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Opioid tolerance

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https://www.readbyqxmd.com/read/28731925/thoracic-paravertebral-block-for-postoperative-pain-management-after-renal-surgery-a-randomised-controlled-trial
#1
Maja Copik, Szymon Bialka, Andrzej Daszkiewicz, Hanna Misiolek
BACKGROUND: Thoracic paravertebral block (ThPVB) combined with general anaesthesia is used in thoracic and general surgery. It provides effective analgesia, reduces surgical stress response and the incidence of chronic postoperative pain. OBJECTIVE: To assess the efficacy of ThPVB in reducing opioid requirements and decreasing the intensity of pain after renal surgery. DESIGN: A prospective, randomised, open label study. SETTING: A single university hospital...
July 20, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28729837/optimization-and-in-vivo-profiling-of-a-refined-rat-model-of-walker-256-breast-cancer-cell-induced-bone-pain-using-behavioral-radiological-histological-immunohistochemical-and-pharmacological-methods
#2
Priyank Shenoy, Andy Kuo, Irina Vetter, Maree T Smith
In the majority of patients with advanced breast cancer, there is metastatic spread to bones resulting in pain. Clinically available drug treatments for alleviation of breast cancer-induced bone pain (BCIBP) often produce inadequate pain relief due to dose-limiting side-effects. A major impediment to the discovery of novel well-tolerated analgesic agents for the relief of pain due to bony metastases is the fact that most cancer-induced bone pain models in rodents relied on the systemic injection of cancer cells, causing widespread formation of cancer metastases and poor general animal health...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28729010/evaluation-of-emergency-department-management-of-opioid-tolerant-cancer-patients-with-acute-pain
#3
Pina M Patel, Lauren F Goodman, Sheri A Knepel, Charles C Miller, Asma Azimi, Gary Phillips, Jillian L Gustin, Amber Hartman
CONTEXT: There are no previously published studies examining opioid doses administered to opioid-tolerant cancer patients during Emergency Department (ED) encounters. OBJECTIVE: To determine if opioid-tolerant cancer patients presenting with acute pain exacerbations receive adequate initial doses of PRN opioids during ED encounters based on home Oral Morphine Equivalents (OME) use. METHODS: We performed a retrospective cohort study of opioid-tolerant cancer patients who received opioids in our ED over a 2-year period...
July 17, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28726190/effect-of-peripheral-%C3%AE-%C3%AE-and-%C3%AE%C2%BA-opioid-ligands-on-the-development-of-tolerance-to-ethanol-induced-analgesia
#4
S K Sudakov, E V Alekseeva, G A Nazarova
We studied the rate of development of tolerance to the ethanol-induced analgesia under the effect of μ-, δ-, and κ-opioid agonists and antagonists not crossing the blood-brain barrier and rapidly inactivated by gastric and duodenal proteolytic enzymes. Activation of gastric κ-opioid receptors eliminated the analgesic effect of ethanol and accelerated the development of tolerance to ethanol-induced analgesia. In contrast, activation of gastric μ-opioid receptors decelerated the development of this tolerance...
July 18, 2017: Bulletin of Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28721089/combination-treatment-of-neuropathic-pain-danish-expert-recommendations-based-on-a-delphi-process
#5
EDITORIAL
Jakob Vormstrup Holbech, Anne Jung, Torsten Jonsson, Mette Wanning, Claus Bredahl, Flemming W Bach
BACKGROUND: Current Danish treatment algorithms for pharmacological treatment of neuropathic pain (NeP) are tricyclic antidepressants (TCA), gabapentin and pregabalin as first-line treatment for the most common NeP conditions. Many patients have insufficient pain relief on monotherapy, but combination therapy had not been included in guidelines until recently. Based on clinical empiricism and scientific evidence, a Delphi consensus process provided a consolidated guidance on pharmacological combination treatment of NeP...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28718638/semisynthesis-and-kappa-opioid-receptor-activity-of-derivatives-of-columbin-a-furanolactone-diterpene
#6
Anil Yilmaz, Rachel Saylor Crowley, Alexander M Sherwood, Thomas E Prisinzano
Columbin (1) is a furanolactone diterpene isolated from the roots of Jateorhiza and Tinospora species. These species generally grow in Asia and Africa and have been used in folk medicine for their apparent analgesic and antipyretic activities. Columbin (1) is of particular interest due to its structural similarity to the known kappa-opioid receptor (KOR) agonist salvinorin A. Given that the KOR is of interest in the study of many serious diseases, such as anxiety, depression, and drug addiction, obtaining natural or semisynthetic molecules with KOR activity recently has gained much interest...
July 18, 2017: Journal of Natural Products
https://www.readbyqxmd.com/read/28709955/neonatal-injury-results-in-sex-dependent-nociceptive-hypersensitivity-and-social-behavioral-deficits-during-adolescence-without-altering-morphine-response
#7
Nikita N Burke, Tuan Trang
Neonatal injury is associated with persistent changes in sensory function and altered nociceptive thresholds that give rise to aberrant pain sensitivity in later life. While these changes are well documented in adult rodents, little is known about the consequences of neonatal injury during adolescence. Since adolescence is a critical developmental period during which persistent pain conditions can arise, we examined the impact of neonatal injury on nociception, social behavior and response to morphine in adolescent Sprague Dawley rats...
July 11, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28707024/experience-of-immediate-ambulation-and-early-discharge-after-tumescent-anesthesia-and-propofol-infusion-in-cosmetic-breast-augmentation
#8
Weiwu Pang, John M Chois, Diana Lambie, Richard Ming-Hui Lin, Zao-Ming Shih
INTRODUCTION: Current cosmetic breast augmentation relies on general anesthesia that normally requires 40 min to total recovery. With experience, the surgical procedure can be completed expediently in 20 min under tumescent anesthesia and propofol full sedation to achieve immediate postoperative ambulation and home discharge readiness, and thus improve patient satisfaction and reduce cost. We retrospectively examined the outcomes of the protocol. MATERIALS AND METHODS: Per protocol, 1200 female patients underwent simple cosmetic breast augmentation accomplished with tumescent anesthesia, immediate mobilization, and early home discharge readiness after surgery...
July 13, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28699698/reduced-dosing-and-liability-in-methadone-maintenance-treatment-by-targeting-oestrogen-signal-for-morphine-addiction
#9
Yao-Chang Chiang, Ruey-Yun Wang, Chieh-Liang Huang, Shue-Hwa Chen, Wen-Jing Ho, Hsien-Yuan Lane, Ing-Kang Ho, Hwei-Ting Yang, Wen-Lung Ma
Methadone maintenance treatment (MMT) is the major tapering therapy for morphine addictive patients. There have gender differences reported in response to MMT. This study discovered that the estrogen-response element single nucleotide polymorphism (ERE-SNP; rs16974799, C/T) of cytochrome 2B6 gene (cyp2b6; methadone catabolic enzyme) responded differently to MMT dosing. Oestradiol was associated with high MMT dosing, high enantiomer (R- or S-) of 2-ethylidene-1,5-dimethyl-3,3-dipheny-pyrrolidine (EDDP; methadone metabolite) to methadone ratio and increased drug-seeking behaviour, implicating oestradiol-CYP-EDDP/methadone axis decreasing MMT efficacy...
July 12, 2017: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/28697991/carbamazepine-effects-on-pain-management-and-serum-il-6-il-10-evaluation-in-addicted-patients-undergoing-surgery
#10
Alireza Salimi, Masoumeh Sabetkasaei, Hanna Raisi, Farzaneh Labibi, Haleh Ameli, Yalda Khazaei-Poul, Kamran Mottaghi, Farhad Safari, Ali Nazem-Bokaei, Seyed-Amir Mohajerani, Malek Zarei, Taraneh Moini-Zanjani
Postoperative pain control remains an important issue in the field of surgery. Assessing and managing patients with acute pain who are addicted to opioids are often challenging. It has been shown that, addicted patients are less tolerant to pain. There is limited evidence to guide the management of acute pain in these patients. Here we studied the effect of preemptive use of carbamazepine on pain behavior and serum IL-6, IL-10 levels in the addicted patients. 90 male patients (25-45 years, BMI 20-27), were divided into 3 group of 30 patients: 1- control, 2- addicted, 3- addicted patients receiving carbamazepine 400mg before surgery...
July 8, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28696784/the-role-of-tramadol-in-pain-management-in-latin-america-a-report-by-the-change-pain-latin-america-advisory-panel
#11
Joäo Batista Santos Garcia, Osvandré Lech, Durval Campos Kraychete, María Antonieta Rico, John Jairo Hernández-Castro, Frantz Colimon, Carlos Guerrero, Manuel Sempértegui Gallegos, Argelia Lara-Solares, José Alberto Flores Cantisani, César Amescua-Garcia, María Del Rocío Guillén Núñez, María Del Rosario Berenguel Cook, Aziza Jreige Iskandar, Patricia Bonilla Sierra
OBJECTIVE: Change Pain Latin America (CPLA) was created to enhance chronic pain understanding and develop pain management improving strategies in this region. During its 7(th) meeting (August 2016), the main objective was to discuss tramadol's role in treating pain in Latin America. Furthermore, potential pain management consequences were considered, if tramadol was to become more stringently controlled. METHODS: Key topics discussed were: main indications for prescribing tramadol, its pharmacological characteristics, safety and tolerability, effects of restrictions on its availability and use, and consequent impact on the pain care quality...
July 11, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28689766/acute-administration-of-tramadol-and-tapentadol-at-effective-analgesic-and-maximum-tolerated-doses-causes-hepato-and-nephrotoxic-effects-in-wistar-rats
#12
Joana Barbosa, Juliana Faria, Sandra Leal, Luís Pedro Afonso, João Lobo, Odília Queirós, Roxana Moreira, Félix Carvalho, Ricardo Jorge Dinis-Oliveira
Tramadol and tapentadol are two atypical synthetic opioid analgesics, with monoamine reuptake inhibition properties. Mainly aimed at the treatment of moderate to severe pain, these drugs are extensively prescribed for multiple clinical applications. Along with the increase in their use, there has been an increment in their abuse, and consequently in the reported number of adverse reactions and intoxications. However, little is known about their mechanisms of toxicity. In this study, we have analyzed the in vivo toxicological effects in liver and kidney resulting from an acute exposure of a rodent animal model to both opioids...
July 6, 2017: Toxicology
https://www.readbyqxmd.com/read/28688296/effects-of-ibudilast-on-oxycodone-induced-analgesia-and-subjective-effects-in-opioid-dependent-volunteers
#13
Z D Cooper, K W Johnson, S K Vosburg, M A Sullivan, J Manubay, D Martinez, J D Jones, P A Saccone, S D Comer
Opioid-induced glial activation is hypothesized to contribute to the development of tolerance to opioid-induced analgesia. This inpatient, double-blind, placebo-controlled, within-subject and between-groups pilot study investigated the dose-dependent effects of ibudilast, a glial cell modulator, on oxycodone-induced analgesia. Opioid-dependent volunteers were maintained on morphine (30mg, PO, QID) for two weeks and received placebo ibudilast (0mg, PO, BID) during the 1st week (days 1-7). On day 8, participants (N=10/group) were randomized to receive ibudilast (20 or 40mg, PO, BID) or placebo for the remainder of the study...
June 17, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28683172/opioids-for-cancer-pain-an-overview-of-cochrane-reviews
#14
REVIEW
Philip J Wiffen, Bee Wee, Sheena Derry, Rae F Bell, R Andrew Moore
BACKGROUND: Pain is a common symptom with cancer, and 30% to 50% of all people with cancer will experience moderate to severe pain that can have a major negative impact on their quality of life. Opioid (morphine-like) drugs are commonly used to treat moderate or severe cancer pain, and are recommended for this purpose in the World Health Organization (WHO) pain treatment ladder. The most commonly-used opioid drugs are buprenorphine, codeine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, oxycodone, tramadol, and tapentadol...
July 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28681626/pharmacokinetics-and-safety-of-fentanyl-sublingual-spray-and-fentanyl-citrate-intravenous-a-single-ascending-dose-study-in-opioid-na%C3%A3-ve-healthy-volunteers
#15
Richard Rauck, D Alexander Oh, Neha Parikh, Christian Koch, Neil Singla, Jin Yu, Srinivas Nalamachu, Santosh Vetticaden
OBJECTIVE: Fentanyl sublingual spray offers rapid pain relief in opioid-tolerant cancer patients, and may be useful in acute or postoperative pain. Both opioid-naïve or nontolerant patients are likely to receive opioids in these settings. Understanding the relationship between systemic exposure of fentanyl sublingual spray and effects on respiratory function in opioid-naïve or nontolerant populations is important to ensure patient safety. This study evaluated single-dose fentanyl sublingual spray in opioid-naïve participants...
July 6, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28662295/%C3%AE-9-containing-nicotinic-acetylcholine-receptors-and-the-modulation-of-pain
#16
REVIEW
Arik J Hone, Denis Servent, J Michael McIntosh
Neuropathic pain is a complex and debilitating syndrome for which there are few effective pharmacological treatments. Opioid-based medications are initially effective for acute pain but tolerance to their analgesic effects quickly develops and long-term use often leads to physical dependence and addiction. Furthermore, neuropathic pain is generally resistant to non-steroidal anti-inflammatory drugs. Other classes of medications including antidepressants, antiepileptics, and voltage-gated calcium channel (VGCC) inhibitors are only partially effective in most patients, may be associated with significant side effects, and have few disease modifying effects on the underlying pathology...
June 29, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28655025/effect-of-buprenorphine-weekly-depot-cam2038-and-hydromorphone-blockade-in-individuals-with-opioid-use-disorder-a-randomized-clinical-trial
#17
Sharon L Walsh, Sandra D Comer, Michelle R Lofwall, Bradley Vince, Naama Levy-Cooperman, Debra Kelsh, Marion A Coe, Jermaine D Jones, Paul A Nuzzo, Fredrik Tiberg, Behshad Sheldon, Sonnie Kim
Importance: Buprenorphine is an efficacious, widely used treatment for opioid use disorder (OUD). Daily oral transmucosal formulations can be associated with misuse, diversion, and nonadherence; these limitations may be obviated by a sustained release formulation. Objective: To evaluate the ability of a novel, weekly, subcutaneous buprenorphine depot formulation, CAM2038, to block euphorigenic opioid effects and suppress opioid withdrawal in non-treatment-seeking individuals with OUD...
June 22, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28654797/simvastatin-prevents-morphine-induced-tolerance-and-dependence-in-mice
#18
Nasim Sadat Pajohanfar, Ehsan Mohebbi, Ahmad Hosseini-Bandegharaei, Mohamadraza Amin, Golnaz Vaseghi, Bahareh Amin
BACKGROUND: Tolerance to analgesic effects of opioids and dependence to them are main concerns in the treatment of chronic pain conditions, limiting clinical application of these drugs. This study aimed to evaluate the effect of simvastatin on the morphine-induced tolerance and dependence in mice. MATERIAL AND METHODS: For this purpose, mice were treated with either daily morphine (20 mg/kg, s.c.) alone, or in combination with simvastatin (2.5, 5 and 10mg/kg, i...
June 24, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28647729/analgesic-effects-of-diluted-bee-venom-acupuncture-mediated-by-%C3%AE-opioid-and-%C3%AE-2-adrenergic-receptors-in-osteoarthritic-rats
#19
Jeong-Eun Huh, Byung-Kwan Seo, Jung-Woo Lee, Chanyoung Kim, Yeon-Cheol Park, Jae-Dong Lee, Yong-Hyeon Baek
Context • Pain from osteoarthritis is associated with peripheral nociception and central pain processing. Given the unmet need for innovative, effective, and well-tolerated therapies, many patients, after looking for more satisfactory alternatives, decide to use complementary and alternative modalities. The analgesic mechanism of subcutaneous injections of diluted bee venom into an acupoint is thought to be part of an anti-inflammatory effect and the central modulation of pain processing. Objectives • Using the rat model of collagenase-induced osteoarthritis (CIOA), the study intended to investigate the analgesic effects of bee venom acupuncture (BVA) as they are related to the acupuncture points and dosage used and to determine whether the analgesic mechanisms of BVA for pain were mediated by opioid or adrenergic receptors...
June 23, 2017: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/28644196/cebranopadol-a-novel-first-in-class-analgesic-drug-candidate-first-experience-in-patients-with-chronic-low-back-pain-in-a-randomized-clinical-trial
#20
Annette Christoph, Marie-Henriette Eerdekens, Maurits Kok, Gisela Volkers, Rainer Freynhagen
Chronic low back pain (LBP) is a common condition, usually with involvement of nociceptive and neuropathic pain components, high economic burden and impact on quality of life. Cebranopadol is a potent, first-in-class drug candidate with a novel mechanistic approach, combining nociceptin/orphanin FQ peptide and opioid peptide receptor agonism. We conducted the first Phase II, randomized, doubleblind, placebo- and active-controlled trial, evaluating the analgesic efficacy, safety, and tolerability of cebranopadol in patients with moderate to severe chronic LBP with and without neuropathic pain component...
June 21, 2017: Pain
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