Fabrizio Benedetti
- Published in print:
- 2008
- Published Online:
- September 2009
- ISBN:
- 9780199559121
- eISBN:
- 9780191724022
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199559121.003.0007
- Subject:
- Neuroscience, Molecular and Cellular Systems
Compared to other systems, little is known about the mechanisms of placebo and placebo-related effects in both the cardiovascular and the respiratory system. Side effects in placebo groups of ...
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Compared to other systems, little is known about the mechanisms of placebo and placebo-related effects in both the cardiovascular and the respiratory system. Side effects in placebo groups of cardiovascular clinical trials are common and might represent the basis of nocebo effects. Heart activity can be conditioned and can also be affected during a placebo analgesic response by the activation of the endogenous opioid systems. Not only may placebo-activated endogenous opioids act on pain transmission and the heart, but on the respiratory centres as well, inducing respiratory depression. Other conditions, like asthma and cough, are powerfully affected by placebos, but the underlying mechanisms are virtually unknown.Less
Compared to other systems, little is known about the mechanisms of placebo and placebo-related effects in both the cardiovascular and the respiratory system. Side effects in placebo groups of cardiovascular clinical trials are common and might represent the basis of nocebo effects. Heart activity can be conditioned and can also be affected during a placebo analgesic response by the activation of the endogenous opioid systems. Not only may placebo-activated endogenous opioids act on pain transmission and the heart, but on the respiratory centres as well, inducing respiratory depression. Other conditions, like asthma and cough, are powerfully affected by placebos, but the underlying mechanisms are virtually unknown.
Jill M. Grimes, Lesley Ricci, Khampaseuth Rasakham, and Richard H. Melloni, Jr.
- Published in print:
- 2005
- Published Online:
- May 2009
- ISBN:
- 9780195168761
- eISBN:
- 9780199865444
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195168761.003.0016
- Subject:
- Neuroscience, Behavioral Neuroscience, Neuroendocrine and Autonomic
This chapter summarizes studies examining the link between drugs of abuse and the behavioral neurobiology of aggressive behavior in animal models. It considers studies examining how drug abuse ...
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This chapter summarizes studies examining the link between drugs of abuse and the behavioral neurobiology of aggressive behavior in animal models. It considers studies examining how drug abuse affects the aggressive response patterns of animals, as well as the development, activity, and function of neural systems implicated in aggression control. It shows that the effects of many commonly abused drugs, illegal and prescribed, on aggression are dependent upon the sex and species of the animal, the dosing and treatment regimen, and the behavioral testing paradigm. Although very few drugs, or drug classes, have been shown to consistently influence aggressive behavior regardless of the aforementioned factors (i.e., species, age, sex, dosing, testing paradigm), there are notable exceptions, including some anabolic androgenic steroids (AAS), nicotine, 3,4-methylenedioxymethamphetamine (MDMA), and mescaline. The administration of various types of AAS has consistently increased aggression in various animal species of varying ages regardless of experimental paradigm, whereas nicotine, MDMA, and mescaline have been shown to consistently decrease aggressive responding.Less
This chapter summarizes studies examining the link between drugs of abuse and the behavioral neurobiology of aggressive behavior in animal models. It considers studies examining how drug abuse affects the aggressive response patterns of animals, as well as the development, activity, and function of neural systems implicated in aggression control. It shows that the effects of many commonly abused drugs, illegal and prescribed, on aggression are dependent upon the sex and species of the animal, the dosing and treatment regimen, and the behavioral testing paradigm. Although very few drugs, or drug classes, have been shown to consistently influence aggressive behavior regardless of the aforementioned factors (i.e., species, age, sex, dosing, testing paradigm), there are notable exceptions, including some anabolic androgenic steroids (AAS), nicotine, 3,4-methylenedioxymethamphetamine (MDMA), and mescaline. The administration of various types of AAS has consistently increased aggression in various animal species of varying ages regardless of experimental paradigm, whereas nicotine, MDMA, and mescaline have been shown to consistently decrease aggressive responding.
Krajnik Małgorzata
- Published in print:
- 2004
- Published Online:
- November 2011
- ISBN:
- 9780198525103
- eISBN:
- 9780191730238
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198525103.003.0007
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making
This chapter discusses opioid-induced pruritus, a common and adverse effect of spinal opioid administration. It discusses pruritus caused by spinal and systemic opioids. The first half focuses on the ...
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This chapter discusses opioid-induced pruritus, a common and adverse effect of spinal opioid administration. It discusses pruritus caused by spinal and systemic opioids. The first half focuses on the pathogenesis and treatment of pruritus caused by spinal opioids. The second half centres on the treatment and pathogenesis of pruritus caused by systemic opioids.Less
This chapter discusses opioid-induced pruritus, a common and adverse effect of spinal opioid administration. It discusses pruritus caused by spinal and systemic opioids. The first half focuses on the pathogenesis and treatment of pruritus caused by spinal opioids. The second half centres on the treatment and pathogenesis of pruritus caused by systemic opioids.
Justin Amery and Michelle Meiring
- Published in print:
- 2009
- Published Online:
- November 2011
- ISBN:
- 9780199567966
- eISBN:
- 9780191730566
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199567966.003.0006
- Subject:
- Palliative Care, Paediatric Palliative Medicine, Patient Care and End-of-Life Decision Making
When dealing with respiratory symptoms, this chapter suggests that one must not panic. Breathing symptoms are frightening for everyone. Mostly, one has more time than he thinks, and symptoms tend to ...
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When dealing with respiratory symptoms, this chapter suggests that one must not panic. Breathing symptoms are frightening for everyone. Mostly, one has more time than he thinks, and symptoms tend to respond well to treatment. One should hope for the best and prepare for the worst: There are two life-threatening situations in this area: acute airway obstruction and massive haemoptysis. Both need forward planning to ensure that, if they happen, the team can be calm, efficient and effective. They should have rapid access to drugs to enable rapid and complete sedation. Non-pharmacological methods are very effective. Meanwhile, the most distressing respiratory symptoms usually respond to low dose opioids and/or benzodiazepines.Less
When dealing with respiratory symptoms, this chapter suggests that one must not panic. Breathing symptoms are frightening for everyone. Mostly, one has more time than he thinks, and symptoms tend to respond well to treatment. One should hope for the best and prepare for the worst: There are two life-threatening situations in this area: acute airway obstruction and massive haemoptysis. Both need forward planning to ensure that, if they happen, the team can be calm, efficient and effective. They should have rapid access to drugs to enable rapid and complete sedation. Non-pharmacological methods are very effective. Meanwhile, the most distressing respiratory symptoms usually respond to low dose opioids and/or benzodiazepines.
John C. Longhurst
- Published in print:
- 2011
- Published Online:
- May 2011
- ISBN:
- 9780195306637
- eISBN:
- 9780199894130
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195306637.003.0009
- Subject:
- Neuroscience, Neuroendocrine and Autonomic
This chapter discusses reflex autonomic regulation of the cardiovascular system by input from finely myelinated and unmyelinated sensory nerve fibers. The focus is on abdominal and cardiac visceral ...
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This chapter discusses reflex autonomic regulation of the cardiovascular system by input from finely myelinated and unmyelinated sensory nerve fibers. The focus is on abdominal and cardiac visceral afferent activation during ischemia, somatic afferent stimulation with exercise and interactions between both afferent systems during electroacupuncture. Important mechanical and chemical stimuli are identified as well as interactions between chemical stimuli, that together provide input to cardiovascular regions in the central nervous system that process this information. For example, acupuncture-evoked modulation of visceral sympathoexcitatory reflex activity is processed in the spinal cord and hypothalamus [arcuate nucleus], midbrain [ventrolateral periaqueductal gray], and medulla [raphé nuclei and rostral ventrolateral medulla (RVLM)]. Both excitatory and inhibitory neurotransmitters, including among others, glutamate, opioids, endocannabinoids, GABA, nociceptin, and serotonin, are involved. The role of individual neurotransmitters varies by nucleus, but in concert they modulate reflex increases in blood pressure through their action on presympathetic RVLM neurons.Less
This chapter discusses reflex autonomic regulation of the cardiovascular system by input from finely myelinated and unmyelinated sensory nerve fibers. The focus is on abdominal and cardiac visceral afferent activation during ischemia, somatic afferent stimulation with exercise and interactions between both afferent systems during electroacupuncture. Important mechanical and chemical stimuli are identified as well as interactions between chemical stimuli, that together provide input to cardiovascular regions in the central nervous system that process this information. For example, acupuncture-evoked modulation of visceral sympathoexcitatory reflex activity is processed in the spinal cord and hypothalamus [arcuate nucleus], midbrain [ventrolateral periaqueductal gray], and medulla [raphé nuclei and rostral ventrolateral medulla (RVLM)]. Both excitatory and inhibitory neurotransmitters, including among others, glutamate, opioids, endocannabinoids, GABA, nociceptin, and serotonin, are involved. The role of individual neurotransmitters varies by nucleus, but in concert they modulate reflex increases in blood pressure through their action on presympathetic RVLM neurons.
Justin Amery and Sat Jassal
- Published in print:
- 2009
- Published Online:
- November 2011
- ISBN:
- 9780199567966
- eISBN:
- 9780191730566
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199567966.003.0020
- Subject:
- Palliative Care, Paediatric Palliative Medicine, Patient Care and End-of-Life Decision Making
This chapter provides a formulary for children's palliative care (CPC) in Africa. It discusses notes on drug treatment in children; principles of effective morphine prescribing; equivalent dose of ...
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This chapter provides a formulary for children's palliative care (CPC) in Africa. It discusses notes on drug treatment in children; principles of effective morphine prescribing; equivalent dose of opioids; children's palliative care (CPC) formulary; and formula for making oral morphine from powder.Less
This chapter provides a formulary for children's palliative care (CPC) in Africa. It discusses notes on drug treatment in children; principles of effective morphine prescribing; equivalent dose of opioids; children's palliative care (CPC) formulary; and formula for making oral morphine from powder.
CICELY SAUNDERS, MARY BAINES, and ROBERT DUNLOP
- Published in print:
- 1995
- Published Online:
- November 2011
- ISBN:
- 9780192625144
- eISBN:
- 9780191730009
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780192625144.003.0003
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
This chapter examines the use of analgesics for the control of terminal pain. Though there is no need to resort automatically to strong analgesics when a patient approaches the terminal stages of his ...
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This chapter examines the use of analgesics for the control of terminal pain. Though there is no need to resort automatically to strong analgesics when a patient approaches the terminal stages of his illness, pain must be relieved as soon as it becomes a matter of complaint. The criteria for giving analgesia, particularly opioids, should be the presence of pain and not the expected length of life. The chapter provides recommended treatment for different levels of terminal pain.Less
This chapter examines the use of analgesics for the control of terminal pain. Though there is no need to resort automatically to strong analgesics when a patient approaches the terminal stages of his illness, pain must be relieved as soon as it becomes a matter of complaint. The criteria for giving analgesia, particularly opioids, should be the presence of pain and not the expected length of life. The chapter provides recommended treatment for different levels of terminal pain.
Sandy M. Comer and James P. Zacny
- Published in print:
- 2005
- Published Online:
- April 2010
- ISBN:
- 9780195165319
- eISBN:
- 9780199894055
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195165319.003.0008
- Subject:
- Psychology, Psychopharmacology
Opioids, which have long been abused, are capable of producing euphoria and other “positive” subjective effects. Although the relationship between positive subjective effects and abuse of a drug is ...
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Opioids, which have long been abused, are capable of producing euphoria and other “positive” subjective effects. Although the relationship between positive subjective effects and abuse of a drug is not necessarily causal, there is a predictive relationship between those drugs that produce a positive spectrum of subjective effects and their likelihood of functioning as reinforcers and being abused. A host of factors influence the subjective effects of opioids (and subsequently their abuse liability); some of the more salient ones are covered in this chapter. It first describes how subjective effects of opioids are measured and then discusses how such factors as dose, route of administration, rate of onset of drug effects, tolerance and dependence, and drug use history can all influence an opioid's subjective effects.Less
Opioids, which have long been abused, are capable of producing euphoria and other “positive” subjective effects. Although the relationship between positive subjective effects and abuse of a drug is not necessarily causal, there is a predictive relationship between those drugs that produce a positive spectrum of subjective effects and their likelihood of functioning as reinforcers and being abused. A host of factors influence the subjective effects of opioids (and subsequently their abuse liability); some of the more salient ones are covered in this chapter. It first describes how subjective effects of opioids are measured and then discusses how such factors as dose, route of administration, rate of onset of drug effects, tolerance and dependence, and drug use history can all influence an opioid's subjective effects.
David C. Currow and Amy P. Abernethy
- Published in print:
- 2012
- Published Online:
- May 2012
- ISBN:
- 9780199591763
- eISBN:
- 9780191739149
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199591763.003.0007
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making
This chapter discusses the pharmacological management of breathlessness. Opioids have demonstrated benefit without documented respiratory toxicity. Several psychotropic agents and nebulized ...
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This chapter discusses the pharmacological management of breathlessness. Opioids have demonstrated benefit without documented respiratory toxicity. Several psychotropic agents and nebulized furosemide have sufficient promise to warrant rigorous prospective studies. Ultimately, reducing the frightening sensation of breathlessness is something that can be achieved predictably with medications currently available.Less
This chapter discusses the pharmacological management of breathlessness. Opioids have demonstrated benefit without documented respiratory toxicity. Several psychotropic agents and nebulized furosemide have sufficient promise to warrant rigorous prospective studies. Ultimately, reducing the frightening sensation of breathlessness is something that can be achieved predictably with medications currently available.
Gail Saiger
- Published in print:
- 2012
- Published Online:
- May 2012
- ISBN:
- 9780199694143
- eISBN:
- 9780191739255
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199694143.003.0020
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making
This chapter presents a case study to illustrate the desired skills, attitudes, and knowledge required for pain assessment and management. It examines several questions such as: How to assess the ...
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This chapter presents a case study to illustrate the desired skills, attitudes, and knowledge required for pain assessment and management. It examines several questions such as: How to assess the patient's pain? How to choose the most appropriate treatment regimen for the patient's pain syndromes? How to initiate an oral opioid? What is incident pain and how to manage it?Less
This chapter presents a case study to illustrate the desired skills, attitudes, and knowledge required for pain assessment and management. It examines several questions such as: How to assess the patient's pain? How to choose the most appropriate treatment regimen for the patient's pain syndromes? How to initiate an oral opioid? What is incident pain and how to manage it?
David C. Currow
- Published in print:
- 2005
- Published Online:
- November 2011
- ISBN:
- 9780198530039
- eISBN:
- 9780191730450
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198530039.003.0013
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
This chapter discusses pharmacological strategies to alleviate dyspnoea or breathlessness in patients with advanced disease. Although significant improvements have been made in the administration of ...
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This chapter discusses pharmacological strategies to alleviate dyspnoea or breathlessness in patients with advanced disease. Although significant improvements have been made in the administration of pharmacological approaches in terminally ill patients suffering from dyspnoea, careful considerations should be made. In easing symptomatic breathlessness, considerations on the validity and generalizability of pharmacotherapy should be discussed and considered. This is because the palliative population is composed of heterogeneous people with various clinical situations, breathlessness problems, and responses to therapy. The main concern of the chapter is breathlessness that is refractory. Discussed in it are: the clinical data and functions of opioids in managing dyspnoea; the functions of other opioids and other medications such as indomethacin, inhaled local anaesthetics, theophylline, and buspirone; and other clinical causes of dyspnoea.Less
This chapter discusses pharmacological strategies to alleviate dyspnoea or breathlessness in patients with advanced disease. Although significant improvements have been made in the administration of pharmacological approaches in terminally ill patients suffering from dyspnoea, careful considerations should be made. In easing symptomatic breathlessness, considerations on the validity and generalizability of pharmacotherapy should be discussed and considered. This is because the palliative population is composed of heterogeneous people with various clinical situations, breathlessness problems, and responses to therapy. The main concern of the chapter is breathlessness that is refractory. Discussed in it are: the clinical data and functions of opioids in managing dyspnoea; the functions of other opioids and other medications such as indomethacin, inhaled local anaesthetics, theophylline, and buspirone; and other clinical causes of dyspnoea.
Annette Vielhaber and Russell K. Portenoy
- Published in print:
- 2003
- Published Online:
- November 2011
- ISBN:
- 9780198528081
- eISBN:
- 9780191730399
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198528081.003.0009
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making
This chapter focuses on the management of pain, particularly neuropathic pain. Pain is experienced approximately by 75 per cent of cancer patients with advanced-stage disease. The neuropathic ...
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This chapter focuses on the management of pain, particularly neuropathic pain. Pain is experienced approximately by 75 per cent of cancer patients with advanced-stage disease. The neuropathic mechanisms are generally involved in almost 40 per cent of cancer pain syndromes. These pains are either disease or treatment related. In patients with metastatic solid tumours, neuropathic pain is generally disease related, while in patients with haematological malignancies, overall pain is less; however, neuropathic pain is prevalent in these patients. Neuropathic pain is a challenging symptom to many healthcare professionals. Although it may respond to opioids, it is less responsive to such treatment compared to other pain caused by pathophysiologies. In patients with haematological malignancies, management of neuropathic pain is more difficult, as non-steroidal anti-inflammatory drugs and intra-spinal catheters are problematic in these populations. Drugs discussed in the chapter that may be an alternative to opiods and which may alleviate neuropathic pain that is unresponsive to opiods include: adjuvant analgesics, corticosteroids, anti-convulsants, anti-depressants, local anaesthetics, and N-methyl-D-aspartate (NMDA) receptor antagonists. Other alternatives included herein are: topical analgesics therapies, intra-spinal therapies, and neural blockade.Less
This chapter focuses on the management of pain, particularly neuropathic pain. Pain is experienced approximately by 75 per cent of cancer patients with advanced-stage disease. The neuropathic mechanisms are generally involved in almost 40 per cent of cancer pain syndromes. These pains are either disease or treatment related. In patients with metastatic solid tumours, neuropathic pain is generally disease related, while in patients with haematological malignancies, overall pain is less; however, neuropathic pain is prevalent in these patients. Neuropathic pain is a challenging symptom to many healthcare professionals. Although it may respond to opioids, it is less responsive to such treatment compared to other pain caused by pathophysiologies. In patients with haematological malignancies, management of neuropathic pain is more difficult, as non-steroidal anti-inflammatory drugs and intra-spinal catheters are problematic in these populations. Drugs discussed in the chapter that may be an alternative to opiods and which may alleviate neuropathic pain that is unresponsive to opiods include: adjuvant analgesics, corticosteroids, anti-convulsants, anti-depressants, local anaesthetics, and N-methyl-D-aspartate (NMDA) receptor antagonists. Other alternatives included herein are: topical analgesics therapies, intra-spinal therapies, and neural blockade.
Sam H. Ahmedzai and Martin F. Muers
- Published in print:
- 2005
- Published Online:
- November 2011
- ISBN:
- 9780192631411
- eISBN:
- 9780191730160
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780192631411.003.0019
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
This chapter examines dyspnoea associated with amyotrophic lateral sclerosis (AML). It explains that dyspnoea is a common symptom in motor neurone diseases. Opioids have been found effective in ...
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This chapter examines dyspnoea associated with amyotrophic lateral sclerosis (AML). It explains that dyspnoea is a common symptom in motor neurone diseases. Opioids have been found effective in reducing the distress of dyspnoea but non-pharmacological measures can also relieve symptoms in many cases. Non-invasive ventilation may also be considered for some patients but careful discussion with patient and family is essential.Less
This chapter examines dyspnoea associated with amyotrophic lateral sclerosis (AML). It explains that dyspnoea is a common symptom in motor neurone diseases. Opioids have been found effective in reducing the distress of dyspnoea but non-pharmacological measures can also relieve symptoms in many cases. Non-invasive ventilation may also be considered for some patients but careful discussion with patient and family is essential.
Sam H. Ahmedzai and Martin F. Muers
- Published in print:
- 2005
- Published Online:
- November 2011
- ISBN:
- 9780192631411
- eISBN:
- 9780191730160
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780192631411.003.0009
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
This chapter examines different types of drugs used in the management of dyspnoea. It describes palliative drug therapies that are usually turned to when disease-orientated strategies are exhausted. ...
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This chapter examines different types of drugs used in the management of dyspnoea. It describes palliative drug therapies that are usually turned to when disease-orientated strategies are exhausted. The chapter explains that appropriate management of breathlessness requires the careful and individualised use of both non-drug and drug measures and suggests that nebulised opioids should not be considered part of standard practice, and that corticosteroids should only be used for a specific reason. Benzodiazepines and opioids are the main classes of drugs used in the palliation of breathlessness.Less
This chapter examines different types of drugs used in the management of dyspnoea. It describes palliative drug therapies that are usually turned to when disease-orientated strategies are exhausted. The chapter explains that appropriate management of breathlessness requires the careful and individualised use of both non-drug and drug measures and suggests that nebulised opioids should not be considered part of standard practice, and that corticosteroids should only be used for a specific reason. Benzodiazepines and opioids are the main classes of drugs used in the palliation of breathlessness.
Wade Berrettini
- Published in print:
- 2013
- Published Online:
- May 2013
- ISBN:
- 9780199655786
- eISBN:
- 9780191757082
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199655786.003.0011
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
This chapter reviews clinical studies of naltrexone in alcoholism and pharmacogenetic studies of naltrexone clinical trials for alcohol addiction. There is growing interest in the association between ...
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This chapter reviews clinical studies of naltrexone in alcoholism and pharmacogenetic studies of naltrexone clinical trials for alcohol addiction. There is growing interest in the association between μ-opioid receptors and addiction. Extensive data, across species, suggest that the 118G form of the μ-opioid receptor is characterized by decreased transcription and translation. Murine, primate, and human laboratory studies show that the 118G (or its species-specific homologue) variant permits alcohol to have a greater rewarding valence, leading to increased alcohol consumption. The human and rhesus data are equally convincing that naltrexone is able to blunt this greater rewarding signal.Less
This chapter reviews clinical studies of naltrexone in alcoholism and pharmacogenetic studies of naltrexone clinical trials for alcohol addiction. There is growing interest in the association between μ-opioid receptors and addiction. Extensive data, across species, suggest that the 118G form of the μ-opioid receptor is characterized by decreased transcription and translation. Murine, primate, and human laboratory studies show that the 118G (or its species-specific homologue) variant permits alcohol to have a greater rewarding valence, leading to increased alcohol consumption. The human and rhesus data are equally convincing that naltrexone is able to blunt this greater rewarding signal.
Markus Heilig
- Published in print:
- 2015
- Published Online:
- November 2015
- ISBN:
- 9780231172363
- eISBN:
- 9780231539029
- Item type:
- chapter
- Publisher:
- Columbia University Press
- DOI:
- 10.7312/columbia/9780231172363.003.0014
- Subject:
- Public Health and Epidemiology, Public Health
This chapter discusses three categories of drugs that people become addicted to. The first of these, morphine-like substances, or “opioids,” are probably the psychoactive drugs whose use goes the ...
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This chapter discusses three categories of drugs that people become addicted to. The first of these, morphine-like substances, or “opioids,” are probably the psychoactive drugs whose use goes the furthest back in the history of mankind. The next drug group—cocaine and amphetamine-like drugs—which can be bundled under the label “psychostimulants,” is important because it hooks right into the core of the brain systems thought to mediate approach behaviors and reward. Finally, alcohol makes up a substance category of its own but is probably able to fill up a catalog of actions more extensive than any other drug category. It is also, for that very reason, the addictive drug where individual differences in drug effects are the greatest.Less
This chapter discusses three categories of drugs that people become addicted to. The first of these, morphine-like substances, or “opioids,” are probably the psychoactive drugs whose use goes the furthest back in the history of mankind. The next drug group—cocaine and amphetamine-like drugs—which can be bundled under the label “psychostimulants,” is important because it hooks right into the core of the brain systems thought to mediate approach behaviors and reward. Finally, alcohol makes up a substance category of its own but is probably able to fill up a catalog of actions more extensive than any other drug category. It is also, for that very reason, the addictive drug where individual differences in drug effects are the greatest.
Benedetti Fabrizio
- Published in print:
- 2014
- Published Online:
- October 2014
- ISBN:
- 9780198705086
- eISBN:
- 9780191789151
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198705086.003.0008
- Subject:
- Neuroscience, Behavioral Neuroscience, Molecular and Cellular Systems
Compared to other systems, little is known about the mechanisms of placebo and placebo-related effects in both the cardiovascular and respiratory systems. Side effects in placebo groups of ...
More
Compared to other systems, little is known about the mechanisms of placebo and placebo-related effects in both the cardiovascular and respiratory systems. Side effects in placebo groups of cardiovascular clinical trials are common and might represent the basis of nocebo effects. Heart activity can be conditioned and can also be affected during a placebo analgesic response by the activation of the endogenous opioid systems. Not only may placebo-activated endogenous opioids act on pain transmission and the heart, but on the respiratory centers as well, inducing respiratory depression. Other conditions, like asthma and cough, are powerfully affected by placebos, but the underlying mechanisms are virtually unknown.Less
Compared to other systems, little is known about the mechanisms of placebo and placebo-related effects in both the cardiovascular and respiratory systems. Side effects in placebo groups of cardiovascular clinical trials are common and might represent the basis of nocebo effects. Heart activity can be conditioned and can also be affected during a placebo analgesic response by the activation of the endogenous opioid systems. Not only may placebo-activated endogenous opioids act on pain transmission and the heart, but on the respiratory centers as well, inducing respiratory depression. Other conditions, like asthma and cough, are powerfully affected by placebos, but the underlying mechanisms are virtually unknown.
Nigel Sykes
- Published in print:
- 2014
- Published Online:
- May 2014
- ISBN:
- 9780199686025
- eISBN:
- 9780191765940
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199686025.003.0018
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
The care of a person with ALS at the end of their life will need particular attention and careful management. As death approaches for a person with ALS it essential that everybody involved—the person ...
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The care of a person with ALS at the end of their life will need particular attention and careful management. As death approaches for a person with ALS it essential that everybody involved—the person with ALS, the family and the professional team—are aware of the changes and that there is proactive planning for the final stages of disease progression. This should include advance care planning and provision of medication so that symptoms can be managed effectively, and the maintenance of good communication between carers, family, and friends. It is important to support not only the patient and family but also the professionals involved. Many people with ALS fear a distressing death but most patients are able to die without distress with appropriate palliative care and support for those around them.Less
The care of a person with ALS at the end of their life will need particular attention and careful management. As death approaches for a person with ALS it essential that everybody involved—the person with ALS, the family and the professional team—are aware of the changes and that there is proactive planning for the final stages of disease progression. This should include advance care planning and provision of medication so that symptoms can be managed effectively, and the maintenance of good communication between carers, family, and friends. It is important to support not only the patient and family but also the professionals involved. Many people with ALS fear a distressing death but most patients are able to die without distress with appropriate palliative care and support for those around them.
A.J. Machin and R.I.M. Dunbar
- Published in print:
- 2014
- Published Online:
- March 2015
- ISBN:
- 9780199652594
- eISBN:
- 9780191804700
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:osobl/9780199652594.003.0009
- Subject:
- History, Ancient History / Archaeology
This chapter examines the role of endorphins in social bonding in humans and non-human primates. After reviewing the evidence from non-primate mammals and the issues that arise from focusing on ...
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This chapter examines the role of endorphins in social bonding in humans and non-human primates. After reviewing the evidence from non-primate mammals and the issues that arise from focusing on rodent-based models of social bonding, the chapter turns to a discussion of the brain opioid theory of social attachment. More specifically, it analyses the suggestion that the endogenous opioids are one of the missing links in the story of primate and human bonding by maintaining long-term relationships and rearing psychologically healthy, socially adept human beings. It also considers the link between endogenous opioids and genetics and the role of endogenous opioids in addiction, pro-social behaviour, and mental health disorders. Finally, it describes the use of functional scanning techniques and pharmacogenetics in investigating the link between the endogenous opioid system and social behaviour.Less
This chapter examines the role of endorphins in social bonding in humans and non-human primates. After reviewing the evidence from non-primate mammals and the issues that arise from focusing on rodent-based models of social bonding, the chapter turns to a discussion of the brain opioid theory of social attachment. More specifically, it analyses the suggestion that the endogenous opioids are one of the missing links in the story of primate and human bonding by maintaining long-term relationships and rearing psychologically healthy, socially adept human beings. It also considers the link between endogenous opioids and genetics and the role of endogenous opioids in addiction, pro-social behaviour, and mental health disorders. Finally, it describes the use of functional scanning techniques and pharmacogenetics in investigating the link between the endogenous opioid system and social behaviour.
