Abstract

NEW HORIZONS IN OPIOID PHARMACOLOGY AND PAIN MANAGEMENT – A REVIEW

U. Hiranmai*, P. Sailaja and Y. Prapurnachandra

ABSTRACT

Opioids exert their effects by binding to specific opioid receptors—mu (MOP), delta (DOP), and kappa (KOP)—which are part of the G-protein-coupled receptor (GPCR) family. A newer addition to this receptor group, the nociceptin/orphanin FQ (NOP) receptor, has been identified as a non-classical member of the opioid receptor family. Depending on their mechanism of action, opioids can function as full agonists, partial agonists, or antagonists at these receptor sites, influencing their analgesic potency and side-effect profile. From a chemical perspective, opioids are categorized into three groups based on their synthesis: natural alkaloids (e.g., morphine and codeine), semi-synthetic derivatives (e.g., oxycodone and hydromorphone), and fully synthetic compounds (e.g., fentanyl and methadone). Regardless of their origin, these drugs primarily act on the central and peripheral nervous systems, modulating pain perception by inducing neuronal hyperpolarization and inhibiting pain signal transmission. With the evolving landscape of pain management, newer opioid formulations and alternatives are being explored to enhance analgesic efficacy whileminimizing the risks associated with opioid use, such as addiction, respiratory depression, and tolerance. This review aims to highlight recent advancements in opioid pharmacology and pain management strategies, providing insights into emerging therapeutic agents such as DSUVIA, OLINVYK (oliceridine), nitazenes, and Vx-548.

Keywords: Opioid analgesics, Pain management strategies, Novel opioid receptors, Emerging opioid therapies, Opioid pharmacology.