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Non opioid analgesics

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https://www.readbyqxmd.com/read/29470146/towards-an-effective-peripheral-visceral-analgesic-responding-to-the-national-opioid-crisis
#1
Michael Camilleri
This is an editorial summarizing recent new developments in visceral analgesics. This promising field is important as a new approach to address abdominal pain with peripheral visceral analgesics is considered a key approach to addressing the current opioid crisis. Some of the novel compounds address peripheral pain mechanisms through modulation of opioid receptors through biased ligands, nociceptin/orphanin FQ opioid peptide (NOP) receptor or dual action on NOP and μ-opioid receptor, buprenorphine and morphiceptin analogs...
February 22, 2018: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/29454629/postoperative-pain-and-analgesia-administration-in-children-after-urological-outpatient-procedures
#2
A Schröder, F A Campbell, W A Farhat, J L Pippi Salle, D J Bägli, A J Lorenzo, M A Koyle
INTRODUCTION: There are limited data about pain patterns, analgesic requirements and factors predicting opioid requirements of children undergoing outpatient urologic surgery. This prospective study aimed to assess recovery profiles and pain medication requirements. METHODS: Patients between 6 months and 12 years of age were recruited prospectively between December 2013 and June 2014. Demographic and operative characteristics were collected. Following discharge home, the parents were asked to administer both acetaminophen and ibuprofen Q6H at a weight-adjusted dose, based on a schedule, until the end of postoperative day 2, and to administer the medication as required on postoperative day 3...
January 31, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29451672/predictors-of-persistent-prescription-opioid-analgesic-use-among-people-without-cancer-in-australia
#3
Samanta Lalic, Natasa Gisev, J Simon Bell, Maarit Jaana Korhonen, Jenni Ilomäki
AIMS: To identify patterns of opioid analgesic use and determine predictors of persistent opioid use among people without cancer. METHODS: A population-based cohort study of Australians initiating prescription opioids from July 2013 to December 2015 was conducted using data from a random 10% sample of people who accessed medicines through Australia's Pharmaceutical Benefits Scheme. A 12-month look-back period was used to define opioid initiation, exclude people with cancer, and determine comorbidities...
February 16, 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29442160/peri-articular-injection-of-an-analgesic-mixture-in-primary-total-hip-arthroplasty-an-effective-strategy-for-pain-control-during-the-first-post-operative-day
#4
Maria Bautista, Meilyn Muskus, Adolfo Llinás, Guillermo Bonilla, Carlos Guerrero, Jairo Moyano
BACKGROUND: Previous studies of soft tissue infiltration in hip arthroplasty present variable results. The purpose of this study is to identify whether injection of an analgesic mixture improves pain management during the immediate post-operative period. MATERIALS AND METHODS: This cohort study compared 129 patients that received peri-articular soft tissue injection with 20 ml of 0.25% bupivacaine and 2 ml of ketorolac (30 mg/1 ml) in 28 ml of saline solution, with 71 patients who did not received injections...
February 13, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29438226/racial-differences-in-presentations-and-predictors-of-acute-pain-following-motor-vehicle-collision
#5
Francesca L Beaudoin, Roee Gutman, Wanting Zhai, Roland C Merchant, Melissa A Clark, Kenneth A Bollen, Phyllis Hendry, Michael C Kurz, Christopher Lewandowski, Claire Pearson, Brian O'Neil, Elizabeth Datner, Patricia Mitchell, Robert Domeier, Samuel A McLean
African-Americans experience a greater burden of acute pain than non-Hispanic white individuals across of variety of acute medical conditions, but it is unknown if this is the case following trauma. We evaluated pain, pain-related characteristics (e.g. peri-traumatic distress), and analgesic treatment in two cohorts of individuals (African-American (n=931) and non-Hispanic white (n=948)) presenting to the emergency department after a motor-vehicle crash (MVC). We performed a propensity-matched analysis (n=796 in each group) to assess racial differences in acute pain in the ED...
February 9, 2018: Pain
https://www.readbyqxmd.com/read/29436434/updates-in-palliative-care-overview-and-recent-advancements-in-the-pharmacological-management-of-cancer-pain
#6
Helen Wood, Andrew Dickman, Angela Star, Jason W Boland
Pain is a common symptom in many types of cancer. Interdisciplinary team management, including pain assessment, explanation to the patient/family, treating the reversible, non-pharmacological treatments and reassessment are essential. This article focuses on the pharmacological management of cancer pain, and overviews and updates on the recent advances in this field. Both non-opioid and opioid analgesia as well as coanalgesics (adjuvants) are reviewed. Within non-opioid analgesia the risks of non-steroidal anti-inflammatory drugs (NSAIDs) are considered and recommendations for NSAIDs in patients at risk of gastrointestinal and cardiovascular toxicity are made...
February 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29436331/impact-of-adherence-to-antidepressants-on-long-term-prescription-opioid-use-cessation
#7
Jeffrey F Scherrer, Joanne Salas, Mark D Sullivan, Brian K Ahmedani, Laurel A Copeland, Kathleen K Bucholz, Thomas Burroughs, F David Schneider, Patrick J Lustman
BACKGROUND: Depression contributes to persistent opioid analgesic use (OAU). Treating depression may increase opioid cessation. Aims To determine if adherence to antidepressant medications (ADMs) v. non-adherence was associated with opioid cessation in patients with a new depression episode after >90 days of OAU. METHOD: Patients with non-cancer, non-HIV pain (n = 2821), with a new episode of depression following >90 days of OAU, were eligible if they received ≥1 ADM prescription from 2002 to 2012...
February 2018: British Journal of Psychiatry: the Journal of Mental Science
https://www.readbyqxmd.com/read/29433783/targeting-the-pains-of-food-insecurity-and-malnutrition-among-internally-displaced-persons-with-nutrient-synergy-and-analgesics-in-organ-meat
#8
REVIEW
Peter O Fayemi, Voster Muchenje, Hasan Yetim, Abdulatef Ahhmed
Living with pain is one of the distressing effects of food insecurity and malnutrition among millions of internally displaced persons (IDPs) worldwide. Vulnerability to emotional pain, metabolic imbalance, chronic illnesses and non-communicable diseases by IDPs are associated with stressed livelihood and restricted access to balanced diets in their camps. Tackling the complexity of issues related to internal displacement is challenging as 45% are globally trapped in protracted conditions. In this review, a diet-based intervention is proposed considering the potential benefits of nutrient synergy and analgesic constituents in organ meat...
February 2018: Food Research International
https://www.readbyqxmd.com/read/29421366/chronic-administration-of-morphine-using-mini-osmotic-pumps-affects-spatial-memory-in-the-male-rat
#9
Erika Brolin, Sofia Zelleroth, Anna Jonsson, Mathias Hallberg, Alfhild Grönbladh, Fred Nyberg
The use of opioid analgesics to treat non-cancer pain has increased over the years. Many chronic pain patients suffer from numerous adverse effects, such as reduced quality of life, development of dependence, and cognitive impairments. Cognitive processes are regulated by several systems, one of which involves growth hormone (GH) and its secondary mediator insulin-like growth factor-1 (IGF-1), but also glutamatergic transmission, including receptors such as the N-methyl-d-aspartate (NMDA)-receptor complex. In the laboratory, repeated injections are commonly used to establish animal models of long-term or chronic drug exposure...
February 5, 2018: Pharmacology, Biochemistry, and Behavior
https://www.readbyqxmd.com/read/29420604/opioid-utilization-among-pediatric-patients-treated-for-newly-diagnosed-acute-myeloid-leukemia
#10
Kelly D Getz, Tamara P Miller, Alix E Seif, Yimei Li, Yuan-Shung V Huang, Brian T Fisher, Richard Aplenc
PURPOSE: A cohort of pediatric patients with AML treated at hospitals contributing to the Pediatric Health Information System was used to evaluate differences in opioid utilization by sex, age, race, and insurance. METHODS: Billing data were used to compute the prevalence of opioid exposure and to quantify rates of utilization among those exposed to opioids as days of use per 1000 inpatient days. Multivariable regressions were used to compare opioid prevalence, and rates of utilization among those exposed...
2018: PloS One
https://www.readbyqxmd.com/read/29410385/functional-magnetic-resonance-imaging-evaluation-of-auricular-percutaneous-electrical-neural-field-stimulation-for-fibromyalgia-protocol-for-a-feasibility-study
#11
Melat Gebre, Anna Woodbury, Vitaly Napadow, Venkatagiri Krishnamurthy, Lisa C Krishnamurthy, Roman Sniecinski, Bruce Crosson
BACKGROUND: Fibromyalgia is a chronic pain state that includes widespread musculoskeletal pain, fatigue, psychiatric symptoms, cognitive and sleep disturbances, and multiple somatic symptoms. Current therapies are often insufficient or come with significant risks, and while there is an increasing demand for non-pharmacologic and especially non-opioid pain management such as that offered through complementary and alternative medicine therapies, there is currently insufficient evidence to recommend these therapies...
February 6, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29408808/pain-control-through-selective-chemo-axotomy-of-centrally-projecting-trpv1-sensory-neurons
#12
Matthew R Sapio, John K Neubert, Danielle M LaPaglia, Dragan Maric, Jason M Keller, Stephen J Raithel, Eric L Rohrs, Ethan M Anderson, John A Butman, Robert M Caudle, Dorothy C Brown, John D Heiss, Andrew J Mannes, Michael J Iadarola
Transient vanilloid potential 1 (TRPV1) agonists are emerging as highly efficacious non-opioid analgesics in preclinical studies. These drugs selectively lesion TRPV1+ primary sensory afferents, which are responsible for the transmission of many noxious stimulus modalities. Resiniferatoxin (RTX) is a very potent and selective TRPV1 agonist and is a promising candidate for treating many types of pain. Recent work establishing intrathecal application of RTX for the treatment of pain resulting from advanced cancer has demonstrated profound analgesia in client-owned dogs with osteosarcoma...
February 6, 2018: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29406367/opioid-use-during-pregnancy-observations-of-opioid-use-and-secular-trend-from-2006-to-2014-at-healthpartners-medical-group
#13
Thomas E Elliott, Caitlin K Frail, Pamala A Pawloski, Avis J Thomas, Ann M Werner, Rebecca C Rossom
OBJECTIVES: Determine the prevalence of opioid use before, during, and after pregnancy and describe its use based on patient-specific characteristics. Determine secular trend of opioid use 2006-2014. METHODS: Retrospective cohort study. A large Upper Midwest integrated healthcare system and insurer. Females age 10 to 50 years with a delivery diagnosis from July 1, 2006 through June 30, 2014. MAIN OUTCOME MEASURE: Prevalence of opioid use before, during, and after pregnancy; description of opioid use during these time periods...
February 5, 2018: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29406174/high-dose-versus-low-dose-local-anaesthetic-for-transversus-abdominis-plane-block-post-caesarean-delivery-analgesia-a-meta-analysis
#14
REVIEW
S C Ng, A S Habib, S Sodha, B Carvalho, P Sultan
BACKGROUND: The optimal local-anaesthetic (LA) dose for transversus-abdominis-plane (TAP) block is unclear. In this meta-analysis, we aimed to determine whether TAP blocks for Caesarean delivery (CD) with low-dose (LD) LA demonstrated non-inferiority in terms of analgesic efficacy, compared with high-dose (HD) LA. METHODS: A literature search was performed for randomised controlled trials examining the analgesic efficacy of TAP blocks vs control after CD. The different dosing used in these studies was classified as HD or LD (bupivacaine equivalents >50 or ≤50 mg per block side, respectively)...
February 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29404943/prediction-of-future-chronic-opioid-use-among-hospitalized-patients
#15
S L Calcaterra, S Scarbro, M L Hull, A D Forber, I A Binswanger, K L Colborn
BACKGROUND: Opioids are commonly prescribed in the hospital; yet, little is known about which patients will progress to chronic opioid therapy (COT) following discharge. We defined COT as receipt of ≥ 90-day supply of opioids with < 30-day gap in supply over a 180-day period or receipt of ≥ 10 opioid prescriptions over 1 year. Predictive tools to identify hospitalized patients at risk for future chronic opioid use could have clinical utility to improve pain management strategies and patient education during hospitalization and discharge...
February 5, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29404882/the-peripheral-corticotropin-releasing-factor-crf-induced-analgesic-effect-on-somatic-pain-sensitivity-in-conscious-rats-involving-crf-opioid-and-glucocorticoid-receptors
#16
REVIEW
Natalia I Yarushkina, Ludmila P Filaretova
The corticotropin-releasing factor (CRF) is involved in somatic pain regulation and may produce an analgesic effect in humans and animals, although the mechanisms of the CRF-induced analgesia remain unclear. CRF action is mediated by the CRF receptors of subtypes 1 and 2 (CRF-R1 and CRF-R2, respectively). Activation of the hypothalamic -pituitary -adrenocortical axis (HPA) is provided by CRF-R1; but CRF-R2 are also involved in the regulation of the HPA axis, and, respectively, glucocorticoids, the end hormones of the HPA axis, also participate in somatic pain regulation...
February 5, 2018: Inflammopharmacology
https://www.readbyqxmd.com/read/29398162/challenges-involved-in-the-development-and-delivery-of-abuse-deterrent-formulations-of-opioid-analgesics
#17
Joshua P Cohen, Mario Mendoza, Carl Roland
PURPOSE: This commentary examines the development, regulatory, and reimbursement challenges facing abuse-deterrent formulation (ADF) products. METHODS: In January 2017, the Tufts Center for the Study of Drug Development convened a roundtable to explore clinical development, regulatory, and reimbursement challenges with respect to ADFs of opioid analgesics. Roundtable participants, who included a range of pharmaceutical industry and other experts, discussed multiple challenges...
February 2, 2018: Clinical Therapeutics
https://www.readbyqxmd.com/read/29396996/intranasal-ketamine-and-its-potential-role-in-cancer-related-pain
#18
Vinita Singh, Theresa W Gillespie, R Donald Harvey
Cancer-related pain continues to be a significant therapeutic challenge, made more difficult by contemporary opioid use and diversion concerns. Conventional treatment utilizing a tiered approach of non-steroidal anti-inflammatory drugs (NSAIDs), opioids, and adjuvant agents is limited; and alternatives are needed for patients with rapidly progressing pain and those who develop hyperalgesia and tolerance to opioids. Ketamine, an N-methyl-D-aspartate (NMDA) selective antagonist, has historically been used for anesthesia in adult and pediatric populations, but has also been investigated for depression, bipolar disorder, and general and post-operative pain management...
February 3, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29383964/acute-intermittent-porphyria-general-aspects-with-focus-on-pain
#19
John Lidemberto Cardenas, Carlos Guerrero
Despite medical advances, the diagnosis and management of acute intermittent porphyria continues to be challenging. Acute pain is one of the most important clinical manifestations in acute intermittent porphyria, but management and pain assessment have been poorly studied in these patients. The lack of information and evidence based recommendations regarding these topics in the medical literature is certainly surprising. Furthermore, pain management is discussed based on extrapolating concepts adopted for other pain syndromes...
January 31, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29379630/the-opioid-abuse-risk-screener-predicts-aberrant-same-day-urine-drug-tests-and-1-year-controlled-substance-database-checks-a-brief-report
#20
Lynnette A Averill, Christopher L Averill, Lyndsay A Staley, J L Ozawa-Kirk, John Sk Kauwe, Patricia Henrie-Barrus
The Opioid Abuse Risk Screener was developed to support well-informed decision-making in opioid analgesic prescribing by extending the breadth of psychiatric risk factors evaluated relative to other non-clinician-administered measures. We examined the preliminary predictive validity of the Opioid Abuse Risk Screener relative to the widely used Screener and Opioid Assessment for Patients with Pain-Revised in predicting aberrant urine drug tests and controlled substance database checks. The Opioid Abuse Risk Screener is significantly different from the Screener and Opioid Assessment for Patients with Pain-Revised in predicting aberrant same-day urine drug tests (Z = 2...
July 2017: Health Psychology Open
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