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Ketamine and NMDA-Receptor Antagonists

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Deer's Treatment of Pain

Abstract

The NMDA receptor plays a significant role in development and maintenance of pain. It is implicated in the development of neuropathic pain, reduced opioid responsiveness, hyperalgesia, and the transition from acute to chronic pain. Hence the NMDA receptor presents an attractive analgesic target for both acute and chronic pain states. This chapter discusses the molecular neurophysiologic mechanisms that mediate the significance of the NMDA receptor. It describes the potential analgesic role of NMDA-receptor antagonists such as ketamine, memantine, amantadine, dextromethorphan, and methadone. The mechanisms, pharmacokinetics, and clinical efficacy of NMDA-receptor antagonists are reviewed in detail. Clinical pearls for the practical use of the NMDA-receptor antagonists are also provided.

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Author information

Authors and Affiliations

  1. Divisions of Palliative Care and Anesthesia Pain Medicine, Massachusetts General Hospital, Boston, MA, USA

    Mihir M. Kamdar

Authors
  1. Mihir M. Kamdar
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Correspondence to Mihir M. Kamdar .

Editor information

Editors and Affiliations

  1. The Spine and Nerve Center of the Virginias, Charleston, WV, USA

    Timothy R. Deer

  2. Evolve Restorative Center, Santa Rosa, CA, USA

    Jason E. Pope

  3. Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA

    Tim J. Lamer

  4. Pain Diagnostics and Interventional Care, Sewickley, PA, USA

    David Provenzano

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Kamdar, M.M. (2019). Ketamine and NMDA-Receptor Antagonists. In: Deer, T., Pope, J., Lamer, T., Provenzano, D. (eds) Deer's Treatment of Pain. Springer, Cham. https://doi.org/10.1007/978-3-030-12281-2_24

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  • DOI: https://doi.org/10.1007/978-3-030-12281-2_24

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-12280-5

  • Online ISBN: 978-3-030-12281-2

  • eBook Packages: MedicineMedicine (R0)

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