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Non-Opioid Analgesics

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https://www.readbyqxmd.com/read/28911965/physiological-roles-of-cns-muscarinic-receptors-gained-from-knockout-mice
#1
REVIEW
Morgane Thomsen, Gunnar Sørensen, Ditte Dencker
Because the five muscarinic acetylcholine receptor subtypes have overlapping distributions in many CNS tissues, and because ligands with a high degree of selectivity for a given subtype long remained elusive, it has been difficult to determine the physiological functions of each receptor. Genetically engineered knockout mice, in which one or more muscarinic acetylcholine receptor subtype has been inactivated, have been instrumental in identifying muscarinic receptor functions in the CNS, at the neuronal, circuit, and behavioral level...
September 11, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28898808/associations-between-statewide-prescription-drug-monitoring-program-pdmp-requirement-and-physician-patterns-of-prescribing-opioid-analgesics-for-patients-with-non-cancer-chronic-pain
#2
Hsien-Chang Lin, Zhi Wang, Carol Boyd, Linda Simoni-Wastila, Anne Buu
OBJECTIVE: State-level prescription drug monitoring programs (PDMPs) have been implemented in most states. PDMPs enable registered prescribers to obtain real-time information on patients' prescription history to reduce non-medical use of controlled drugs. This study examined whether PDMP implementation and different levels of PDMP requirements were associated with physicians' patterns of prescribing opioid analgesics for patients with non-cancer chronic pain. METHODS: This is a secondary analysis study using cross-sectional national data...
September 5, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28893675/design-recruitment-outcomes-and-sample-characteristics-of-the-strategies-for-prescribing-analgesics-comparative-effectiveness-space-trial
#3
Erin E Krebs, Agnes C Jensen, Sean Nugent, Beth DeRonne, Indulis Rutks, David Leverty, Amy Gravely, Siamak Noorbaloochi, Matthew J Bair, Kurt Kroenke
This manuscript describes the study protocol, recruitment outcomes, and baseline participant characteristics for the Strategies for Prescribing Analgesics Comparative Effectiveness (SPACE) trial. SPACE is a pragmatic randomized comparative effectiveness trial conducted in multiple VA primary care clinics within one VA health care system. The objective was to compare benefits and harms of opioid therapy versus non-opioid medication therapy over 12months among patients with moderate-to-severe chronic back pain or hip/knee osteoarthritis pain despite analgesic therapy; patients already receiving regular opioid therapy were excluded...
September 8, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28893633/enhanced-recovery-open-versus-laparoscopic-left-donor-nephrectomy-a-randomized-controlled-trial
#4
Ahmed M Mansour, Ahmed R El-Nahas, Bedeir Ali-El-Dein, Ahmed Abdelfattah, Ahmed Hamed, Ahmed Abdel-Rahman, Ibrahim Eraky, Ahmed A Shokeir
OBJECTIVE: To compare recovery outcomes between laparoscopic donor nephrectomy (LDN) and open donor nephrectomy (ODN) within a specified Enhanced Recovery Program (ERP) for left kidney donations. MATERIALS AND METHODS: A phase III randomized trial was conducted between January 2013 and June 2015, eligible left side donors were randomized to laparoscopic or open donor nephrectomy in a 1:1 ratio with recovery optimized within a standardized ERP. The primary outcome was patient-reported measure of physical fatigue, as measured by the physical fatigue domain of the translated Multidimensional Fatigue Inventory 20 (MFI-20)...
September 8, 2017: Urology
https://www.readbyqxmd.com/read/28893309/efficacy-and-safety-of-controlled-release-oxycodone-naloxone-versus-controlled-release-oxycodone-in-korean-patients-with-cancer-related-pain-a-randomized-controlled-trial
#5
Kyung-Hee Lee, Tae Won Kim, Jung-Hun Kang, Jin-Soo Kim, Jin-Seok Ahn, Sun-Young Kim, Hwan-Jung Yun, Young-Jun Eum, Sung Ae Koh, Min Kyoung Kim, Yong Sang Hong, Jeong Eun Kim, Gyeong-Won Lee
BACKGROUND: Controlled-release oxycodone/naloxone (OXN-CR) maintains the effect of opioid-induced analgesia through oxycodone while reducing the occurrence rate of opioid-induced constipation through naloxone. The present study was designed to assess the non-inferiority of OXN-CR to controlled-release oxycodone (OX-CR) for the control of cancer-related pain in Korean patients. METHODS: In this randomized, open-labeled, parallel-group, phase IV study, we enrolled patients aged 20 years or older with moderate to severe cancer-related pain [numeric rating scale (NRS) pain score ≥4] from seven Korean oncology/hematology centers...
September 11, 2017: Chinese Journal of Cancer
https://www.readbyqxmd.com/read/28890382/in-vitro-genotoxicity-and-in-vivo-subchronic-evaluation-of-the-anti-inflammatory-pyrazole-compound-lqfm021
#6
Soraia Santa de Moura, Renato Ivan de Ávila, Lara Barroso Brito, Rhaul de Oliveira, Gisele Augusto Rodrigues de Oliveira, Francine Pazini, Ricardo Menegatti, Aline Carvalho Batista, Cesar Koppe Grisolia, Marize Campos Valadares
Scientific evidences have highlighted 5-(1-(3-fluorophenyl)-1H-pyrazol-4-yl)-2H-tetrazole (LQFM021) as a promising anti-inflammatory, analgesic and antinociceptive agent due to its effects on peripheral opioid receptors associated with activation of the nitric oxide/cGMP/KATP pathway. Despite these important pharmacological findings, toxicity data of LQFM021 are scarce. Thus, this study investigated the in vitro genotoxicity of LQFM021 through cytokinesis-block micronucleus assay (OECD Nº 487/2014). Moreover, zebrafish model was used to assess the embryotoxicity potential of LQFM021 using fish embryo toxicity test (OECD Nº 236/2013) with extended exposure to evaluate subchronic larval development...
September 7, 2017: Chemico-biological Interactions
https://www.readbyqxmd.com/read/28875826/current-treatment-options-for-osteoarthritis
#7
Sevdalina Lambova, Walter Hermann, Ulf Müller-Ladner
BACKGROUND: Osteoarthritis (ОА) is the most common joint disease and a leading cause for impaired function and disability with significant treatment costs and socio-economic burden. Despite recent achievements in the knowledge on disease pathogenesis, the treatment is still a challenge and contrary to inflammatory joint diseases, no disease-modifying drugs are currently available for OA. OBJECTIVE: Different response in different localizations of the disease further complicates the therapeutic choice...
August 29, 2017: Current Rheumatology Reviews
https://www.readbyqxmd.com/read/28875436/predictors-of-daily-pain-medication-use-in-individuals-with-recurrent-back-pain
#8
John A Sturgeon, Jennifer M Hah, Yasamin Sharifzadeh, Stephanie K Middleton, Thomas Rico, Kevin A Johnson, Sean C Mackey
PURPOSE: A key component to chronic pain management regimens is the use of analgesic medications. Psychological factors, such as mood states, may also affect the use of pain medications for individuals with chronic pain, but few observational studies have examined how these factors may predict pain medication use at the daily level. METHODS: Daily assessments from 104 individuals with back pain were used to examine fluctuations in daily pain intensity, mood, sleep quality, and physical activity as predictors of the likelihood of pain medication (opioid and non-opioid) use and levels of medication use on the same day...
September 5, 2017: International Journal of Behavioral Medicine
https://www.readbyqxmd.com/read/28860850/a-randomized-double-blind-study-of-hydromorphone-hydrochloride-extended-release-tablets-versus-oxycodone-hydrochloride-extended-release-tablets-for-cancer-pain-efficacy-and-safety-in-japanese-cancer-patients-exheal-a-phase-iii-study-of-extended-release-hydromorphone
#9
Satoshi Inoue, Yoji Saito, Satoru Tsuneto, Etsuko Aruga, Azusa Ide, Yasuyuki Kakurai
BACKGROUND: In Japan, there are limited options for switching opioid analgesics. Hydromorphone is an opioid analgesic that is routinely used instead of morphine for cancer pain; however, it is not yet available in Japan. The aim of this study was to assess the efficacy and safety of hydromorphone (DS-7113b) extended-release tablets in opioid-naïve patients with cancer pain not relieved by non-opioid analgesics. SUBJECTS AND METHODS: This was a multicenter, randomized, double-blind, parallel-group trial...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28860845/dexmedetomidine-in-perioperative-acute-pain-management-a-non-opioid-adjuvant-analgesic
#10
REVIEW
Chaoliang Tang, Zhongyuan Xia
Many nociceptive, inflammatory, and neuropathic pathways contribute to perioperative pain. Although opioids have long been a mainstay for perioperative analgesia, other non-opioid therapies, and dexmedetomidine, in particular, have been increasingly used as part of a multimodal analgesic regimen to provide improved pain control while minimizing opioid-related side effects. This article reviews the evidence supporting the preoperative, intraoperative, and postoperative efficacy of dexmedetomidine as an adjuvant, and the efficacy of intravenous, spinal canal, and nerve block analgesia with dexmedetomidine for perioperative acute pain treatment...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28860712/a-comparison-of-oral-controlled-release-morphine-and-oxycodone-with-transdermal-formulations-of-buprenorphine-and-fentanyl-in-the-treatment-of-severe-pain-in-cancer-patients
#11
Krzysztof Nosek, Wojciech Leppert, Hanna Nosek, Jerzy Wordliczek, Dariusz Onichimowski
AIM OF THE STUDY: To compare analgesia and adverse effects during oral morphine and oxycodone and transdermal fentanyl and buprenorphine administration in cancer patients with pain. PATIENTS AND METHODS: Cancer patients treated at home and in outpatient clinics with severe pain (numerical rating scale score 6-10) fail to respond to non-opioids and/or weak opioids. All patients were randomized to either morphine, oxycodone, fentanyl or buprenorphine and divided into subgroups with predominant neuropathic and nociceptive pain component...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28851798/study-protocol-for-a-multi-institutional-randomised-double-blinded-placebo-controlled-phase-iii-trial-investigating-additive-efficacy-of-duloxetine-for-neuropathic-cancer-pain-refractory-to-opioids-and-gabapentinoids-the-direct-study
#12
Hiromichi Matsuoka, Hiroto Ishiki, Satoru Iwase, Atsuko Koyama, Takashi Kawaguchi, Yoshiyuki Kizawa, Tatsuya Morita, Yoshinobu Matsuda, Tempei Miyaji, Keisuke Ariyoshi, Takuhiro Yamaguchi
INTRODUCTION: Management of patients with cancer suffering from neuropathic pain refractory to opioids and gabapentinoids remains an important challenge. Duloxetine is one of the choices after first-line treatment fails. The efficacy of duloxetine has been reported in patients with non-cancer disease and in chemotherapy-induced peripheral neuropathy, but no randomised clinical trials have examined its effects on neuropathic cancer pain refractory to first-line treatment. The objective of this study is to assess the analgesic efficacy of duloxetine in patients suffering from neuropathic cancer pain refractory to opioids and gabapentinoids...
August 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28833803/important-statistical-considerations-in-the-evaluation-of-post-market-studies-to-assess-whether-opioids-with-abuse-deterrent-properties-result-in-reduced-abuse-in-the-community
#13
Kunthel By, Jana K McAninch, Stephine L Keeton, Alex Secora, Cynthia J Kornegay, Catherine S Hwang, Thomas Ly, Mark S Levenson
PURPOSE: Abuse, misuse, addiction, overdose, and death associated with non-medical use of prescription opioids have become a serious public health concern. Reformulation of these products with abuse-deterrent properties is one approach for addressing this problem. FDA has approved several extended-release opioid analgesics with abuse-deterrent labeling, the bases of which come from pre-market studies. As all opioid analgesics must be capable of delivering the opioid in order to reduce pain, abuse-deterrent properties do not prevent abuse, nor do pre-market evaluations ensure that there will be reduced abuse in the community...
August 23, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28832395/multiple-sites-and-actions-of-gabapentin-induced-relief-of-ongoing-experimental-neuropathic-pain
#14
Kirsty Bannister, Chaoling Qu, Edita Navratilova, Janice Oyarzo, Jennifer Yanhua Xie, Tamara King, Anthony H Dickenson, Frank Porreca
Gabapentin (GBP) is a first-line therapy for neuropathic pain, but its mechanisms and sites of action remain uncertain. We investigated GBP-induced modulation of neuropathic pain following spinal nerve ligation (SNL) in rats. Intravenous or intrathecal GBP reversed evoked mechanical hypersensitivity and produced conditioned place preference (CPP) and dopamine (DA) release in the nucleus accumbens (NAc) selectively in SNL rats. Spinal GBP also significantly inhibited dorsal horn wide-dynamic-range neuronal responses to a range of evoked stimuli in SNL rats...
August 21, 2017: Pain
https://www.readbyqxmd.com/read/28821939/analgesic-use-in-patients-with-knee-and-or-hip-osteoarthritis-referred-to-an-outpatient-center-a-cross-sectional-study-within-the-amsterdam-osteoarthritis-cohort
#15
Jesper Knoop, Joyce van Tunen, Martin van der Esch, Leo D Roorda, Joost Dekker, Marike van der Leeden, Willem F Lems
Although analgesics are widely recommended in current guidelines, underuse and inadequate prescription of analgesics seem to result in suboptimal treatment effects in patients with knee and/or hip osteoarthritis (OA). This study aimed (i) to describe the use of analgesics; and (ii) to determine factors that are related to analgesic use in patients with knee and/or hip OA referred to an outpatient center. A cross-sectional study with data from 656 patients with knee and/or hip OA referred to an outpatient center (Amsterdam Osteoarthritis (AMS-OA) cohort) was conducted...
August 18, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28818631/topical-medical-cannabis-tmc-a-new-treatment-for-wound-pain-three-cases-of-pyoderma-gangrenosum
#16
Vincent Maida, Jason Corban
Pain associated with integumentary wounds is highly prevalent yet it remains an area of significant unmet need within healthcare. Currently, systemically administered opioids are the mainstay of treatment. However, recent publications are casting opioids in a negative light given their high side effect profile, inhibition of wound healing, and association with accidental overdose, incidents that are frequently fatal. Thus, novel analgesic strategies for wound-related pain need to be investigated. The ideal methods of pain relief for wound patients are modalities that are topical, lack systemic side effects, non-invasive, self-administered, and display rapid onset of analgesia...
August 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28817416/nicotinic-modulation-of-descending-pain-control-circuitry
#17
Iboro C Umana, Claire A Daniele, Brooke A Miller, Keith Gallagher, Meghan A Brown, Chandrika Abburi, Peggy Mason, Daniel S McGehee
Along with the well-known rewarding effects, activation of nicotinic acetylcholine receptors (nAChRs) can also relieve pain, and some nicotinic agonists have analgesic efficacy similar to opioids. A major target of analgesic drugs is the descending pain modulatory pathway, including the ventrolateral periaqueductal gray (vlPAG) and the rostral ventromedial medulla (RVM). Although activating nAChRs within this circuitry can be analgesic, little is known about the subunit composition and cellular effects of these receptors, particularly within the vlPAG...
July 3, 2017: Pain
https://www.readbyqxmd.com/read/28815799/characterization-of-opioid-use-in-sickle-cell-disease
#18
Jin Han, Jifang Zhou, Santosh L Saraf, Victor R Gordeuk, Gregory S Calip
PURPOSE: Opioid analgesics are commonly used to treat vaso-occlusive pain episodes in sickle cell disease (SCD), but comprehensive evidence characterizing opioid use in this patient population is limited. Our objective was to characterize opioid use patterns among SCD patients using a large nationwide database. METHODS: A large, US medical claims database was utilized to identify a cohort of 3882 SCD patients, and characteristics of opioid use were analyzed. Clinical variables including age, gender, medication use, health care utilization, and medical history were evaluated for correlations with opioid use...
August 16, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28805471/prolonged-release-oxycodone-and-naloxone-treatment-counteracts-opioid-induced-constipation-in-patients-with-severe-pain-compared-to-previous-analgesic-treatment
#19
Gineke Koopmans-Klein, Joeri Van Op den Bosch, Yvonne van Megen, Hans Prenen, Frank Huygen, Isabelle Mancini
OBJECTIVE: Treatment with prolonged-release oxycodone/naloxone (PR OXN) has been shown to improve opioid induced constipation (OIC) in constipated patients. This publication reports on a real-life observational study investigating the efficacy of PR OXN with regard to bowel function in patients switching to PR OXN from WHO step 1, step 2 and step 3 opioids. METHODS: Patients with chronic pain experiencing insufficient pain relief and/or unacceptable side effects were switched to PR OXN and monitored in this observational study with respect to efficacy regarding bowel function and efficacy regarding pain relief in comparison with previous analgesic therapy...
September 11, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28782695/analgesics-and-sport-performance-beyond-the-pain-modulating-effects
#20
REVIEW
Darias Holgado, James Hopker, Daniel Sanabria, Mikel Zabala
Analgesics are used widely in sport to treat pain and inflammation associated with injury. However, there is growing evidence that some athletes might be taking these substances in an attempt to enhance performance. Although the pharmacologic action of analgesics and their use in treating pain with and without anti-inflammatory effect is well established, their effect on sport performance is debated. The aim of this review was to evaluate the evidence of whether analgesics are capable of enhancing exercise performance and, if so, to what extent...
August 4, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
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