In this talk we will discuss the following topics:
Opioid receptor structure.
Second messenger system overview.
Desensitization: an immediate effect of opioid use on the receptors and the second messenger system.
Tolerance: days to a week after opioid use disorder the mechanism for sensitization to kick in.
Dependence: a need for opioid use due to severe pains leading to dependence. (See DSM-4 for an exhaustive diagnostic criteria)
Addiction and withdrawal: an addictive state. (See DSM-4 and DSM-5 for an exhaustive diagnostic criteria.)
Opioid receptor disposition.
Adaptation of intracellular signaling mechanism.
System level counteradaptation.
Differential tolerance development.
References:
Effects of Acute and Chronic Opiate Receptor Activation
Brunton, Laurence; Knollman, Bjorn; Hilal-Dandan, Randa. Goodman and Gilman's The Pharmacological Basis of Therapeutics, 13th Edition (Goodman and Gilman's the Pharmacological Basis of Therapeutics) (p. 1362). McGraw Hill LLC. Kindle Edition.
Receptor specificity of endogenous opioids and effects of receptor activation on neurons.
Brunton, Laurence; Knollman, Bjorn; Hilal-Dandan, Randa. Goodman and Gilman's The Pharmacological Basis of Therapeutics, 13th Edition (Goodman and Gilman's the Pharmacological Basis of Therapeutics) (p. 1358). McGraw Hill LLC. Kindle Edition.
FDA's recommendations for OUD:
Information about Medication-Assisted Treatment (MAT) | FDA
https://www.fda.gov/drugs/information-drug-class/information-about-medication-assisted-treatment-mat
Diagnostic criteria for opioid use dependence and opioid use disorder
The ASAM National Practice Guideline for the Treatment of Opioid Use Disorder – 2020 Focused Update
https://www.asam.org/quality-care/clinical-guidelines/national-practice-guideline?gclid=CjwKCAiAg9urBhB_EiwAgw88mZm1lh6sE-rLtgkJP3w3ij1KSUJ4PkKqNrISFpagDzlQbRitsIJFBhoCQJIQAvD_BwE
npg-jam-supplement.pdf
https://sitefinitystorage.blob.core.windows.net/sitefinity-production-blobs/docs/default-source/guidelines/npg-jam-supplement.pdf?sfvrsn=a00a52c2_2
Psychiatry Online | DSM Legacy
https://dsm.psychiatryonline.org/dsmPreviousEditions
APA_DSM_Changes_from_DSM-IV-TR_-to_DSM-5.pdf
https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM_Changes_from_DSM-IV-TR_-to_DSM-5.pdf
Grasp opioid receptor concepts: desensitization, dependence, addiction, withdrawal.
* Identify μ receptors, understanding desensitization.
* Differentiate tolerance levels specific to opioid actions across organs and systems.
* Understand the effects of opioid withdrawal at the levels of tolerance, dependence, and addiction
. * Summarize DSM-5 criteria for opioid use disorder.
No credit card information needed.
MD., MSc., MSc., BSc
Mobeen Syed is the CEO of DrBeen Corp, a modern online medical education marketplace. Mobeen is a medical doctor and a software engineer. He graduated from the prestigious King Edward Medical University Lahore. He has been teaching medicine since 1994. Mobeen is also a software engineer and engineering leader. In this role, Mobeen has run teams consisting of hundreds of engineers and millions of dollars of budgets. Mobeen loves music, teaching, and doing business. He lives in Cupertino CA.
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2 Comments
kakavand@*.com
Jan 17 2024, 8:55 pm
Please give me the CMEs. Thank you.
nas@*.com
Jan 11 2024, 8:06 pm
Interesting video . I have been taking morphine , statex 25mg / 3 hrs for 40 years it gives me a 70% reduction in pain , makes life bearable . Taking more does no good , if I stop taking the pills the pain , very localized becomes unbearable . I HAVE TRIED EVERY therapy NOTHING HAS HELPED