Abstract
channels via a G protein–coupled mechanism. Ziconotide, an N-type calcium channel antagonist, effective in the treatment of neuropathic, nociceptive, and mixed neuropathic/nociceptive pain [1,2] blocks calcium influx into the presynaptic nerve terminal, preventing the release of neurotransmitters into the synapse. Unlike morphine, which acts indirectly and only partially (because some of the µ-opioid receptors are not linked to N-type calcium channels), ziconotide directly inhibits the N-type calcium channel. The phenomenon of tolerance observed with opioids, given the lack of coupling of µ-opioid receptors with calcium channels, has not been observed with ziconotide because it acts directly on calcium channels.An algorithm allowing identification of the “
Highlights
Pasquale De Negri*, Tiziana Tirri, Sergio Mameli and Alfonso Papa IRCCS, Centro di Riferimento, Oncologico della, Basilicata Rionero in Vulture, Italy
The Polyanalgesic Consensus Conference called the intrathecal administration of opioids and ziconotide as first-line therapy for chronic cancer pain
Unlike morphine, which acts indirectly and only partially, ziconotide directly inhibits the N-type calcium channel
Summary
Pasquale De Negri*, Tiziana Tirri, Sergio Mameli and Alfonso Papa IRCCS, Centro di Riferimento, Oncologico della, Basilicata Rionero in Vulture, Italy. The Polyanalgesic Consensus Conference called the intrathecal administration of opioids and ziconotide as first-line therapy for chronic cancer pain. An algorithm allowing identification of the “ideal” patient for intrathecal analgesic therapy and clear information on the use of ziconotide in cancer pain are not still available.
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