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Non-Opioid Analgesics

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https://www.readbyqxmd.com/read/29332567/nociceptin-orphanin-fq-peptide-nop-receptor-modulators-an-update-in-structure-activity-relationships
#1
Carlo Mustazza, Stefano Pieretti, Francesca Marzoli
Nociceptin /Orphanin FQ Peptide" receptor (NOPr) is a G-protein-coupled receptor with the nociceptin/orphanin FQ peptide (N/OFQ) as endogenous agonist. It is expressed in the nervous system as well as in some non-neural tissues. Its activation has pronociceptive effect at the supraspinal level, whereas at the spinal level it produces nociceptive effects at low doses and antinociceptive effects at higher doses. NOPr is also involved in mood and blood pressure regulation, immunoregulation, airway constriction, feeding, urination, bowel motility, learning and memory...
January 10, 2018: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/29325708/promising-roles-for-pharmacists-in-addressing-the-u-s-opioid-crisis
#2
Wilson M Compton, Christopher M Jones, Jack B Stein, Eric M Wargo
Overdoses of prescription or illicit opioids claimed the lives of 116 Americans each day in 2016, and the crisis continues to escalate. As healthcare systems evolve to address the crisis, the potential of pharmacists to make a positive difference is significant. In addition to utilizing available prescription drug monitoring programs to help prevent diversion of opioids, practicing pharmacists can be alert for signs of opioid misuse by patients (e.g., multiple prescriptions from different physicians) as well as inappropriate prescribing or hazardous drug combinations that physicians may not be aware of (e...
December 31, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29305813/a-simultaneous-mixed-effects-pharmacokinetic-model-for-nefopam-n-desmethylnefopam-and-nefopam-n-oxide-in-human-plasma-and-urine
#3
Aravind Mittur
BACKGROUND AND OBJECTIVE: Nefopam is a non-opioid, non-steroidal, central analgesic thought to act via multiple mechanisms including potent inhibition of serotonin-norepinephrine reuptake and modulation of voltage-sensitive calcium and sodium channels. There has been a resurgence in its use for postoperative pain and neuropathic pain. Dosing route-dependent metabolism and clinical effects have been described following intravenous and oral nefopam. N-desmethylnefopam and nefopam N-oxide are metabolites of clinical interest...
January 5, 2018: European Journal of Drug Metabolism and Pharmacokinetics
https://www.readbyqxmd.com/read/29304875/antinociceptive-tolerance-to-nsaids-in-the-anterior-cingulate-cortex-is-mediated-via-endogenous-opioid-mechanism
#4
Nana Tsiklauri, Natia Pirkulashvili, Ivliane Nozadze, Marina Nebieridze, Gulnaz Gurtskaia, Elene Abzianidze, Merab G Tsagareli
BACKGROUND: In the past decade several studies have reported that in some brain areas, particularly, in the midbrain periaqueductal gray matter, rostral ventro-medial medulla, central nucleus of amygdala, nucleus raphe magnus, and dorsal hippocampus, microinjections of non-steroidal anti-inflammatory drugs (NSAIDs) induce antinociception with distinct development of tolerance. Given this evidence, in this study we investigated the development of tolerance to the analgesic effects of NSAIDs diclofenac, ketorolac and xefocam microinjected into the rostral part of anterior cingulate cortex (ACC) in rats...
January 6, 2018: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29304831/randomized-controlled-pilot-study-of-an-educational-video-plus-telecare-for-the-early-outpatient-management-of-musculoskeletal-pain-among-older-emergency-department-patients
#5
Timothy F Platts-Mills, Allison G Hollowell, Gary F Burke, Sheryl Zimmerman, Joseph A Dayaa, Benjamin R Quigley, Montika Bush, Morris Weinberger, Mark A Weaver
BACKGROUND: Musculoskeletal pain is a common reason for emergency department (ED) visits. Following discharge from the ED, patients, particularly older patients, often have difficulty controlling their pain and managing analgesic side effects. We conducted a pilot study of an educational video about pain management with and without follow-up telephone support for older adults presenting to the ED with musculoskeletal pain. METHODS: ED patients aged 50 years and older with musculoskeletal pain were randomized to: (1) usual care, (2) a brief educational video only, or (3) a brief educational video plus a protocol-guided follow-up telephone call from a physician 48-72 hours after discharge (telecare)...
January 5, 2018: Trials
https://www.readbyqxmd.com/read/29298517/histamine-h1-receptor-antagonists-facilitate-electroacupuncture-analgesia
#6
Jaung-Geng Lin, Yu-Chen Lee, Cheng-Hao Tu, Iona MacDonald, Hsin-Yi Chung, Sih-Ting Luo, Shih-Ya Hung, Yi-Hung Chen
This study investigated the influence of the histamine H1 receptor antagonists, chlorpheniramine (CHL) and pyrilamine, on the analgesic effects of acupuncture in mice. Nociceptive response was evaluated by the acetic acid-induced abdominal writhe test. Electroacupuncture (EA) at bilateral ST36 reduced the manifestations of acetic acid-induced abdominal writhing, whereas needle insertion without electrostimulation had no such effect. Notably, EA treatment was not associated with any analgesic effects in mice pretreated with naloxone...
January 3, 2018: American Journal of Chinese Medicine
https://www.readbyqxmd.com/read/29278929/comparing-the-efficacy-of-tolterodine-and-gabapentin-versus-placebo-in-catheter-related-bladder-discomfort-after-percutaneous-nephrolithotomy-a-randomized-clinical-trial
#7
Robab- Maghsoudi, Saeed Farhadi-Niaki, Masoud Etemadian, Amir Hossein Kashi, Pejman Shadpour, Asemaneh Shirani, Rana Samadinezhad-Khoshbaf-Sorkhabi, Meghdad Tabatabaei
PURPOSE: The purpose of this study was to compare the efficacy of tolterodine and gabapentin versus placebo in catheter related bladder discomfort (CRBD) following percutaneous nephrolithotomy (PCNL). MATERIALS AND METHODS: This study was a double-blind parallel group randomized clinical trial. Patients who were candidates of PCNL were enrolled. Patients were randomized to treatment groups of tolterodine 2 mg PO (group T, N=50), gabapentin 600 mg PO (group G, N=50), and placebo (group P, N=70) one hour before operation using balanced block randomization...
December 26, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/29278838/multiple-injections-per-injection-episode-high-risk-injection-practice-among-people-who-injected-pills-during-the-2015-hiv-outbreak-in-indiana
#8
Dita Broz, Jon Zibbell, Carrie Foote, Jeremy C Roseberry, Monita R Patel, Caitlin Conrad, Erika Chapman, Philip J Peters, Richard Needle, Cameron McAlister, Joan M Duwve
BACKGROUND: Misuse of prescription opioid analgesics (POA) has increased dramatically in the US, particularly in non-urban areas. We examined injection practices among persons who inject POA in a rural area that experienced a large HIV outbreak in 2015. METHODS: Between August-September 2015, 25 persons who injected drugs within the past 12 months were recruited in Scott County, Indiana for a qualitative study. Data from in-depth, semi-structured interviews were analyzed...
December 23, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/29273520/progress-in-understanding-mechanisms-of-opioid-induced-gastrointestinal-adverse-effects-and-respiratory-depression
#9
REVIEW
Mohammad Zafar Imam, Andy Kuo, Sussan Ghassabian, Maree T Smith
Opioids evoke analgesia through activation of opioid receptors (predominantly the μ opioid receptor) in the central nervous system. Opioid receptors are abundant in multiple regions of the central nervous system and the peripheral nervous system including enteric neurons. Opioid-related adverse effects such as constipation, nausea, and vomiting pose challenges for compliance and continuation of the therapy for chronic pain management. In the post-operative setting opioid-induced depression of respiration can be fatal...
December 19, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/29261401/prevalence-of-and-comorbid-health-conditions-associated-with-pediatric-prescription-opioid-use-in-the-us
#10
Souvik Banerjee, Carl L Roland, Richard Willke, Jack Mardekian, Louis P Garrison
Prescription opioids are among the most effective analgesics to treat moderate to severe pain; however, little is known about the use of prescription opioids in children, particularly those receiving an extended-release formulation for the treatment of chronic pain. In this retrospective study, the authors determined the prevalence of prescription opioid use among 7-17-year-old children and associated comorbid health conditions from 2010 to 2013 using Truven Health MarketScan (MarketScan) and Optum Clinformatics DataMart (Optum)...
December 20, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/29261227/overview-of-microrna-modulation-in-analgesic-research
#11
Sujay Ramanathan, Botros B Shenoda, Seena K Ajit
MicroRNA(miRNA)-mediated gene regulation underlies cellular processes, playing an important role in homeostasis and diseases. The expression and function of miRNAs are altered by various pharmacological agents, with differences in the endogenous levels of miRNAs influencing drug efficacy and toxicity. Thus, miRNA levels could be a biomarker for predicting treatment response, efficacy, and safety. In addition, elucidating the mechanistic significance of miRNA alterations can aid in the identification of therapeutic targets and patient selection, and guide personalized therapy...
December 20, 2017: Current Protocols in Pharmacology
https://www.readbyqxmd.com/read/29258881/prevalence-and-changes-in-analgesic-medication-utilisation-1-year-prior-to-total-joint-replacement-in-an-older-cohort-of-patients
#12
M C S Inacio, K Cashman, N L Pratt, M H Gillam, G Caughey, S E Graves, E E Roughead
OBJECTIVES: To evaluate the prevalence and change in analgesic medications use prior to joint replacement in older patients between 2001 and 2012. METHODS: A population based epidemiological study was conducted. Opioids, non-steroidal anti-inflammatories (NSAIDs), paracetamol, corticosteroid injections, medications for neuropathic pain, hypnotics, and muscle relaxants supplied 1 year prior to total knee replacement (TKR, n = 15,517) and hip replacement (THR, n = 10,018) were assessed...
December 16, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/29248605/pain-treatment-practices-of-community-dwelling-black-older-adults
#13
Sheria G Robinson-Lane, April Hazard Vallerand
Black older adults often experience disparities in pain treatment that results in unmet pain needs. The aims of this study were to assess the pain management experiences of a group of community dwelling Black older adults and identify gaps in clinical practice. A qualitative, descriptive design was employed using the methodology of ethnography. The setting was an urban, low-income, community elderly housing high-rise facility. Participants included facility residents (n = 106); of these, 20 completed structured qualitative interviews...
December 13, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29248528/feasibility-safety-and-efficacy-of-subcutaneous-peripheral-nerve-field-stimulation-for-the-treatment-of-refractory-low-back-pain-a-two-year-single-center-study
#14
Basem Ishak, Benito Campos, Heike Brunn, Andreas W Unterberg, Rezvan Ahmadi
Chronic low back pain is challenging to treat. Minimal invasive neurostimulation therapies, such as subcutaneous peripheral nerve field stimulation (SPNS), improve pain relief and quality of life,. The goal of the present study was to assess the usefulness, safety, and efficacy of SPNS in patients with chronic low back pain (CLBP). Twenty-six consecutive patients with CLBP were prospectively included in the study. For trial neurostimulation, two electrodes were implanted vertically at a depth of 1 cm into the subcutaneous tissue, ≤ 10 cm from the region of maximum pain...
December 14, 2017: Neuroscience
https://www.readbyqxmd.com/read/29245214/the-efficiency-and-safety-of-local-liposomal-bupivacaine-infiltration-for-pain-control-in-total-hip-arthroplasty-a-systematic-review-and-meta-analysis
#15
REVIEW
Xin Zhang, Qing Yang, Zhi Zhang
OBJECTIVE: This meta-analysis aimed to compare the efficiency and safety of local liposomal bupivacaine infiltration and traditional cocktail analgesia for pain management in total hip arthroplasty (THA). METHODS: PubMed, Embase, Web of science, Medline, and Cochrane library databases were systematically searched. INCLUSION CRITERIA: Participants: patients planned for a THA with a diagnosis of hip osteoarthritis. INTERVENTIONS: liposomal bupivacaine was administrated in the experimental groups for pain control...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29240048/why-patients-are-afraid-of-opioid-analgesics-study-on-opioid-perception-in-patients-treated-for-chronic-pain
#16
Michał Graczyk, Alina Borkowska, Małgorzata Krajnik
INTRODUCTION    Opiophobia is deemed one of the key barriers in effective pain management.  OBJECTIVES    The study aimed to assess overall perception of opioids in cancer patients suffering from and treated for chronic pain, as well as determine the nature of their most common, related fears.  PATIENTS AND METHODS    The study comprised 100 palliative care patients who suffered from chronic cancer or non-cancer pain. Initially, they had to complete a survey exploring their knowledge on analgesics and potential fear of using opioids...
December 14, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29236967/postoperative-analgesia-after-pulmonary-resection-with-a-focus-on-video-assisted-thoracoscopic-surgery
#17
Marzia Umari, Valentina Carpanese, Valeria Moro, Gaia Baldo, Stefano Addesa, Enrico Lena, Stefano Lena, Umberto Lucangelo
Video-assisted thoracoscopic surgery is a widespread technique that has been linked to improved postoperative respiratory function, reduced hospital length of stay and a higher level of tolerability for the patients. Acute postoperative pain is of considerable significance, and the late development of neuropathic pain syndrome is also an issue. As anaesthesiologists, we have investigated the available evidence to optimize postoperative pain management. An opioid-sparing multimodal approach is highly recommended...
December 8, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29234960/a-new-postoperative-pain-management-intravenous-acetaminophen-acelio%C3%A2-leads-to-enhanced-recovery-after-esophagectomy-a-propensity-score-matched-analysis
#18
Yu Ohkura, Junichi Shindoh, Masaki Ueno, Toshiro Iizuka, Shusuke Haruta, Harushi Udagawa
PURPOSES: To investigate the efficacy of postoperative scheduled intravenous acetaminophen to reduce the opioid use and enhance the recovery after esophagectomy. METHODS: A propensity score-matched population was created using the 93 and 69 consecutive patients who underwent esophagectomy for esophageal cancer before and after the introduction of postoperative scheduled intravenous acetaminophen, and the short-term clinical outcomes were compared. RESULTS: Significant defervescence was demonstrated in the Acetaminophen group (A-group) compared with control group (C-group) during the perioperative period (p < 0...
December 12, 2017: Surgery Today
https://www.readbyqxmd.com/read/29231916/-the-use-of-transdermal-fentanyl-in-the-treatment-of-patients-suffering-from-chronic-non-cancer-pain-case-reports
#19
Tatiana Pietrzyńska, Łukasz Pietrzyński
The use of strong opioids for the treatment of chronic non-cancer pain (CNCP) has gained undisputed acceptance among specialists and should be considered when other pharmacological treatments are not effective or cause serious side effects. However, drugs from the third step of analgesic ladder still raise concerns among doctors and patients in the case of long-term therapy. A CASE REPORT: The authors present reports of three cases of patients with CNCP caused by musculoskeletal disorders and numerous comorbidities...
November 23, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29227577/management-of-pain-in-end-stage-renal-disease-patients-short-review
#20
REVIEW
Rupesh Raina, Vinod Krishnappa, Mona Gupta
Pain management in end stage renal disease (ESRD) patients is a complex and challenging task to accomplish, and effective pain and symptom control improves quality of life. Pain is prevalent in more than 50% of hemodialysis patients and up to 75% of these patients are treated ineffectively due to its poor recognition by providers. A good history for PQRST factors and intensity assessment using visual analog scale are the initial steps in the management of pain followed by involvement of palliative care, patient and family counseling, discussion of treatment options, and correction of reversible causes...
December 11, 2017: Hemodialysis International
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