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Cebranopadol
Cebranopadol (developmental code TRN-228 and formerly GRT-6005) is an analgesic of the benzenoid class which is currently under development internationally by Tris Pharma, a private pharmaceutical company in the United States. The drug was originally discovered and developed by Grünenthal, a German pharmaceutical company and formerly developed by Park Therapeutics and Depomed, pharmaceutical companies in the United States, for the treatment of a variety of different acute and chronic pain states. As of November 2014, it is in phase III clinical trials. Cebranopadol is unique in its mechanism of action via acting as a full agonist of the μ-opioid receptor (Ki = 0.7 nM; EC50 = 1.2 nM; IA = 104%) and nociceptin receptor (or NOP receptor) (Ki = 0.9 nM; EC50 = 13.0 nM; = 89%). It has lower affinity for the δ-opioid receptor (Ki = 18 nM; EC50 = 110 nM; IA = 105%), and is a partial agonist of the κ-opioid receptor (Ki = 2.6 nM; EC50 = 17  ...
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Nociceptin Receptor
The nociceptin opioid peptide receptor (NOP), also known as the nociceptin/orphanin FQ (N/OFQ) receptor or kappa-type 3 opioid receptor, is a protein that in humans is encoded by the ''OPRL1'' (opioid receptor-like 1) gene. The nociceptin receptor is a member of the opioid subfamily of G protein-coupled receptors whose natural Ligand (biochemistry), ligand is the 17 amino acid neuropeptide known as nociceptin, nociceptin (N/OFQ). This receptor is involved in the regulation of numerous brain activities, particularly instinctive and emotional behaviors. Antagonists targeting NOP are under investigation for their role as treatments for depression and Parkinson's disease, whereas NOP agonists have been shown to act as powerful, non-addictive painkillers in non-human primates. Although NOP shares high sequence identity (~60%) with the ‘classical’ opioid receptors Μ-opioid receptor, μ-OP (MOP), Κ-opioid receptor, κ-OP (KOP), and Δ-opioid receptor, δ-OP (DOP), it possesses litt ...
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Depomed
Assertio Therapeutics, Inc. (formerly Depomed, Inc.) is an American specialty pharmaceutical company. It mainly markets products for treatment in neurology, pain and diseases of the central nervous system. Depomed was founded in 1995 and is headquartered in Newark, California. It is a publicly traded company on NASDAQ, with several products approved by the United States Food and Drug Administration (FDA). On August 15, 2018, the company announced its name change from Depomed, Inc., to Assertio Therapeutics, Inc. As of 2019, Assertio markets three products approved by the FDA: Gralise, Cambia, and Zipsor. History 1995-2009 Depomed was founded in 1995 and later became headquartered in Newark, California. A joint venture between Élan and Depomed, DDL, was established in January 2000. Élan withdrew from operational involvement in September 2003, with Depomed gaining full ownership. In September 2003, the company's subsidiary Depomed Development Ltd. acquired the exclusive righ ...
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Oral Administration
Oral administration is a route of administration whereby a substance is taken through the Human mouth, mouth, swallowed, and then processed via the digestive system. This is a common route of administration for many medications. Oral administration can be easier and less painful than other routes of administration, such as Injection (medicine), injection. However, the onset of action is relatively low, and the effectiveness is reduced if it is not absorbed properly in the digestive system, or if it is broken down by digestive enzymes before it can reach the bloodstream. Some medications may cause gastrointestinal side effects, such as nausea or vomiting, when taken orally. Oral administration can also only be applied to conscious patients, and patients able to swallow. Terminology ''Per os'' (; ''P.O.'') is an adverbial phrase meaning literally from Latin "through the mouth" or "by mouth". The expression is used in medicine to describe a treatment that is taken orally (but not ...
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κ-opioid Receptor
The κ-opioid receptor or kappa opioid receptor, abbreviated KOR or KOP for its ligand ketazocine, is a G protein-coupled receptor that in humans is encoded by the ''OPRK1'' gene. The KOR is coupled to the G protein Gi/G0 and is one of four related receptors that bind opioid-like compounds in the brain and are responsible for mediating the effects of these compounds. These effects include altering nociception, consciousness, motor control, and mood. Dysregulation of this receptor system has been implicated in alcohol and drug addiction. The KOR is a type of opioid receptor that binds the opioid peptide dynorphin as the primary endogenous ligand (substrate naturally occurring in the body). In addition to dynorphin, a variety of natural alkaloids, terpenes and synthetic ligands bind to the receptor. The KOR may provide a natural addiction control mechanism, and therefore, drugs that target this receptor may have therapeutic potential in the treatment of addiction . There ...
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Psychotomimetic
A drug with psychotomimetic (also known as psychomimetic or psychotogenic) actions mimics the symptoms of psychosis, including delusions and/or delirium, as opposed to only hallucinations. Psychotomimesis is the onset of psychotic symptoms following the administration of such a drug. Some rarely used drugs of the opioid class have psychotomimetic effects. Particularly, mixed kappa receptor agonist mu receptor antagonist opioid analgesics can cause dose-related psychotomimesis. This adverse effect, incidence 1–2%, limits their use. Pentazocine and butorphanol fall under this opioid class. There is evidence that cannabinoids are psychotomimetic, especially delta-9-tetrahydrocannabinol (Δ9-THC). D'Souza et al. (2004) found that intravenous THC produced effects that resemble schizophrenia in both the positive symptoms (hallucinations, delusions, paranoia, and disorganized thinking) and negative symptoms (avolition, asociality, apathy, alogia, and anhedonia). Certain strains of ...
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Tolerability
In pharmacology, tolerability refers to the degree to which overt adverse effects of a drug can be tolerated by a patient. Tolerability of a particular drug can be discussed in a general sense, or it can be a quantifiable measurement as part of a clinical study. Usually, it is measured by the rate of "dropouts", or patients that forfeit participation in a study due to extreme adverse effects. Tolerability, however, is often relative to the severity of the medical condition a drug is designed to treat. For instance, cancer patients may tolerate significant pain or discomfort during a chemotherapeutic study with the hope of prolonging survival or finding a cure, whereas patients experiencing a benign condition, such as a headache, are less likely to. As an example, tricyclic antidepressants (TCAs) are very poorly tolerated and often produce severe side effects including sedation, orthostatic hypotension, and anticholinergic effects, whereas newer antidepressants have far fewer ad ...
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Efficacy
Efficacy is the ability to perform a task to a satisfactory or expected degree. The word comes from the same roots as '' effectiveness'', and it has often been used synonymously, although in pharmacology a distinction is now often made between efficacy and effectiveness. The word ''efficacy'' is used in pharmacology and medicine to refer both to the maximum response achievable from a pharmaceutical drug in research settings, and to the capacity for sufficient therapeutic effect or beneficial change in clinical settings. Pharmacology In pharmacology, efficacy () is the maximum response achievable from an applied or dosed agent, for instance, a small molecule drug. Intrinsic activity is a relative term for a drug's efficacy relative to a drug with the highest observed efficacy. It is a purely descriptive term that has little or no mechanistic interpretation. In order for a drug to have an effect, it needs to bind to its target, and then to affect the function of this tar ...
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Respiration (physiology)
In physiology, respiration is the transport of oxygen from the outside environment to the Cell (biology), cells within Tissue (biology), tissues, and the removal of carbon dioxide in the opposite direction to the environment by a respiratory system. The physiological definition of respiration differs from the Cellular respiration, biochemical definition, which refers to a metabolic process by which an organism obtains energy (in the form of ATP and NADPH) by oxidizing nutrients and releasing waste products. Although physiologic respiration is necessary to sustain cellular respiration and thus life in animals, the processes are distinct: cellular respiration takes place in individual cells of the organism, while physiologic respiration concerns the Diffusion#Diffusion vs. bulk flow diffusion, diffusion and transport of metabolites between the organism and the external environment. Exchange of gases in the lung occurs by ventilation and perfusion. Ventilation refers to the in-and-ou ...
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Motor Coordination
In physiology, motor coordination is the orchestrated movement of multiple body parts as required to accomplish intended actions, like walking. This coordination is achieved by adjusting kinematic and kinetic parameters associated with each body part involved in the intended movement. The modifications of these parameters typically relies on sensory feedback from one or more sensory modalities (see multisensory integration), such as proprioception and vision. Properties Large degrees of freedom Goal-directed and coordinated movement of body parts is inherently variable because there are many ways of coordinating body parts to achieve the intended movement goal. This is because the degrees of freedom (DOF) is large for most movements due to the many associated neuro- musculoskeletal elements.Bernstein N. (1967). The Coordination and Regulation of Movements. Pergamon Press. New York. Some examples of non-repeatable movements are when pointing or standing up from sitting. Ac ...
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Drug Tolerance
Drug tolerance or drug insensitivity is a pharmacological concept describing subjects' reduced reaction to a drug following its repeated use. Increasing its dosage may re-amplify the drug's effects; however, this may accelerate tolerance, further reducing the drug's effects. Drug tolerance is indicative of drug use but is not necessarily associated with drug dependence or addiction. The process of tolerance development is reversible (e.g., through a drug holiday) and can involve both physiological factors and psychological factors. One may also develop drug tolerance to side effects, in which case tolerance is a desirable characteristic. A medical intervention that has an objective to increase tolerance (e.g., allergen immunotherapy, in which one is exposed to larger and larger amounts of allergen to decrease one's allergic reactions) is called drug desensitization. The opposite concept to drug tolerance is reverse tolerance, in which case the subject's reaction or effect wil ...
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Nociceptive Pain
Pain is a distressing feeling often caused by intense or damaging stimuli. The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage." Pain motivates organisms to withdraw from damaging situations, to protect a damaged body part while it heals, and to avoid similar experiences in the future. Congenital insensitivity to pain may result in reduced life expectancy. Most pain resolves once the noxious stimulus is removed and the body has healed, but it may persist despite removal of the stimulus and apparent healing of the body. Sometimes pain arises in the absence of any detectable stimulus, damage or disease. Pain is the most common reason for physician consultation in most developed countries. It is a major symptom in many medical conditions, and can interfere with a person's quality of life and general functioning. People in pain e ...
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Neuropathic Pain
Neuropathic pain is pain caused by a lesion or disease of the somatosensory nervous system. Neuropathic pain may be associated with abnormal sensations called dysesthesia or pain from normally non-painful stimuli (allodynia). It may have continuous and/or episodic (paroxysmal) components. The latter resemble stabbings or electric shocks. Common qualities include burning or coldness, "pins and needles" sensations, numbness and itching. Up to 7–8% of the European population is affected by neuropathic pain, and in 5% of persons it may be severe. The pain may result from disorders of the peripheral nervous system or the central nervous system (brain and spinal cord). Neuropathic pain may occur in isolation or in combination with other forms of pain. Medical treatments focus on identifying the underlying cause and relieving pain. In cases of peripheral neuropathy, the pain may progress to insensitivity. Diagnosis Diagnosis of pain conditions relies on the character of the pain w ...
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