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Antipyretische Analgetika: Fieber-, Rheuma- oder Schmerzmittel

Non-steroidal anti-inflammatory drugs (NSAIDs): Antirheumatic, anti-pyretic or analgesic drugs?

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Zusammenfassung

Die Entdeckung der analgetischen Wirkungen von antipyretischen Analgetika ist nicht im Tierversuch geschehen, sondern hat sich nach der Einführung dieser Substanzen als Antipyretika oder Antirheumatika in der Klinik ergeben. Die Opiate entstammen dem Erfahrungsschatz der Volksmedizin (Morphin). Die Opioide sind quasi als Wirkungsanaloga entwickelt und wegen ihrer vergleichbaren Rezeptoraktivität in die Therapie eingeführt worden. Keiner dieser Wirkstoffe zeigt eine klare dosisabhängige analgetische Wirksamkeit, zumindest in biometrisch korrekten Versuchsanordnungen. Im vorliegenden Artikel werden drei Fragen diskutiert: 1. Warum sind alle bisherigen Analgetika nicht als Analgetika gesucht und gefunden worden? 2. Warum ist der Wirkungsnachweis im Experiment schwierig und meist nur über Schmerzsurrogate wie evozierte Po-tenziale etc. möglich? 3. Welche Konsequenzen haben moderne Einsichten über Wirkungsort und Wirkungsweise von Analgetika für die Entwicklung neuer möglicherweise selektiverer analgetischer Wirkstoffe?

Abstract

This manuscript reviews some aspects of the unorthodox development of analgesics. Most of them were not discovered by systematic research for analgesics; rather they were developed primarily as antipyretic or antirheumatic drugs that later became analgesics due to clinical observations. One reason for this development may be that the definition and quantification of analgesic effects under clinical circumstances is rather difficult and a clear dose-response relationship almost impossible to obtain. These drawbacks limit the discovery of new analgesics. On the other hand, modern insights into the site of action and the mode of action of antipyretic analgesics are likely to further the discovery of new and better analgesics.

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  1. Institut für Experimentelle und Klinische Pharmakologie und Toxikologie, Friedrich-Alexander Universität Erlangen-Nürnberg, Universitätsstraße 22, D-91054, Erlangen

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Brune, K. Antipyretische Analgetika: Fieber-, Rheuma- oder Schmerzmittel. Schmerz 9, 166–172 (1995). https://doi.org/10.1007/BF02528156

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  • DOI: https://doi.org/10.1007/BF02528156

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