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The NMDA/Nitric Oxide Synthase Cascade in Opioid Analgesia and Tolerance

  • Chapter
Glutamate and Addiction

Part of the book series: Contemporary Clinical Neuroscience ((CCNE))

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Abstract

Despite their widespread use in the management of pain, opioids have a number of issues that limit their overall utility. Chronic use of opioids is associated with a progressive decline in their analgesic efficacy, an effect commonly termed tolerance. Although analgesic responses can usually be regained with escalation of the dose, the therapeutic index of these drugs decreases with tolerance because tolerance develops to various opioid actions at different rates, making the clinical management of patients more difficult. Thus, understanding the ways in which tolerance can either be eliminated or diminished would be a significant advantage in the therapeutic use of these agents.

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Authors
  1. Gavril W. Pasternak MD,PhD
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  2. Yuri Kolesnikov MD,PhD
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Editor information

Editors and Affiliations

  1. Clinical Medical Branch, Division of Treatment Research and Development, National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH), Bethesda, MD, USA

    Barbara H. Herman PhD

  2. Pharmacology, Integrative & Cellular Neurobiology Research Branch (PICNRB), Division of Neuroscience & Behavioral Research (DNBR), National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH), Bethesda, MD, USA

    Jerry Frankenheim PhD

  3. Treatment Research Branch, Division of Clinical and Prevention Research, National Institute on Drug Abuse (NIAAA), National Institutes of Health (NIH), Bethesda, MD, USA

    Raye Z. Litten PhD

  4. Division of Neuropharmacological Drug Products Center for Drug Evaluation and Research, Office of Drug Evaluation I, Food and Drug Administration, Rockville, MD, USA

    Philip H. Sheridan MD

  5. Laboratory of Molecular and Cellular Neurobiology, Division of Intramural Clinical and Biological Research, National Institute on Drug Abuse (NIAAA) National Institutes of Health (NIH), Bethesda, MD, USA

    Forrest F. Weight MD

  6. Division of Treatment Research and Development, National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH), Bethesda, MD, USA

    Steven R. Zukin MD

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© 2002 Springer Science+Business Media New York

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Pasternak, G.W., Kolesnikov, Y. (2002). The NMDA/Nitric Oxide Synthase Cascade in Opioid Analgesia and Tolerance. In: Herman, B.H., Frankenheim, J., Litten, R.Z., Sheridan, P.H., Weight, F.F., Zukin, S.R. (eds) Glutamate and Addiction. Contemporary Clinical Neuroscience. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-306-4_28

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  • DOI: https://doi.org/10.1007/978-1-59259-306-4_28

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-234-6

  • Online ISBN: 978-1-59259-306-4

  • eBook Packages: Springer Book Archive

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