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Opioid withdrawal

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https://www.readbyqxmd.com/read/28326948/rare-presentation-of-intrathecal-morphine-withdrawal-psychosis
#1
Rohit Aiyer, Vivek Jain, Anurag Bhatia, Boris Mekinulov, Semih Gungor
We report a case of a 57-year-old male patient with intrathecal morphine pump failure who presented with psychosis as part of a clinical presentation of opioid withdrawal. The patient was being treated for chronic back pain with an intrathecal morphine pump for several years. The patient spontaneously started to experience psychotic symptoms which included disorganized thinking, delusional thoughts, paranoia, auditory and visual hallucinations. Upon interrogation of intrathecal pump, it was found not to be functioning, thereby not delivering intrathecal morphine...
February 28, 2017: Pain Management
https://www.readbyqxmd.com/read/28322465/opioid-substitution-therapy-or-hidden-opioids-are-a-minefield-for-nalmefene-an-atypical-case-series-of-11-patients-in-lorraine
#2
Melissa Yéléhé-Okouma, Hervé Martini, Jérémie Lemarié, Pierre Labroca, Nadine Petitpain, Valérie Gibaja, François Paille, Pierre Gillet
Opioid antagonists such as naltrexone and nalmefene are used in drug therapy for alcoholism. Nalmefene, approved in Europe in February 2013 for the reduction of alcohol consumption is used in patients with alcohol dependence. We report 11 cases of opioid withdrawal syndrome after a single dose of nalmefene in patients usually treated with methadone, buprenorphine, but also with fentanyl or loperamide. Nalmefene is both a partial agonist and an antagonist of opioid receptors. Regarding to its opioid antagonist activity, nalmefene is contraindicated in patients with an opioid treatment...
March 21, 2017: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/28303899/the-behavioral-effects-of-the-antidepressant-tianeptine-require-the-mu-opioid-receptor
#3
Benjamin Adam Samuels, Katherine M Nautiyal, Andrew C Kruegel, Marjorie R Levinstein, Valerie M Magalong, Madalee M Gassaway, Steven G Grinnell, Jaena Han, Michael A Ansonoff, John E Pintar, Jonathan A Javitch, Dalibor Sames, René Hen
Depression is a debilitating chronic illness that affects around 350 million people worldwide. Current treatments, such as selective serotonin reuptake inhibitors (SSRIs), are not ideal because only a fraction of patients achieve remission. Tianeptine is an effective antidepressant with a previously unknown mechanism of action. We recently reported that tianeptine is a full agonist at the mu-opioid receptor (MOR). Here we demonstrate that the acute and chronic antidepressant-like behavioral effects of tianeptine in mice require MOR...
March 17, 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28301697/managing-opioid-withdrawal-for-hospital-patients-in-custody
#4
Connie R Shi, Manjinder S Kandola, Matthew Tobey, Elizabeth Singer
Dr. Brown, a hospitalist, admits Mark, a patient transferred from a local jail for management of cellulitis. The patient, who was taken into custody two days prior to hospital admission, has a history of intravenous heroin use. Mark explains that he had been prescribed buprenorphine-naloxone maintenance therapy for opioid use disorder for several years prior to being arrested and had not used other opioids during that time. As a policy, the jail where Mark is detained does not prescribe opioid agonists, and his maintenance therapy was stopped upon his arrival there...
March 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28301217/neuromodulation-with-percutaneous-electrical-nerve-field-stimulation-is-associated-with-reduction-in-signs-and-symptoms-of-opioid-withdrawal-a-multisite-retrospective-assessment
#5
Adrian Miranda, Arturo Taca
BACKGROUND: Finding an effective, non-pharmacological approach to treat opioid withdrawal could remove some of the barriers associated with pharmacotherapy. The BRIDGE® is a noninvasive, percutaneous electrical nerve field stimulator developed to target pain. OBJECTIVES: This pilot study aimed to determine (1) the effects of the BRIDGE on withdrawal scores during the induction phase of opioid withdrawal therapy, (2) the percentage of subjects who successfully transitioned to medication assisted therapy (MAT)...
March 16, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28294636/indirect-treatment-comparison-of-two-non-invasive-patient-controlled-analgesia-treatments-for-acute-post-operative-pain-management
#6
Pablo Katz, Shweta Takyar, Pamela Palmer, Hiltrud Liedgens
OBJECTIVES: To evaluate the relative clinical efficacy, safety, and tolerability associated with two non-invasive patient-controlled analgesia (PCA) treatments, sufentanil sublingual tablet system (SSTS) and fentanyl iontophoretic patient-controlled transdermal system (PCTS). These two treatments have recently been approved in the EU for the management of acute moderate-to-severe post-operative pain in adult patients. METHODS: As no head-to-head trials comparing SSTS and PCTS currently exist, indirect treatment comparison (ITC) analyses were conducted to evaluate SSTS or PCTS versus intravenous (IV) morphine PCA...
March 15, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28293525/surgical-site-infiltration-for-abdominal-surgery-a-novel-neuroanatomical-based-approach
#7
Girish P Joshi, Jeffrey E Janis, Eric M Haas, Bruce J Ramshaw, Mikio A Nihira, Brian J Dunkin
BACKGROUND: Provision of optimal postoperative analgesia should facilitate postoperative ambulation and rehabilitation. An optimal multimodal analgesia technique would include the use of nonopioid analgesics, including local/regional analgesic techniques such as surgical site local anesthetic infiltration. This article presents a novel approach to surgical site infiltration techniques for abdominal surgery based upon neuroanatomy. METHODS: Literature searches were conducted for studies reporting the neuroanatomical sources of pain after abdominal surgery...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28292795/primary-care-management-of-opioid-use-disorders-abstinence-methadone-or-buprenorphine-naloxone
#8
REVIEW
Anita Srivastava, Meldon Kahan, Maya Nader
OBJECTIVE: To advise physicians on which treatment options to recommend for specific patient populations: abstinence-based treatment, buprenorphine-naloxone maintenance, or methadone maintenance. SOURCES OF INFORMATION: PubMed was searched and literature was reviewed on the effectiveness, safety, and side effect profiles of abstinence-based treatment, buprenorphine-naloxone treatment, and methadone treatment. Both observational and interventional studies were included...
March 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28286852/acute-myocardial-infarction-following-naltrexone-consumption-a-case-report
#9
Bita Dadpour, Arash Gholoobi, Shahrad Tajoddini, Amir Habibi
Cardiovascular effects of opioid withdrawal have long been studied. It was reported that patients with underlying ischemic heart disease and atherosclerotic vessels may be complicated by a sudden physical and emotional stress due to withdrawal syndrome. But some other believes sudden increase in catecholamine level as a sympathetic overflow might effect on heart with and without underlying ischemia. In the current study, a patient on methadone maintenance therapy (MMT) who experienced myocardial infarction (MI) after taking naltrexone was described...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28285326/endogenous-opioid-system-a-promising-target-for-future-smoking-cessation-medications
#10
REVIEW
Haval Norman, Manoranjan S D'Souza
BACKGROUND: Nicotine addiction continues to be a health challenge across the world. Despite several approved medications, smokers continue to relapse. Several human and animal studies have evaluated the role of the endogenous opioid system as a potential target for smoking cessation medications. METHODS: In this review, studies that have elucidated the role of the mu (MORs), delta (DORs), and kappa (KORs) opioid receptors in nicotine reward, nicotine withdrawal, and reinstatement of nicotine seeking will be discussed...
March 11, 2017: Psychopharmacology
https://www.readbyqxmd.com/read/28282523/adolescent-community-reinforcement-approach-implementation-and-treatment-outcomes-for-youth-with-opioid-problem-use
#11
Mark D Godley, Lora L Passetti, Geetha A Subramaniam, Rodney R Funk, Jane Ellen Smith, Robert J Meyers
BACKGROUND: This paper compares adolescents with primary opioid problem use (OPU) to those with primary marijuana or alcohol problem use (MAPU) who received up to six months of Adolescent Community Reinforcement Approach (A-CRA), an empirically supported treatment. METHODS: Intake clinical characteristics, treatment implementation measures, and clinical outcomes of two substance problem groups (OPU and MAPU) were compared using data from 1712 adolescents receiving A-CRA treatment...
February 22, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28280516/evaluation-of-analgesic-activity-of-papaver-libanoticum-extract-in-mice-involvement-of-opioids-receptors
#12
Mohamad Ali Hijazi, Ahmed El-Mallah, Maha Aboul-Ela, Abdalla Ellakany
Papaver libanoticum is an endemic plant to Lebanese region (family Papaveraceae) that has not been investigated before. The present study aimed to explore the analgesic activity of dried ethanolic extract of Papaver libanoticum (PLE) using tail flick, hot plate, and acetic acid induced writhing models in mice. The involvement of opioid receptors in the analgesic mechanism was investigated using naloxone antagonism. Results demonstrated that PLE exhibited a potent dose dependent analgesic activity in all tested models for analgesia...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28280461/glutamate-and-opioid-antagonists-modulate-dopamine-levels-evoked-by-innately-attractive-male-chemosignals-in-the-nucleus-accumbens-of-female-rats
#13
María-José Sánchez-Catalán, Alejandro Orrico, Lucía Hipólito, Teodoro Zornoza, Ana Polache, Enrique Lanuza, Fernando Martínez-García, Luis Granero, Carmen Agustín-Pavón
Sexual chemosignals detected by vomeronasal and olfactory systems mediate intersexual attraction in rodents, and act as a natural reinforcer to them. The mesolimbic pathway processes natural rewards, and the nucleus accumbens receives olfactory information via glutamatergic projections from the amygdala. Thus, the aim of this study was to investigate the involvement of the mesolimbic pathway in the attraction toward sexual chemosignals. Our data show that female rats with no previous experience with males or their chemosignals display an innate preference for male-soiled bedding...
2017: Frontiers in Neuroanatomy
https://www.readbyqxmd.com/read/28278146/cdc-grand-rounds-public-health-strategies-to-prevent-neonatal-abstinence-syndrome
#14
Jean Y Ko, Sara Wolicki, Wanda D Barfield, Stephen W Patrick, Cheryl S Broussard, Kimberly A Yonkers, Rebecca Naimon, John Iskander
Neonatal abstinence syndrome (NAS) is a drug withdrawal syndrome that most commonly occurs in infants after in utero exposure to opioids, although other substances have also been associated with the syndrome (1). NAS usually appears within 48-72 hours of birth with a constellation of clinical signs, including central nervous system irritability (e.g., tremors), gastrointestinal dysfunction (e.g., feeding difficulties), and temperature instability (1) (Box 1). Opioid exposure during pregnancy might result from clinician-approved use of prescription opioids for pain relief; misuse or abuse of prescription opioids; illicit use (e...
March 10, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28268215/randomised-comparison-of-a-novel-buprenorphine-oral-lyophilisate-versus-existing-buprenorphine-sublingual-tablets-in-opioid-dependent-patients-a-first-in-patient-phase-ii-randomised-open-label-safety-study
#15
John Strang, Kylie Reed, Karolina Bogdanowicz, James Bell, Rob van der Waal, Jenny Keen, Pete Beavan, Shelagh Baillie, Alastair Knight
AIMS: To test the safety of new buprenorphine oral lyophilisate wafer ("bup-lyo") versus standard sub-lingual buprenorphine ("bup-SL"). DESIGN: Randomised (2:1) open-label study; opioid-dependent subjects; subsequent partial cross-over. SETTINGS: Specialised clinical trials facility and addictions treatment facility. PARTICIPANTS: Opioid-dependent subjects (n = 36) commencing buprenorphine maintenance (personalised dose-titration) including patients co-using alcohol, cocaine and benzodiazepines (below thresholds)...
March 8, 2017: European Addiction Research
https://www.readbyqxmd.com/read/28245872/public-sector-low-threshold-office-based-buprenorphine-treatment-outcomes-at-year-7
#16
Elenore Patterson Bhatraju, Ellie Grossman, Babak Tofighi, Jennifer McNeely, Danae DiRocco, Mara Flannery, Ann Garment, Keith Goldfeld, Marc N Gourevitch, Joshua D Lee
BACKGROUND: Buprenorphine maintenance for opioid dependence remains of limited availability among underserved populations, despite increases in US opioid misuse and overdose deaths. Low threshold primary care treatment models including the use of unobserved, "home," buprenorphine induction may simplify initiation of care and improve access. Unobserved induction and long-term treatment outcomes have not been reported recently among large, naturalistic cohorts treated in low threshold safety net primary care settings...
February 28, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/28237362/intravenous-buprenorphine-a-substitute-for-naloxone-in-methadone-overdosed-patients
#17
Nasim Zamani, Hossein Hassanian-Moghaddam
Administration of naloxone is a common treatment for opioid-dependent patients who present with respiratory depression. Although safe in opioid-naive patients, naloxone may cause severe and even life-threatening complications in opioid-dependent patients, including acute respiratory distress syndrome and myocardial infarction. It has been suggested that administration of buprenorphine, a partial μ-opioid receptor agonist, to an opioid-intoxicated patient may result in reversal of respiratory depression with less severe withdrawal signs and symptoms...
February 23, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28236159/an-examination-of-care-practices-of-pregnant-women-incarcerated-in-jail-facilities-in-the-united-states
#18
C M Kelsey, Nickole Medel, Carson Mullins, Danielle Dallaire, Catherine Forestell
OBJECTIVE: The number of incarcerated women in the United States has been steadily increasing over the last 30 years. An estimated 6-10% of these women are pregnant at intake. Previous studies on the health needs and care of pregnant incarcerated women have focused mainly on prison settings. Therefore, we examined the pregnancy-related accommodations and health care provided for regional jail populations. METHOD: The present study is a quantitative survey (administered through phone or email to employees of predominately jail medical facilities) of common practices and policies employed across 53 jail facilities in the United States as a function of geographic region (North vs...
February 24, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28231495/drug-induced-panic-attacks-analysis-of-cases-registered-in-the-french-pharmacovigilance-database
#19
Delphine Abadie, Anaïs Essilini, Virginie Fulda, Aurore Gouraud, Mélissa Yéléhé-Okouma, Joëlle Micallef, François Montastruc, Jean Louis Montastruc
BACKGROUND: The potential role of drugs in the onset of panic attacks (PAs) is poorly understood. AIM: The objective of our study was to characterize drug-induced PAs. METHOD: We performed an analysis of PAs registered in the French pharmacovigilance database between 01/01/1985 and 05/11/2014. RESULTS: Among the 163 recorded cases, 136 (83.4%) were directly related to drugs, mainly antidepressants (11.3%, mainly serotonin reuptake inhibitors), mefloquine (7...
February 9, 2017: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/28223849/review-about-gabapentin-misuse-interactions-contraindications-and-side-effects
#20
REVIEW
Gabriel C Quintero
The current work is targeted to review the risks of gabapentin misuse, its potential interactions with other drugs, side effects and use contraindications. This review consists of a total of 99 biographical references (from the year 1983 to 2016). A publication search of PubMed was performed from January 1983 to December 2016. It included animal studies, clinical studies, case studies and reviews related to gabapentin misuse, potential interactions, side effects and use contraindications. The search terms were gabapentin, anticonvulsant and antiepileptic...
2017: Journal of Experimental Pharmacology
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