Unique pain management compounds

Pain in Sickle Cell Disease (SCD) is a major comorbidity and unique with acute pain due to recurrent and episodic vaso-occlusive crises as well as chronic pain, which can span an individual's entire life. Opioids are the mainstay treatment for pain in SCD. Due to recent health crises raised by adverse effects including deaths from opioid use, pain management in SCD is adversely affected. Cannabis and its products are most widely used for pain in multiple conditions and also by patients with SCD on their own...

Familial benign pemphigus, or Hailey-Hailey disease (HHD), is a rare (1 in 50,000), benign, autosomal dominant cutaneous disorder that causes a painful rash and blistering commonly occurring in the intertriginous folds. Despite having a good prognosis, there is no cure for HHD and the disease can be quite debilitating to the quality of life. The complexity of HHD can be compounded by superimposed eczema herpeticum (EH) or Kaposi's varicelliform eruption, which is caused by a viral infection occurring in preexistent cutaneous conditions...

Chronic pain is a common public health problem that has a detrimental impact on patient health, quality of life (QoL), and function, and poses a substantial socioeconomic burden. Evidence supports the redefinition of chronic pain as a distinct disease entity, not simply a symptom of injury or illness. Chronic pain conditions are characterized by three types of pain pathophysiology (i.e. nociceptive, neuropathic, and centralized pain/central sensitization) influenced by a cluster of coexisting psychosocial factors...

Essential oils (EOs), also known as volatile oils, are concentrated natural plant products which contain volatile aroma compounds. Most EOs are derived by steam distillation, a tradition which can be traced back as many as 5000 years. They possess unique properties which result in various possibilities for application, also in modern medical contexts. Areas for medical aromatherapy include respiratory diseases, pain management or stress alleviation, amongst many others. Different modes of application exist: The rich ingredients can be absorbed by the body by anointment, gentle massage, inhalation, or oral intake of capsules...

Melnick-Needles syndrome (M-NS) is a rare genetic disorder which primarily affects skeletal developments. M-NS may also affect the cardiorespiratory and renal systems. A 35 kg patient presented complaining of abdominal pain. Following a positive pregnancy test and ultrasound examination, she was diagnosed with a ruptured ectopic pregnancy. She had a significant background history of M-NS, obstructive sleep apnoea (with narrow gauge tracheostomy in situ), obstructive lung disease and scoliosis. She received fluid resuscitation, and the case was managed using an open salpingectomy and clot evacuation under combined spinal/epidural anaesthesia...

BACKGROUND: Chronic pain is common and can be challenging to manage. Despite increased utilisation of opioids, the safety and efficacy of long-term use of these compounds for chronic non-cancer pain (CNCP) remains controversial. This overview of Cochrane Reviews complements the overview entitled 'High-dose opioids for chronic non-cancer pain: an overview of Cochrane Reviews'. OBJECTIVES: To provide an overview of the occurrence and nature of adverse events associated with any opioid agent (any dose, frequency, or route of administration) used on a medium- or long-term basis for the treatment of CNCP in adults...

The lack of successful translation of basic research discoveries into safe and effective treatments for chronic pain patients has led to increased scrutiny of the preclinical models used in pain research, particularly for osteoarthritis, where there is a significant disconnect between the animal models used to study the structural versus symptomatic aspects of the disease. Companion dogs offer a unique opportunity to assess osteoarthritis pain in a physiologically relevant 'model' of the disease. Approximately 20% of the canine pet population spontaneously develops osteoarthritis, translating to at least 15 million dogs in the United States alone...

INTRODUCTION: The emergence of extensively drug-resistant tuberculosis (XDR-TB) is a challenging paradigm shift faced by the TB control programs worldwide today. The treatment is further compounded with unique management difficulties faced in pediatric patients. Treatment of XDR-TB requires prolonged chemotherapy with second-line drugs which offer lesser potency and increased risk of drug-related side effects. We present a case of spinal XDR-TB in a child, managed with extended second-line antitubercular chemotherapy (ATT)...

All skin diseases involve some element of stigmatization and psychosocial consequence for the individual patient, but few, if any, skin diseases can match the impact of hidradenitis suppurativa (HS) on the patient. The inflamed lesions progressing to noninflamed nodules and abscesses are not only perceived as unclean and stigmatizing by the patients, but also cause pain and scarring making this inflammatory skin disorder unique. It is obvious that the disease has a significant negative impact on the patients' quality of life (QOL)...

Although selective metabolic and receptor-based molecular agents will surely be included in the future of prostate cancer diagnosis and therapy, currently available inorganic compounds-such as (18)F-NaF for the diagnosis of bony disease and (223)RaCl2 for the therapy of bone metastases-were recently shown to be superior to standard (99m)Tc-phosphonates for diagnosis and (153)Sm-ethylenediaminetetramethylene phosphonate or (89)SrCl2 for therapy. The advantages of (18)F-NaF include improved lesion detection and, when used in combination with CT, improved diagnostic confidence and specificity...

A compounded preparation is needed when no commercially manufactured medication is available to adequately address a patient's medical needs. Among the greatest therapeutic challenges faced by both patients and caregivers is the treatment required by individuals who have a terminal condition. It is difficult to find evidence-based studies on the management of end-of-life situations because each patient's medical case is unique. In addition, maintaining a controlled environment for such patients is difficult...

Gabapentin (1-aminomethyl-cyclohexaneacetic acid) is an amino acid that has the structure of the neurotransmitter γ -aminobutyric acid (GABA). It is a novel drug used for the treatment of postoperative pain with antihyperalgesic properties and a unique mechanism of action. Gabapentin and the related, more potent compound pregabalin have been shown to be beneficial in the treatment of neuropathic pain as well as postoperative pain following spinal surgery and hysterectomy. This study reviews five aspects of gabapentin: (1) chemical and structural characteristics; (2) pharmacokinetics and pharmacodynamics; (3) application in acute pain management; (4) adverse effects; and (5) drug safety...

TRV130 is a G protein-biased ligand at the µ-opioid receptor. In preclinical studies it was potently analgesic while causing less respiratory depression and gastrointestinal dysfunction than morphine, suggesting unique benefits in acute pain management. A first-in-human study was conducted with ascending doses of TRV130 to explore its tolerability, pharmacokinetics, and pharmacodynamics in healthy volunteers. TRV130 was well-tolerated over the dose range 0.15 to 7 mg administered intravenously over 1 hour...

Pikes Peak Hospice and Palliative Care, Inc., provides care for more than 200 patients with terminal disease who reside at home, in long-term care facilities, in assisted living facilities, or in its acute-care Inpatient Unit. Over the past 4 years, its pharmacy has evolved to provide individualized compounded preparations to meet the unique and complex needs of these patients. An integral part of this evolution was development and implementation of topical treatment for pain. These patients often have multiple medical conditions and complicated health issues...

Compounding pharmacists can provide a great therapeutic service to pain management patients who have overcome an addiction to prescribed or illegal drugs or alcohol. By collaborating with the physician and the patient, the compounder can develop an effective analgesic formulation with no addictive potential; a preparation that can be safely adjusted to meet changing medical needs. In this report, we present a personal account of the value of two compounded preparations that relieve severe musculoskeletal pain without producing mood-altering effects, as well as information about how those compounds are prepared...

GAB(A) (γ-aminobutyric acid) is abundantly expressed within the brain, and spinal cord pain circuits where it acts as the principal mediator of fast inhibitory neurotransmission. However, drugs that target GABA(A) receptor function such as the classical benzodiazepines have not been optimised to promote analgesia, are limited by side effects and are not routinely used for this purpose in humans. Compounds such as NS11394, L-838,417, HZ166 and TPA023 all bind to the same benzodiazepine site on the GABA(A) receptor to allosterically modulate receptor function and enhance the actions of GABA...

Fentanyl pectin nasal spray is a novel intranasal formulation for the management of breakthrough cancer pain in patients taking and tolerant to opioids for persistent cancer pain. The pectin-based delivery modulates the product's transmucosal absorption. Nasal delivery allows fentanyl pectin nasal spray to achieve a greater maximum plasma concentration than oral transmucosal fentanyl products and at a much faster rate. Compared with intranasal fentanyl compounded with aqueous solutions, the pectin-based system decreases the maximum plasma concentration and prolongs exposure to more closely match the time course of a typical breakthrough cancer pain episode...

BACKGROUND: Sublingual buprenorphine-naloxone (buprenorphine SL) is a preparation that is used to treat opioid dependence. In addition, the Drug Enforcement Administration (DEA) has acknowledged the legality of an off-label use to treat pain with a sublingual buprenorphine preparation. Buprenorphine SL is unique among the opioid class of analgesics; this compound has a high affinity for the mu-receptor, yet only partially activates it. Thus, buprenorphine SL can provide analgesia, yet minimize opioid side effects...

In view of the characteristics of different analgesic methods applied to nasal operation, the principle of point selection in acupuncture anesthesia, the frequency of electroacupuncture and the assessment of operation, it was stated that the compound acupuncture anesthesia not only prevented from incomplete analgesia of local anesthesia, but also avoided the adverse reactions of general anesthesia in this paper. Moreover, by reducing the dose of narcotics, the unique advantage of acupuncture anesthesia could be displayed...

Despite their widespread Internet availability and use, many of the new drugs of abuse remain unfamiliar to health care providers. The herbal marijuana alternatives, like K2 or Spice, are a group of herbal blends that contain a mixture of plant matter in addition to chemical grade synthetic cannabinoids. The synthetic cathinones, commonly called "bath salts," have resulted in nationwide emergency department visits for severe agitation, sympathomimetic toxicity, and death. Kratom, a plant product derived from Mitragyna speciosa Korth, has opioid-like effects, and has been used for the treatment of chronic pain and amelioration of opioid-withdrawal symptoms...