ReviewPain medicine (Malden, Mass.)2012
Preclinical pharmacology and opioid combinations.
Review in Pain medicine (Malden, Mass.), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 60 citations in OpenAlex.
- Single dose oral analgesics for acute postoperative pain in adults - an overview of Cochrane reviews.The Cochrane database of systematic reviews · 2015Pooled it
- Effect of pretreatment with hydromorphone or buprenorphine on thermal antinociception induced by fentanyl in awake cats.Journal of feline medicine and surgery · 2016Trial
- A phase 3, randomized, double-blind comparison of analgesic efficacy and tolerability of Q8003 vs oxycodone or morphine for moderate-to-severe postoperative pain following bunionectomy surgery.Pain medicine (Malden, Mass.) · 2013Trial
- Paracetamol and NSAIDs in Cancer Pain Management: Evidence Review and Treatment Considerations.Current treatment options in oncology · 2026Review
- Neurotoxicity mechanisms and clinical implications of six common recreational drugs.Frontiers in pharmacology · 2025Review
- Review
- Opioid Receptor-Mediated Regulation of Neurotransmission in the Brain.Frontiers in molecular neuroscience · 2022Review
- Synergistic immune and antinociceptive effects induced from the combination of two different vaccines against morphine/heroin in mouse.Human vaccines & immunotherapeutics · 2021Article
- Substance use disorders: diagnosis and management for hospitalists.Journal of community hospital internal medicine perspectives · 2020Review
- The use of rotation to fentanyl in cancer-related pain.Journal of pain research · 2017Article
- Splice variation of the mu-opioid receptor and its effect on the action of opioids.British journal of pain · 2014Article
- Prevention of etomidate-induced myoclonus: which is superior: Fentanyl, midazolam, or a combination? A Retrospective comparative study.Medical science monitor : international medical journal of experimental and clinical research · 2014Article
- It's MORe exciting than mu: crosstalk between mu opioid receptors and glutamatergic transmission in the mesolimbic dopamine system.Frontiers in pharmacology · 2014Review
- Neoclerodanes as atypical opioid receptor ligands.Journal of medicinal chemistry · 2013Review
- Article
- Opioid administration and rescue dose: exploring the effects of opioid combinations.Brazilian journal of anesthesiology (Elsevier)Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
Abstract
Although effective alone, opioids are often used in combination with other drugs for relief of moderate to severe pain. Guidelines for acute perioperative pain recommend the use of multimodal therapy for pain management, although combinations of opioids are not specifically recommended. Mu opioid drugs include morphine, heroin, fentanyl, methadone, and morphine 6β-glucuronide (M6G). Their mechanism of action is complex, resulting in subtle pharmacological differences among them and with unpredictable differences in their potency, effectiveness, and tolerability among patients. Highly selective mu opioids do not bind to a single receptor. Rather, they interact with a large number of mu receptor subtypes with different activation profiles for the various drugs. Thus, mu-receptor-based drugs are not all the same and it may be possible to utilize these differences for enhanced pain control in a clinical setting. These differences among the drugs raise the question of whether combinations might result in better pain relief with fewer side effects. This concept has already been demonstrated between two mu opioids in preclinical studies and clinical trials on other combinations are ongoing. This article reviews the current state of knowledge about mu opioid receptor pharmacology, summarizes preclinical evidence for synergy from opioid combinations, and highlights the complex nature of the mu opioid receptor pharmacology.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.