Articles: opioid-analgesics.
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The concept of multiple opioid receptors reconciles a large body of clinical and pharmacological data. Recent studies have shown that there are also multiple opioid binding sites. It would appear that there is considerable variability between species in both the specificity and selectivity of opioid receptors. ⋯ Already subspecies of mu, kappa, and sigma receptors are being postulated. Both pharmacological and neurochemical methods may reveal even more. Some of the newer kappa agonists differ in their pharmacology from the prototypic kappa agonist ethylketazocine.
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We reviewed 526 medical records of surgical patients and interviewed 81 of these patients. We also sent questionnaires to house staff (57 of 97 responded) and nurses (70 of 142 responded) involved in the care of these patients. ⋯ Physicians prescribed drugs in doses that were often inadequate and to be given at inflexible intervals. The optimal doses and duration of action of meperidine, as judged by the house staff and nurses, did not agree with the accepted pharmacologic profile of this drug.