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Immune Mechanisms of Pain and Analgesia is the first volume to discuss a new concept of immune-neural interplays leading to pain or analgesia. It argues the classical view that pain and its control are restricted to the nervous system, offering a comprehensive overview of the emerging area of immune mechanisms in pain and its control. It challenges the traditional view that pain sensation or suppression is attributed exclusively to the nervous system and presents a critical analysis of this new concept. The book is written by an internationally recognized group of researchers and discusses complex and controversial issues such as cytokines and their pain-exacerbating but also analgesic effects, the production of opioids by immune cells, peripheral analgesic and anti-inflammatory actions of opioids, immunomodulatory effects of opiates, and immunosuppressive effects of pain.
"Review of immune and glial factors within the peripheral and central nervous systems that relate to chronic pain states. Discussion of novel immune and glial targets for clinical pain control that may yield new analgesic drugs"--Provided by publisher.
New updated edition first published with Cambridge University Press. This new edition includes 29 chapters on topics as diverse as pathophysiology of atherosclerosis, vascular haemodynamics, haemostasis, thrombophilia and post-amputation pain syndromes.
The Essence of Analgesia and Analgesics is an invaluable practical resource for clinicians giving pain relief in any clinical setting, describing the pharmacologic principles and clinical use of all available pain medications. As well as detailed overviews of pain processing and analgesic theory, sections are dedicated to oral and panteral opioid analgesics, neuraxial opioids, NSAIDs, local anesthetics, anticonvulsant type analgesics, NMDA antagonists, alpha adrenergic analgesics, antidepressant analgesics, muscle relaxants, adjuvant medications, and new and emerging analgesics. The concise format of the chapters allows for quick and easy reading and assimilation of information. Enhanced by summary tables and figures, each chapter provides an overview of a particular drug, covering chemical structure, mode of activity, indications, contraindications, common doses and uses, advantages and disadvantages, and drug related adverse events. Key references are also provided. Edited by leading experts in pain management, this is essential reading for any clinician involved in pain management.
"Before neurons and their role in pain were understood, there have been many explanations to account for pain. Hippocrates (370-460 BCE) believed that it was due to an imbalance in vital fluids and in the 11th century Avicenna (980-1037) theorized that there were a number of feeling senses including touch, pain and titillation. Today we talk about four types of pain: 1) Nociceptive pain: Typically the result of tissue injury, 2) Inflammatory pain: An abnormal inflammation caused by an inappropriate response by the body's immune system, 3) Neuropathic pain: Pain caused by nerve irritation and 4) Functional pain: Pain without obvious origin. About 20% of adults have chronic pain and 7% of adults have chronic pain that frequently limits life or work activities, which increases with age. In this book we have gathered recent international research on pain and pain management from internationally renowned researchers from around the world, which we hope will be of interest to the reader"--
This textbook provides an overview of pain management useful to specialists as well as non-specialists, surgeons, and nursing staff.
Acute pain has a physiological protective role in preventing tissue damage. However, pain can become chronic due to a multitude of pathophysiological states, such as: trauma, inflammation, neural injury, viral infection, cancer, autoimmune diseases and vascular and metabolic disorders. These pathological states can trigger alterations of the pain pathways that can lead to hypersensitivity, and in such circumstances, pain loses its protective role and instead, becomes persistent and debilitating affecting seriously to the quality of life of patients. Chronic pain is one of the most important health problems worldwide. It has been estimated that 10% of adults are diagnosed with chronic pain each year. However, despite the high prevalence of chronic pain, its management is still no fully satisfactory probably due to the variety of chronic pain conditions with different etiologies (neuropathic, visceral and musculoskeletal pain), and because their pathophysiological mechanisms are only partially known. Therefore, there is a huge need for new effective therapies for the control and/or prevention of the different types of chronic pain. Chronic pain is associated with plastic changes in pain circuits of the peripheral and central nervous system, including changes in the expression of ion channels, neurotransmitters and receptors. In addition, there is growing consensus on non-neuronal mechanisms that can amplify or resolve chronic pain, and cells traditionally thought to act just as coordinators of the inflammatory response (such as immune and glial cells) are now accepted as real modulators of pain signaling. In this regard, animal models of persistent pain, such as models of neuropathic and visceral pain and models of arthritis, are helping to elucidate our understanding of the pathogenesis of chronic pain and make it possible to test experimental treatments.
This volume addresses neuronal pain mechanisms at the peripheral, spinal and supraspinal level which are thought to significantly contribute to pain and which may be the basis for the development of new treatment principles. Chapters on nociceptive mechanisms in the peripheral nociceptive system address the concept of hyperalgesic priming, the role of voltage-gated sodium channels in different inflammatory and neuropathic pain states, the hyperalgesic effects of NGF in different tissues and in inflammatory and neuropathic pain states, and the contribution of proteinase activated receptors (PAR) to the development of pain in several chronic pain conditions. Chapters on nociceptive mechanisms in the spinal cord address the particular role of NO and of glial cell activation in the generation and maintenance of inflammatory and neuropathic pain and it discusses the potential role of local inhibitory interneurons, of the endogenous endocannabinoid system and the importance of non-neuronal immune mechanisms in opioid signaling in the control of pain. Furthermore, it is presented how spinal mechanisms contribute to the expression of peripheral inflammation.
Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
This volume represents edited material that was presented at a conference on brainstem modulation of spinal nociception held in Beaune, France during July, 1987. Pain Modulation, Volume 77 in the series Progress in Brain Research reviews, analyses and suggests new research strategies on several relevant topics including: the endogenous opioid peptides; sites of action of opiates; the role of biogenic animes and non-opioid peptides in analgesia; dorsal horn circuitry; behavioural factors in the activation of pain modulating networks and clinical studies of nociceptive modulation.