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Non-Opioid Analgesics

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https://www.readbyqxmd.com/read/28104570/high-risk-injecting-behaviour-among-people-who-inject-pharmaceutical-opioids-in-australia
#1
Jenny Iversen, George Dertadian, Louise Geddes, Lisa Maher
BACKGROUND: Use of opioid analgesic medicines has doubled globally over the past decade, with a concomitant increase in prevalence of injection of pharmaceutical opioids (PO), including in Australia. This study investigates types of PO injected, methods used to prepare PO for injection and correlates of recent (last 6 months) PO injection among a large national sample of people who inject drugs (PWID). METHODS: The Australian NSP Survey (ANSPS), conducted annually at ∼50 NSP services across Australia, consists of a brief self-administered questionnaire and provision of a capillary dried blood spot for HIV and hepatitis C antibody testing...
January 16, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28103892/prehospital-intravenous-fentanyl-to-patients-with-hip-fracture-an-observational-cohort-study-of-risk-factors-for-analgesic-non-treatment
#2
Kristian D Friesgaard, Erika F Christensen, Hans Kirkegaard, Mette D Bendtsen, Flemming B Jensen, Lone Nikolajsen
BACKGROUND: Patients with proximal femoral neck fracture have a high short-term mortality, a high risk of postoperative complications, and impaired quality of life. One of the challenges related to the prehospital treatment of these patients is to administer systemic opioids fast and properly. Effective analgesic prehospital treatment ought be initiated rapidly in order to alleviate the stress that follows acute pain, to facilitate transportation, and to improve quality of care. The objectives of this study were to explore the prevalence of prehospital administration of intravenous fentanyl to patients with proximal femoral neck fracture in the ambulances and to assess risk factors for analgesic non-treatment...
January 19, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28097532/medication-overuse-in-chronic-pain
#3
REVIEW
Eric S Hsu
PURPOSE OF REVIEW: Chronic pain is usually managed by various pharmacotherapies after exhausting the conservative modalities such as over-the-counter choices. The goal of this review is to investigate current state of opioids and non-opioid medication overuse that includes NSAIDs, skeletal muscle relaxants, antidepressants, membrane stabilization agents, and benzodiazepine. How to minimize medication overuse and achieve better outcome in chronic pain management? RECENT FINDINGS: Although antidepressants and membrane stabilization agents contribute to the crucial components for neuromodulation, opioids were frequently designated as a rescue remedy in chronic pain since adjunct analgesics usually do not provide instantaneous relief...
January 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28088389/nalfurafine-is-a-g-protein-biased-agonist-having-significantly-greater-bias-at-the-human-than-rodent-form-of-the-kappa-opioid-receptor
#4
Selena S Schattauer, Jamie R Kuhar, Allisa Song, Charles Chavkin
Nalfurafine is a moderately selective kappa opioid receptor (KOR) analgesic with low incidence of dysphoric side effects in clinical development for the treatment of uremic pruritis. The basis for its reduced dysphoric effect compared to other KOR agonists is not clear, but prior studies suggest that the aversive properties of KOR agonists require p38α MAPK activation through an arrestin-dependent mechanism. To determine whether nalfurafine is a functionally selective KOR agonist, we measured its potency to activate the G protein-dependent early phase of Extracellular Signal-Regulated Kinase (ERK1/2) phosphorylation and the arrestin-dependent late phase of p38 MAPK signaling...
January 11, 2017: Cellular Signalling
https://www.readbyqxmd.com/read/28087986/barriers-to-access-to-opioid-medicines-for-patients-with-opioid-dependence-a-review-of-legislation-and-regulations-in-eleven-central-and-eastern-european-countries
#5
Marjolein J M Vranken, Aukje K Mantel-Teeuwisse, Saskia Jünger, Lukas Radbruch, Willem Scholten, John A Lisman, Marija Subataite, Marie-Hélène D B Schutjens
BACKGROUND AND AIMS: Barriers linked to drug control systems are considered to contribute to inequitable access to controlled medicines, leaving millions of people in pain and suffering. Most studies focus on access to opioids for the treatment of severe (cancer) pain. This study aims to identify specific access barriers for patients with opioid dependence in legislation and regulations of 11 Central and Eastern European countries. METHODS: This study builds on a previous analysis of legislation and regulations as part of the EU 7th Framework Access To Opioid Medication in Europe (ATOME) project...
January 14, 2017: Addiction
https://www.readbyqxmd.com/read/28086853/taking-action-to-reduce-pain-action-study-rationale-design-and-protocol-of-a-randomized-trial-of-a-proactive-telephone-based-coaching-intervention-for-chronic-musculoskeletal-pain-among-african-americans
#6
Rozina H Bhimani, Lee J S Cross, Brent C Taylor, Laura A Meis, Steven S Fu, Kelli D Allen, Sarah L Krein, Tam Do, Robert D Kerns, Diana J Burgess
BACKGROUND: Rates of chronic pain are rising sharply in the United States and worldwide. Presently, there is evidence of racial disparities in pain treatment and treatment outcomes in the United States but few interventions designed to address these disparities. There is growing consensus that chronic musculoskeletal pain is best addressed by a biopsychosocial approach that acknowledges the role of psychological and environmental factors, some of which differ by race. METHODS/DESIGN: The primary aim of this randomized controlled trial is to test the effectiveness of a non-pharmacological, self-regulatory intervention, administered proactively by telephone, at improving pain outcomes and increasing walking among African American patients with hip, back and knee pain...
January 13, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28065184/long-term-outcomes-in-the-management-of-painful-diabetic-neuropathy
#7
Lauren M Mai, A John Clark, Allan S Gordon, Mary E Lynch, Pat K Morley-Forster, Howard Nathan, Catherine Smyth, Larry W Stitt, Cory Toth, Mark A Ware, Dwight E Moulin
BACKGROUND: Painful diabetic neuropathy (PDN) is a frequent complication of diabetes mellitus. Current treatment recommendations are based on short-term trials, generally of ≤3 months' duration. Limited data are available on the long-term outcomes of this chronic disease. The objective of this study was to determine the long-term clinical effectiveness of the management of chronic PDN at tertiary pain centres. METHODS: From a prospective observational cohort study of patients with chronic neuropathic non-cancer pain recruited from seven Canadian tertiary pain centres, 60 patients diagnosed with PDN were identified for analysis...
January 9, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28061485/comparison-of-the-effects-of-sufentanil-and-fentanyl-intravenous-patient-controlled-analgesia-after-lumbar-fusion
#8
Do Keun Kim, Seung Hwan Yoon, Ji Yong Kim, Chang Hyun Oh, Jong Kwon Jung, Jin Kim
OBJECTIVE: Postoperative pain is one of the major complaints of patients after lumbar fusion surgery. The authors evaluated the effects of intravenous patient controlled analgesia (IV-PCA) using fentanyl or sufentanil on postoperative pain management and pain-related complications. METHODS: Forty-two patients that had undergone surgery with lumbar instrumentation and fusion at single or double levels constituted the study cohort. Patients were equally and randomly allocated to a sufentanil group (group S) or a fentanyl group (group F) for patient controlled analgesia (PCA)...
January 1, 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28050704/swallowing-action-immediately-before-intravenous-fentanyl-at-induction-of-anesthesia-prevents-fentanyl-induced-coughing-a-randomized-controlled-study
#9
Saori Sako, Shoji Tokunaga, Masanori Tsukamoto, Jun Yoshino, Naoyuki Fujimura, Takeshi Yokoyama
PURPOSE: Fentanyl is a strong µ-opioid analgesic which attenuates the stimulation of surgical invasion and tracheal intubation. However, intravenous fentanyl often induces coughing [fentanyl-induced coughing (FIC)] during induction of anesthesia. We found that the swallowing action, when requested at induction of anesthesia, attenuated FIC. In the current study, we investigated the relationship between the occurrence of FIC and the swallowing action. METHODS: The study included American Society of Anesthesiologists physical status I or II patients, aged 20-64 years, who were undergoing elective surgery...
January 3, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28050391/comparison-of-efficacy-and-safety-of-intramuscular-piroxicam-and-tramadol-for-post-operative-pain-in-patients-undergoing-caesarean-delivery
#10
Tejashree Thippeswamy, Bhuvana Krishnaswamy, Girish M Bengalorkar, Narayanaswamy Mariyappa
INTRODUCTION: Post-caesarean section pain can be both stressful and unfavourable. Effective and rapid reduction of pain facilitates early ambulation and care of the new born. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and opioids are used for pain relief but they are associated with adverse effects both in the mother and the child. AIM: To evaluate efficacy and safety of piroxicam and tramadol in post-caesarean section pain. MATERIALS AND METHODS: Primigravidae who underwent elective caesarean section received either piroxicam 20mg or tramadol 100mg intra-muscularly, following recovery from anaesthesia...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28043841/non-opioid-pain-management-in-benign-minimally-invasive-hysterectomy-a-systematic-review
#11
REVIEW
Emily Blanton, Georgine Lamvu, Insiyyah Patanwala, Kenneth I Barron, Kathryn Witzeman, Frank F Tu, Sawsan As-Sanie
BACKGROUND: Less postoperative pain is typically associated with a minimally invasive hysterectomy compared to a laparotomy approach but poor pain control can still be an issues. Multiple guidelines exist for managing postoperative pain yet most are not specialty-specific and are based on procedures bearing little relevance to a minimally invasive hysterectomy. OBJECTIVE: To determine if there is enough quality evidence within the benign gynecology literature to make non-opioid pain control recommendations for women undergoing a benign minimally invasive hysterectomy...
December 30, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28039239/non-opioid-analgesics-in-adults-after-major-surgery-systematic-review-with-network-meta-analysis-of-randomized-trials
#12
V Martinez, H Beloeil, E Marret, D Fletcher, P Ravaud, L Trinquart
BACKGROUND: Morphine, and analgesics other than morphine (AOM), are commonly used to treat postoperative pain after major surgery. However, which AOM provides the best efficacy-safety profile remains unclear. METHODS: Randomized trials of any AOM alone or any combination of AOM compared with placebo or another AOM in adults undergoing major surgery and receiving morphine patient-controlled analgesia were included in a network meta-analysis. The outcomes were morphine consumption, pain, incidence of nausea, vomiting at 24 h and severe adverse effects...
January 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28035035/analysis-of-u-47700-a-novel-synthetic-opioid-in-human-urine-by-lc-ms-ms-and-lc-qtof
#13
Steven W Fleming, Justin C Cooley, Leonard Johnson, C Clinton Frazee, Kristina Domanski, Kurt Kleinschmidt, Uttam Garg
The illicit drug market has rapidly evolved from synthetic cannabinoids to cathinone derivatives and now a new emerging threat of synthetic opioids. These compounds were mostly developed by pharmaceutical companies during drug discovery. The new psychoactive substances are not routinely covered in drug screening and may go undetected. Recently fentanyl analogous, AH-7921, MT-45 and now U-47700 have been encountered in clinical and forensic casework. U-47700 is gaining popularity on drug user forms as a legal alternative to heroin...
December 29, 2016: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/28033519/characteristics-of-new-depression-diagnoses-in-patients-with-and-without-prior-chronic-opioid-use
#14
Jeffrey F Scherrer, Joanne Salas, F David Schneider, Kathleen K Bucholz, Mark D Sullivan, Laurel A Copeland, Brian K Ahmedani, Thomas Burroughs, Patrick J Lustman
: Chronic use (>90 Days) of opioid analgesics significantly increases the risk of development of new depression episodes (NDE). It is unclear whether depression that develops in this manner is similar to or different from NDE in persons not exposed to opioid analgesic use (OAU). METHODS: VA patients were classified into two groups, those who did not receive an opioid and developed depression (non-OAU+NDE, n=4314) and those that had >90 days OAU and developed NDE (OAU+NDE, n=444)...
December 21, 2016: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28025373/trends-in-opioid-analgesic-use-in-encounters-involving-physician-trainees-in-u-s-emergency-departments
#15
Maryann Mazer-Amirshahi, Peter M Mullins, Christie Sun, Jesse M Pines, Lewis S Nelson, Jeanmarie Perrone
BACKGROUND: Opioid analgesic use has increased dramatically in emergency departments (EDs), but the relative contribution of physician trainees has not been explored. We assessed trends in opioid utilization focusing on ED encounters where a physician trainee was involved. METHODS: We studied ED visits from the National Hospital Ambulatory Medical Care Survey, 2001-2011. Adult ED visits in which an opioid was administered in the ED or prescribed at discharge were stratified by whether or not there was trainee involvement...
December 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28019066/opioid-analgesic-use-among-patients-presenting-with-acute-abdominal-pain-and-factors-associated-with-surgical-diagnoses
#16
D Khemani, M Camilleri, A Roldan, A D Nelson, S-Y Park, A Acosta, A R Zinsmeister
BACKGROUND: The prevalence of chronic opioid use among non-cancer patients presenting with acute abdominal pain (AAP) is unknown. The aim was to characterize opioid use, constipation, diagnoses, and risk factors for surgical diagnoses among non-cancer patients presenting with AAP to an emergency department (ED). METHODS: We performed a retrospective, observational cohort study of all (n=16,121) adult patients (88% from MN, IA and WI) presenting during 2014 with AAP...
December 25, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/27984770/improving-quality-of-life-in-patients-with-advanced-cancer-targeting-metastatic-bone-pain
#17
REVIEW
Roger von Moos, Luis Costa, Carla Ida Ripamonti, Daniela Niepel, Daniele Santini
Metastatic bone disease in patients with advanced cancer is frequently associated with skeletal complications. These can be debilitating, causing pain, impaired functioning and decreased quality of life, as well as reduced survival. This review considers how the management of metastatic bone pain might be optimised, to limit the considerable burden it can impose on affected patients. Cancer-related pain is notoriously under-reported and under-treated, despite the availability of many therapeutic options. Non-opioid and opioid analgesics can be used; the latter are typically administered with radiotherapy, which forms the current standard of care for patients with metastatic bone pain...
January 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/27983881/hysingla%C3%A2-er-a-once-daily-single-entity-hydrocodone-with-abuse-deterrent-properties-in-treating-chronic-nonmalignant-and-nonneuropathic-pain-in-patients-with-osteoarthritis
#18
Louise Taber, Stacy Baldridge, Ellie He, Steven R Ripa
OBJECTIVES: Osteoarthritis (OA)-related chronic pain is associated with physical and psychosocial impairment as well as poorer quality of life. There is limited literature on long-term opioid therapy in OA patients. This post hoc analysis of OA patients assessed the long-term safety and effectiveness of a once-daily, single-entity, extended-release formulation of hydrocodone (HYD) with abuse-deterrent properties for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which other treatment options are inadequate...
January 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/27966726/broccoli-sprouts-in-analgesia-preclinical-in-vivo-studies
#19
Nieves Baenas, María Eva González-Trujano, Omar Guadarrama-Enríquez, Francisco Pellicer, Cristina García-Viguera, Diego A Moreno
BACKGROUND: Broccoli is a rich source of health-promoting glucosinolates, phenolic compounds, minerals and vitamins, which might have potential to alleviate pain. AIM: To explore the antinociceptive effects of a broccoli sprout aqueous extract (BSE) in experimental models of pain and an opioid mechanism. MATERIALS AND METHODS: the BSE was administered to mice and rats that were subjected to the writhing and formalin tests, respectively. Gastric damage or sedative-like response, as adverse effects observed in anti-inflammatory non-steroidal and opioid analgesic drugs, respectively, were also explored...
December 14, 2016: Food & Function
https://www.readbyqxmd.com/read/27964824/pain-in-amyotrophic-lateral-sclerosis
#20
REVIEW
Adriano Chiò, Gabriele Mora, Giuseppe Lauria
Pain is a largely neglected symptom in patients with amyotrophic lateral sclerosis (ALS) although it is reported by most of these patients. It occurs at all stages of the disease and can be an onset symptom preceding motor dysfunction. Pain is correlated with a deterioration in patients' quality of life and increased prevalence of depression. In the later stages of ALS, pain can be severe enough to require increased use of sedative and analgesic drugs, and is among the events that predict clinical deterioration and death...
February 2017: Lancet Neurology
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