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Non-Opioid Analgesics

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https://www.readbyqxmd.com/read/29790356/-non-opioid-analgesics
#1
Jitka Fricová
Non-opioid analgesics are commonly used to treat mild and moderate acute and chronic pain. They can be used as monotherapy; however, they have greater efficacy in combination with weak and strong opioids. Unlike opioids, long-term use of non-steroidal anti-inflammatory drugs does not lead to physical dependence. One of the main disadvantages of the NSA is the risk of gastrointestinal side effects, especially bleeding into the digestive tract. This is increased especially in ulcerative disease and in higher doses, but also in the elderly (over 65 years), also with concomitant administration of corticosteroids, anticoagulants or other NSAIDs...
2018: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/29790354/-opioids-and-new-trends-in-pain-therapy
#2
Jan Lejčko
Opioids are well known for their ability to reduce the perception of pain without a loss of consciousness. However, the influence of opioids on organism is very complex. Clinical pharmacology of currently available opioid analgesics is determined by three major factors - their opioid receptor properties, pharmacokinetic properties and genetic polymorphism in the opiate receptor and cytochrome P450 isoform. In acute severe pain are opioids very efficient. Long-term experience with opioid analgesia in patients with cancer pain has shown high favorable risk/benefit ratio...
2018: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/29789137/serratus-intercostal-interfascial-block-as-an-opioid-saving-strategy-in-supra-umbilical-open-surgery
#3
M T Fernández Martín, S López Álvarez, M A Pérez Herrero
INTRODUCTION: The administration of local anaesthetic in the serratus-intercostal space provides adequate analgesia in non-reconstructive breast surgery. The aim of this study was to evaluate whether the blockage of the last intercostal nerves (T7-T11) can lead to opioid savings in supra-umbilical open surgery procedures. MATERIAL AND METHODS: A prospective observational study was conducted on patients undergoing open supra-umbilical surgery under general anaesthesia and with a serratus-intercostal plane block [modified Blocking the bRanches of IntercostaL nerves in the Middle Axillary line (BRILMA)] as an associated analgesic strategy...
May 19, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29782941/dopamine-and-serotonin-metabolism-associated-with-morphine-reward-and-its-inhibition-with-buspirone-a-study-in-the-rat-striatum
#4
Darakhshan Jabeen Haleem, Shazia Nawaz, Tabinda Salman
Adaptations within the nucleus accumbens (NAc) and caudate nucleus (CN) dopamine neurotransmission are involved in behavioral sensitization and enhanced incentive motivation towards drug paired stimuli which lead to drug addiction. Serotonin (5-hydroxytryptamine; 5-HT) can modulate dopamine neurotransmission to reduce rewarding effects of drugs of abuse. A recent study from our laboratory shows that rewarding effects of morphine are inhibited in rats co-treated with buspirone. To understand the neurochemical mechanism involved in morphine addiction and its inhibition with buspirone, present study determines the effects of buspirone, morphine and their co-administration on the metabolism of serotonin and dopamine in the NAc and CN...
May 18, 2018: Pharmacology, Biochemistry, and Behavior
https://www.readbyqxmd.com/read/29777732/antinociceptive-effect-of-tadalafil-in-various-pain-models-involvement-of-opioid-receptors-and-nitric-oxide-cyclic-gmp-pathways
#5
Mohammad M Mehanna, Souraya Domiati, Hania Nakkash Chmaisse, Ahmed El Mallah
Nitric oxide has been proven to play an important role in nociception, accordingly, its promoters, phosphodiesterase inhibitors have been investigated as pain response modulators. Aiming to evaluate the central effect of tadalafil, a phosphodiesterase 5 inhibitor, and to determine its EC50, tail flick and hot plate tests were utilized. On the other hand, its nociceptive peripheral analgesic effect was assessed through acetic-acid induced writhing model. Formalin test was used to appraise both non-inflammatory and inflammatory pain responses...
May 16, 2018: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/29760868/non-medical-use-of-prescription-drugs-by-young-men-impact-of-potentially-traumatic-events-and-of-social-environmental-stressors
#6
Ansgar Rougemont-Bücking, Véronique S Grazioli, Simon Marmet, Jean-Bernard Daeppen, Mélissa Lemoine, Gerhard Gmel, Joseph Studer
Background : Non-medical use of prescription drugs (NMUPD) is an increasing phenomenon associated with physical and psychological consequences. This study investigated the effects of distinct forms of stress on NMUPD. Methods : Data from 5308 young adult men from the Swiss cohort study on substance use risk factors (C-SURF) were analysed regarding NMUPD of sleeping pills, tranquilizers, opioid analgesics, psychostimulants, and antidepressants. Various forms of stress (discrete, potentially traumatic events, recent and long-lasting social-environmental stressors) during the period preceding the NMUPD assessment were measured...
2018: European Journal of Psychotraumatology
https://www.readbyqxmd.com/read/29756342/safety-of-preoperative-ibuprofen-in-pediatric-tonsillectomy
#7
Alexander Michael, Farrel J Buchinsky, Glenn Isaacson
OBJECTIVE: Oral ibuprofen is believed to be safe and effective after pediatric adenotonsillectomy. There has been little study of its use as a preoperative analgesic. We attempt to document its safety in this setting. STUDY DESIGN: Individual case control study. METHODS: Children who underwent tonsillectomy or adenotonsillectomy from January 2013 to December 2015 did not receive preoperative ibuprofen. Those who underwent tonsillectomy or adenotonsillectomy from January 2016 to December 2017 received oral ibuprofen 7 mg/kg preoperatively...
May 14, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29743284/vertebroplasty-versus-sham-procedure-for-painful-acute-osteoporotic-vertebral-compression-fractures-vertos-iv-randomised-sham-controlled-clinical-trial
#8
Cristina E Firanescu, Jolanda de Vries, Paul Lodder, Alexander Venmans, Marinus C Schoemaker, Albert J Smeet, Esther Donga, Job R Juttmann, Caroline A H Klazen, Otto E H Elgersma, Frits H Jansen, Alexander V Tielbeek, Issam Boukrab, Karen Schonenberg, Willem Jan J van Rooij, Joshua A Hirsch, Paul N M Lohle
OBJECTIVE: To assess whether percutaneous vertebroplasty results in more pain relief than a sham procedure in patients with acute osteoporotic compression fractures of the vertebral body. DESIGN: Randomised, double blind, sham controlled clinical trial. SETTING: Four community hospitals in the Netherlands, 2011-15. PARTICIPANTS: 180 participants requiring treatment for acute osteoporotic vertebral compression fractures were randomised to either vertebroplasty (n=91) or a sham procedure (n=89)...
May 9, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29740688/the-safety-and-efficacy-of-oxycodone-versus-fentanyl-in-percutaneous-microwave-ablation-of-a-liver-tumour-abutting-the-capsule
#9
Wen-Tao Wu, Zhen-Yu Jia, Yu Chen, Qi-Feng Chen, Qing-Quan Zu, Zheng-Qiang Yang, Sheng Liu, Hai-Bin Shi
PURPOSE: The present study compared the safety and efficacy of oxycodone with those of fentanyl under non-intubated general anaesthesia in percutaneous microwave ablation (MWA) of a liver tumour abutting the capsule. MATERIALS AND METHODS: Thirty-eight patients underwent MWA of liver cancers abutting the capsule. Patients received 0.1 mg/kg oxycodone (O group) or 1 μg/kg fentanyl (F group) prior to the start of ablation. Both groups received continuous infusions of propofol for non-intubated general anaesthesia during ablation...
May 8, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29740351/pain-therapy-guided-by-purpose-and-perspective-in-light-of-the-opioid-epidemic
#10
REVIEW
Amie L Severino, Arash Shadfar, Joshua K Hakimian, Oliver Crane, Ganeev Singh, Keith Heinzerling, Wendy M Walwyn
Prescription opioid misuse is an ongoing and escalating epidemic. Although these pharmacological agents are highly effective analgesics prescribed for different types of pain, opioids also induce euphoria, leading to increasing diversion and misuse. Opioid use and related mortalities have developed in spite of initial claims that OxyContin, one of the first opioids prescribed in the USA, was not addictive in the presence of pain. These claims allayed the fears of clinicians and contributed to an increase in the number of prescriptions, quantity of drugs manufactured, and the unforeseen diversion of these drugs for non-medical uses...
2018: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/29739543/special-indications-for-opioid-free-anaesthesia-and-analgesia-patient-and-procedure-related-including-obesity-sleep-apnoea-chronic-obstructive-pulmonary-disease-complex-regional-pain-syndromes-opioid-addiction-and-cancer-surgery
#11
REVIEW
Adrian Sultana, David Torres, Roman Schumann
Opioid-free anaesthesia (OFA) is a technique where no intraoperative systemic, neuraxial or intracavitary opioid is administered with the anaesthetic. Opioid-free analgesia similarly avoids opioids in the perioperative period. There are many compelling reasons to avoid opioids in the surgical population. A number of case reports and, increasingly, prospective studies from all over the world support its benefits, especially in the morbidly obese population with or without sleep apnoea. A derivative technique is opioid sparing, where the same techniques are used but some opioid use is allowed...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29735341/postoperative-pain-management-among-native-and-non-native-israeli-citizens-data-from-the-european-pain-out-registry
#12
Silviu Brill, Haggai Sharon, Anat Yafe, Shoshana Hazan, Lior Dayan
PURPOSE: It has been widely reported that minority groups receive inferior emergency pain management. We aimed to determine whether this is true in the postoperative setting, as effective postoperative analgesia is an essential component of high quality medical care. DESIGN: A retrospective case-control study of paired 248 postsurgical Israeli patients. METHODS: Data were gathered from the European Union's "PAIN-OUT" registry. Quality of care measures, composite pain score, composite side effect score, and composite emotional score were analyzed...
May 4, 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29733095/assessment-of-outcomes-following-high-dose-opioid-tapering-in-a-veterans-healthcare-system
#13
Lauren Hundley, Shelley Spradley, Scott Donelenko
OBJECTIVE: To assess the impact of tapering of chronic high dose opioid therapy in veterans prompted by the implementation of the Opioid Safety Initiative in 2013. DESIGN: IRB and VA Office of Research and Development-approved retrospective, observational chart review. SETTING: North Florida/South Georgia Veterans Health System Patients: Veterans on high dose opioid therapy (≥300 mg of morphine equivalents per day) for chronic non-cancer pain as of 1/1/2012 with an opioid agreement discontinuation note documented in the medical record were included...
March 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29727163/aminoguanidine-hydrazone-derivatives-as-non-peptide-npff1-receptor-antagonists-reverse-opioid-induced-hyperalgesia
#14
Hassan Hammoud, Khadija Elhabazi, Raphaëlle Quillet, Isabelle Bertin, Valérie Utard, Emilie Laboureyras, Jean-Jacques Bourguignon, Frederic Bihel, Guy Simonnet, Frederic Simonin, Martine Schmitt
Neuropeptide FF receptors (NPFF1R and NPFF2R) and their endogenous ligand Neuropeptide FF have been shown previously to display anti-opioid properties and to play a critical role in the adverse effects associated with chronic administrations of opiates including the development of opioid-induced hyperalgesia and analgesic tolerance. In this work, we sought to identify novel NPFF receptors ligands by focusing our interest on a series of heterocycles as rigidified non-peptide NPFF receptor ligands, starting from already described aminoguanidine hydrazones (AGH's)...
May 4, 2018: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/29724879/unit-dose-packaging-and-unintentional-buprenorphine-naloxone-exposures
#15
George Sam Wang, S Geoffrey Severtson, Gabrielle E Bau, Richard C Dart, Jody L Green
BACKGROUND AND OBJECTIVES: Buprenorphine accounts for the most opioid-related pediatric hospital admissions when compared with other opioid analgesics. Since 2010, several manufacturers began distributing their buprenorphine products with unit-dose packaging (UDP). Our main objective in this study is to evaluate the impact of UDP on unintentional pediatric buprenorphine-naloxone poison center exposures. METHODS: This is an observational surveillance study in which the Researched Abuse, Diversion, and Addiction-Related Surveillance System Poison Center Program is used...
May 3, 2018: Pediatrics
https://www.readbyqxmd.com/read/29722036/curcumin-in-turmeric-basic-and-clinical-evidence-for-a-potential-role-in-analgesia
#16
REVIEW
U J Eke-Okoro, R B Raffa, J V Pergolizzi, F Breve, R Taylor
WHAT IS KNOWN AND OBJECTIVE: Current analgesic pharmacotherapy-opioids, non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen (paracetamol) and related drugs-is effective for acute pain, but their use is limited by adverse effects on the renal, hepatic, cardiovascular or gastrointestinal systems, or they have potential for abuse. Therefore, alternative options are desired. Compounds used in traditional medicine might offer such alternatives, but the evidence must be based on pharmacologic properties and on clinical trial data...
May 2, 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29716637/is-intravenously-administered-subdissociative-dose-ketamine-non-inferior-to-morphine-for-prehospital-analgesia-the-ketamorph-study-study-protocol-for-a-randomized-controlled-trial
#17
Clément Le Cornec, Said Lariby, Vivien Brenckmann, Jean Benoit Hardouin, Claude Ecoffey, Marion Le Pottier, Philippe Fradin, Hélène Broch, Amine Kabbaj, Yannick Auffret, Florence Deciron, Céline Longo, François Javaudin, Quentin Le Bastard, Joël Jenvrin, Emmanuel Montassier
BACKGROUND: Acute pain is a common condition among prehospital patients and prompt management is pivotal. Opioids are the most frequently analgesics used in the prehospital setting. However, opioids are highly addictive, and some patients may develop opioid dependence, even when they are exposed to brief opioid treatments. Therefore, alternative non-opioid analgesia should be developed to manage pain in the prehospital setting. Used at subdissociative doses, ketamine, a noncompetitive N-methyl-D-aspartate and glutamate receptor antagonist, provides analgesic effects accompanied by preservation of protective airway reflexes...
May 2, 2018: Trials
https://www.readbyqxmd.com/read/29716484/effect-on-neonatal-outcome-of-pharmacological-interventions-for-attenuation-of-the-maternal-haemodynamic-response-to-tracheal-intubation-a-systematic-review
#18
A Aman, B Salim, K Munshi, S A Raza, F A Khan
The primary aim of this systematic review was to assess the effect on neonatal outcome of pharmacological interventions used for attenuation of the haemodynamic response to tracheal intubation in patients undergoing caesarean section under general anaesthesia. A systematic search of randomised controlled trials from 1990 to 2015 was conducted. The primary outcome measure was the Apgar score at five minutes and secondary outcomes were umbilical arterial blood gas parameters and neurological adaptive capacity scores...
May 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29715520/-i-was-a-little-surprised-qualitative-insights-from-patients-enrolled-in-a-12-month-trial-comparing-opioids-to-non-opioid-medications-for-chronic-musculoskeletal-pain
#19
Marianne S Matthias, Melvin T Donaldson, Agnes C Jensen, Erin E Krebs
Chronic musculoskeletal pain is a major public health problem. Although opioid prescribing for chronic pain has increased dramatically since the 1990s, this practice has come under scrutiny because of increases in opioid-related harms and lack of evidence for long-term effectiveness. The Strategies for Prescribing Analgesics Comparative Effectiveness (SPACE) trial was a pragmatic 12-month randomized trial comparing benefits and harms of opioid versus non-opioid medications for chronic musculoskeletal pain. The current qualitative study was designed to better understand trial results by exploring patients' experiences, including perceptions of medications, experiences with the intervention, and whether expectations were met...
April 28, 2018: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29705271/effects-of-human-sult1a3-sult1a4-genetic-polymorphisms-on-the-sulfation-of-acetaminophen-and-opioid-drugs-by-the-cytosolic-sulfotransferase-sult1a3
#20
Ahsan F Bairam, Mohammed I Rasool, Fatemah A Alherz, Maryam S Abunnaja, Amal A El Daibani, Katsuhisa Kurogi, Ming-Cheh Liu
Sulfoconjugation has been shown to be critically involved in the metabolism of acetaminophen (APAP), morphine, tapentadol and O-desmethyl tramadol (O-DMT). The objective of this study was to investigate the effects of single nucleotide polymorphisms (SNPs) of human SULT1A3 and SULT1A4 genes on the sulfating activity of SULT1A3 allozymes toward these analgesic compounds. Twelve non-synonymous coding SNPs (cSNPs) of SULT1A3/SULT1A4 were investigated, and the corresponding cDNAs were generated by site-directed mutagenesis...
April 26, 2018: Archives of Biochemistry and Biophysics
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