Acute and Neuropathic Pain

P Honore and M F Jarvis, Abbott Laboratories, Abbott Park, IL, USA © 2007 Elsevier Ltd. All Rights Reserved.

6.14.1 Introduction: Pain States 328

6.14.2 Neuropathophysiology of Pain 328

6.14.3 Experimental Pain Models 331

6.14.3.1 Models of Acute Pain 331

6.14.3.1.1 Acute thermal pain 331

6.14.3.1.2 Acute mechanical pain 332

6.14.3.1.3 Acute chemical pain 332

6.14.3.2 Models of Nociceptive Pain 333

6.14.3.2.1 Adjuvant-induced arthritis 333

6.14.3.2.2 Unilateral inflammation 333

6.14.3.2.3 Models of osteoarthritic pain 333

6.14.3.3 Models of Neuropathic Pain 334

6.14.3.3.1 Direct trauma to nerves 334

6.14.3.3.2 Inflammation/neuritis/nerve compression 334

6.14.3.3.3 Diabetes 335

6.14.3.3.4 Chemotherapy-induced neuropathic pain (vincristine/paclitaxel/platine) 335

6.14.4 Clinical Trial Issues 335 6.14.4.1 Translational Medicine in Pain 337

6.14.5 Current Treatments 337

6.14.5.1 Opioids 338

6.14.5.2 Anti-Inflammatory Drugs 338

6.14.5.2.1 Nonsteroidal anti-inflammatory drugs 338

6.14.5.2.2 Cyclooxygenase-2 inhibitors 339

6.14.5.3 Analgesic Adjuvants 339

6.14.5.3.1 Amitriptyline 339

6.14.5.3.2 Antiepileptics 339

6.14.5.3.3 Pregabalin 339

6.14.5.3.4 Antidepressants 339

6.14.6 Unmet Medical Needs 340

6.14.7 New Research Areas 340

6.14.7.1 Neuronal Nicotinic Receptor Agonists 340

6.14.7.2 Vanilloid Receptor Modulators 340

6.14.7.3 Excitatory Amino Acid Receptor Antagonists 341

6.14.7.4 Calcium Channel Modulators 342

6.14.7.5 Cannabinoids 342

6.14.7.6 Sodium Channel Modulators 343

6.14.7.7 Purines 344

6.14.7.7.1 P1 receptor agonists 344

6.14.7.7.2 P2 receptor antagonists 344

6.14.7.8 Emerging Pain Targets 345

6.14.8 Conclusions 346 References 346

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