Histamine-releasing and allergenic properties of opioid analgesic drugs: resolving the two.

摘要: Opioid analgesics are amongst the most commonly administered drugs in hospitals. Whether natural or synthetic, they show some common structural features, morphine-like pharmacological action and binding specificity for complementary opioid receptors. Tramadol differs from other possessing monoaminergic activity addition to its affinity µ receptor. Many opioids potent histamine releasers producing a variety of haemodynamic changes anaphylactoid reactions, but relationship appearance these effects plasma concentration is complex there no direct invariable between two. Studies histamine-releasing effects, chiefly centred on morphine, reveal variable findings conclusions often due range factors including differences technical measurements, dose, mode administration, site injection, anatomical distribution receptors heterogeneity patient responses. Morphine itself has multiple vasculature haemodynamically-active mediators released along with contribute responses drug administration. Despite their heavy use occasional apparent anaphylactic-like side-effects, immunoglobulin E antibody-mediated immediate hypersensitivity reactions not encountered. Uncertainties associated skin testing known histamine-releasers, general unavailability drug-specific antibody tests frequent failure adequately investigate establish underlying mechanisms by distinguishing true anaphylactic reactions. Clinical implications diagnosis speculations rarity Type 1 allergies presented.