRefPubMed
62.
Zurück zum Zitat Walker AH, Jaffe JM, Gunasegaram S et al (1998) Characterization of an allelic variant in the nifedipine-specific element of CYP3A4: ethnic distribution and implications for prostate cancer risk. Mutations in brief no. 191. Online. Hum Mutat 12:289PubMed Walker AH, Jaffe JM, Gunasegaram S et al (1998) Characterization of an allelic variant in the nifedipine-specific element of CYP3A4: ethnic distribution and implications for prostate cancer risk. Mutations in brief no. 191. Online. Hum Mutat 12:289PubMed
63.
Zurück zum Zitat Walker VA, Hoskin PJ, Hanks GW et al (1988) Evaluation of WHO analgesic guidelines for cancer pain in a hospital-based palliative care unit. J Pain Symptom Manage 3:145–149CrossRefPubMed Walker VA, Hoskin PJ, Hanks GW et al (1988) Evaluation of WHO analgesic guidelines for cancer pain in a hospital-based palliative care unit. J Pain Symptom Manage 3:145–149CrossRefPubMed
64.
Zurück zum Zitat Wehrmann T, Rausch D, Seiler KU et al (1997) Tilidine does not affect human sphincter of Oddi motility – a randomized, controlled study. Aliment Pharmacol Ther 11:987–992CrossRefPubMed Wehrmann T, Rausch D, Seiler KU et al (1997) Tilidine does not affect human sphincter of Oddi motility – a randomized, controlled study. Aliment Pharmacol Ther 11:987–992CrossRefPubMed
65.
Zurück zum Zitat Weiss J, Sawa E, Riedel KD et al (2008) In vitro metabolism of the opioid tilidine and interaction of tilidine and nortilidine with CYP3A4, CYP2C19, and CYP2D6. Naunyn Schmiedebergs Arch Exp Pathol Pharmakol 378:275–282CrossRef Weiss J, Sawa E, Riedel KD et al (2008) In vitro metabolism of the opioid tilidine and interaction of tilidine and nortilidine with CYP3A4, CYP2C19, and CYP2D6. Naunyn Schmiedebergs Arch Exp Pathol Pharmakol 378:275–282CrossRef
66.
Zurück zum Zitat Wild JE, Grond S, Kuperwasser B et al (2010) Long-term safety and tolerability of tapentadol extended release for the management of chronic low back pain or osteoarthritis pain. Pain Pract 10:416–427CrossRefPubMed Wild JE, Grond S, Kuperwasser B et al (2010) Long-term safety and tolerability of tapentadol extended release for the management of chronic low back pain or osteoarthritis pain. Pain Pract 10:416–427CrossRefPubMed
67.
Zurück zum Zitat Wu CY, Wittick JJ (1977) Separation of five major alkaloids in gum opium and quantitation of morphine, codeine, and thebaine by isocratic reverse phase high performance liquid chromatography. Anal Chem 49:359–363CrossRefPubMed Wu CY, Wittick JJ (1977) Separation of five major alkaloids in gum opium and quantitation of morphine, codeine, and thebaine by isocratic reverse phase high performance liquid chromatography. Anal Chem 49:359–363CrossRefPubMed
68.
Zurück zum Zitat Zernikow B, Schiessl C, Wamsler C et al (2006) Practical pain control in pediatric oncology. Recommendations of the German Society of Pediatric Oncology and Hematology, the German Association for the Study of Pain, the German Society of Palliative Care, and the Vodafone Institute of Children’s Pain Therapy and Palliative Care. Schmerz 20:24–39CrossRefPubMed Zernikow B, Schiessl C, Wamsler C et al (2006) Practical pain control in pediatric oncology. Recommendations of the German Society of Pediatric Oncology and Hematology, the German Association for the Study of Pain, the German Society of Palliative Care, and the Vodafone Institute of Children’s Pain Therapy and Palliative Care. Schmerz 20:24–39CrossRefPubMed
69.
Zurück zum Zitat Zollner C, Schafer M (2008) Opioids in anesthesia. Anaesthesist 57:729–740 (quiz 741–722)CrossRefPubMed Zollner C, Schafer M (2008) Opioids in anesthesia. Anaesthesist 57:729–740 (quiz 741–722)CrossRefPubMed
Metadaten
Titel
Differenzialindikation von Opioiden in der Schmerztherapie
verfasst von
Dr. J. Heyn
Prof. Dr. S. C. Azad
Publikationsdatum
02.10.2017
Verlag
Springer Medizin
Erschienen in
Die Anaesthesiologie / Ausgabe 11/2017
Print ISSN: 2731-6858
Elektronische ISSN: 2731-6866
DOI
https://doi.org/10.1007/s00101-017-0369-2

Weitere Artikel der Ausgabe 11/2017

Der Anaesthesist 11/2017 Zur Ausgabe

Das könnte Sie auch interessieren

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.