Diagrammatic representation of neuronal mechanisms underlying opioid tolerance, which decreases resting membrane potential, increases the action-potential.

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Diagrammatic representation of neuronal mechanisms underlying opioid tolerance, which decreases resting membrane potential, increases the action-potential duration (APD), and increases neurotransmitter release. μ-OR indicates μ-opioid receptor; IEG, immedia... Diagrammatic representation of neuronal mechanisms underlying opioid tolerance, which decreases resting membrane potential, increases the action-potential duration (APD), and increases neurotransmitter release. μ-OR indicates μ-opioid receptor; IEG, immediate early genes (c-fos, FosB); PKA, protein kinase A; CREB, cAMP response element-binding protein; APD, action-potential duration; pCREB, phosphorylated CREB protein; Gi/Go, inhibitory G proteins; Gs, stimulatory G protein; CaMK-II, calcium/calmodulin-dependent protein kinase II; PLA2, phospholipase A2; δ-OR, δ opioid receptor; NO, nitric oxide; nNOS, neuronal nitric oxide synthetase; HPETE, hydroperoxyeicosatetraenoic acid. Kanwaljeet J. S. Anand et al. Pediatrics 2010;125:e1208-e1225 ©2010 by American Academy of Pediatrics