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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
#1
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...
August 14, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28797863/palliative-care-development-in-mongolia
#2
Odontuya Davaasuren, Frank Ferris
CONTEXT: Since the year 2000, Mongolia has established the foundation measures for a national palliative care program and has made several significant achievements. METHODS: Systematic reviews and observational studieson palliative care development in Mongolia have taken place overthe past 16 years. RESULTS: Mongolia began palliative care development in 2000 with the creation of the Mongolian Palliative Care Society and the Palliative Care Department...
August 7, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28797721/intact-blood-brain-barrier-transport-of-small-molecular-drugs-in-animal-models-of-amyloid-beta-and-alpha-synuclein-pathology
#3
Sofia Gustafsson, Veronica Lindström, Martin Ingelsson, Margareta Hammarlund-Udenaes, Stina Syvänen
Pathophysiological impairment of the neurovascular unit, including the integrity and dynamics of the blood-brain barrier (BBB), has been denoted both a cause and consequence of neurodegenerative diseases. Pathological impact on BBB drug delivery has also been debated. The aim of the present study was to investigate BBB drug transport, by determining the unbound brain-to-plasma concentration ratio (Kp,uu,brain), in aged AβPP-transgenic mice, α-synuclein transgenic mice, and wild type mice. Mice were dosed with a cassette of five compounds, including digoxin, levofloxacin (1 mg/kg, s...
August 5, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28792650/oral-oxycodone-naloxone-for-pain-control-in-liver-cirrhosis-observational-study-in-patients-with-symptomatic-metastatic-hepatocellular-carcinoma
#4
Francesco Tovoli, Stefania De Lorenzo, Boaz Gedaliahu Samolsky Dekel, Fabio Piscaglia, Francesca Benevento, Giovanni Brandi, Luigi Bolondi
BACKGROUND & AIMS: Pain management in liver cirrhosis is a clinical challenge. Most analgesics are metabolized in the liver and cirrhosis may deeply alter their concentration, favoring the appearance of side effects. We aimed to assess the efficacy and safety of oral prolonged-release association of oxycodone/naloxone tablets (OXN) in the treatment of moderate/severe cancer pain in cirrhotic patients with metastatic hepatocellular carcinoma (HCC). METHODS: We enrolled n=32 HCC patients with moderate/severe cancer pain unresponsive to paracetamol alone or associated with codeine or tramadol...
August 9, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28791598/opioid-medications-in-the-management-of-chronic-abdominal-pain
#5
REVIEW
Dajie Wang
PURPOSE OF REVIEW: Chronic abdominal pain is a complex medical condition. The causes of chronic abdominal pain are extremely diverse ranging from chronic pancreatitis, Crohn's disease, to chronic pain with no clear etiology. Treatment of chronic abdominal pain remains a challenge in our clinical practice. While current interventions with celiac plexus blocks and pain medications provide some relief for these patients, but these treatments are typically less efficacious and limited by various adverse effects...
August 8, 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28769582/cyp2d6-phenotypes-are-associated-with-adverse-outcomes-related-to-opioid-medications
#6
Jennifer L St Sauver, Janet E Olson, Veronique L Roger, Wayne T Nicholson, John L Black, Paul Y Takahashi, Pedro J Caraballo, Elizabeth J Bell, Debra J Jacobson, Nicholas B Larson, Suzette J Bielinski
BACKGROUND: Variation in the CYP2D6 gene may affect response to opioids in both poor and ultrarapid metabolizers, but data demonstrating such associations have been mixed, and the impact of variants on toxicity-related symptoms (e.g., nausea) is unclear. Therefore, we examined the association between CYP2D6 phenotype and poor pain control or other adverse symptoms related to the use of opioids in a sample of primary care patients. MATERIALS AND METHODS: We identified all patients in the Mayo Clinic RIGHT Protocol who were prescribed an opioid medication between July 01, 2013 and June 30, 2015, and categorized patients into three phenotypes: poor, intermediate to extensive, or ultrarapid CYP2D6 metabolizers...
2017: Pharmacogenomics and Personalized Medicine
https://www.readbyqxmd.com/read/28767570/effects-of-oxycodone-on-immune-function-in-patients-undergoing-radical-resection-of-rectal-cancer-under-general-anesthesia
#7
Jia-Hua Cui, Wan-Wei Jiang, Ya-Jing Liao, Qing-Hui Wang, Min Xu, Yu Li
This study aims to explore the effect of oxycodone hydrochloride injection on the immune function of patients who underwent radical resection of rectal cancer under general anesthesia.Eighty patients were enrolled and randomly divided into group A and B (n = 40, each). All patients underwent general intravenous anesthesia. At the end of surgery, each patient in group A was injected with 5 mg (5 mL) of oxycodone hydrochloride, while 5 mg (5 mL) of morphine hydrochloride in group B. Venous blood was withdrawn in both groups at different time points...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28760650/grip-strength-in-mice-with-joint-inflammation-a-rheumatology-function-test-sensitive-to-pain-and-analgesia
#8
Ángeles Montilla-García, Miguel Á Tejada, Gloria Perazzoli, José M Entrena, Enrique Portillo-Salido, Eduardo Fernández-Segura, Francisco J Cañizares, Enrique J Cobos
Grip strength deficit is a measure of pain-induced functional disability in rheumatic disease. We tested whether this parameter and tactile allodynia, the standard pain measure in preclinical studies, show parallels in their response to analgesics and basic mechanisms. Mice with periarticular injections of complete Freund's adjuvant (CFA) in the ankles showed periarticular immune infiltration and synovial membrane alterations, together with pronounced grip strength deficits and tactile allodynia measured with von Frey hairs...
July 29, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28754812/outpatient-cpoe-orders-discontinued-due-to-erroneous-entry-prospective-survey-of-prescribers-explanations-for-errors
#9
Thu-Trang T Hickman, Arbor Jessica Lauren Quist, Alejandra Salazar, Mary G Amato, Adam Wright, Lynn A Volk, David W Bates, Gordon Schiff
BACKGROUND: Computerised prescriber order entry (CPOE) systems users often discontinue medications because the initial order was erroneous. OBJECTIVE: To elucidate error types by querying prescribers about their reasons for discontinuing outpatient medication orders that they had self-identified as erroneous. METHODS: During a nearly 3 year retrospective data collection period, we identified 57 972 drugs discontinued with the reason 'Error (erroneous entry)...
July 28, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28748177/hypoglycemic-effects-of-tramadol-analgesia-in-hospitalized-patients-a-case-control-study
#10
Larry K Golightly, Bonita A Simendinger, Gerard R Barber, Nancy M Stolpman, Steven D Kick, Michael T McDermott
BACKGROUND: In outpatient populations, hypoglycemia has been associated with tramadol. We sought to determine the magnitude of risk for hypoglycemia associated with tramadol use in hospitalized patients. METHODS: During a 2-year period of observation, adult inpatients who received ≥1 dose of tramadol were identified and their medical records were reviewed. Patients were included if they had blood or plasma glucose (BG) concentrations measured on at least two occasions within five days after the initial administration of tramadol...
2017: Journal of Diabetes and Metabolic Disorders
https://www.readbyqxmd.com/read/28745394/opioids-for-chronic-non-cancer-pain-in-children-and-adolescents
#11
REVIEW
Tess E Cooper, Emma Fisher, Andrew L Gray, Elliot Krane, Navil Sethna, Miranda Al van Tilburg, Boris Zernikow, Philip J Wiffen
BACKGROUND: Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization guidelines for pharmacological treatments for children's persisting pain acknowledge that pain in children is a major public health concern of high significance in most parts of the world. While in the past, pain was largely dismissed and was frequently left untreated, views on children's pain have changed over time, and relief of pain is now seen as importantWe designed a suite of seven reviews on chronic non-cancer pain and cancer pain (looking at antidepressants, antiepileptic drugs, non-steroidal anti-inflammatory drugs, opioids, and paracetamol as priority areas) in order to review the evidence for children's pain utilising pharmacological interventions in children and adolescents...
July 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28740422/preoperative-intravenous-ibuprofen-does-not-influence-postoperative-narcotic-use-in-patients-undergoing-elective-hernia-repair-a-randomized-double-blind-placebo-controlled-prospective-trial
#12
Lauren S Sparber, Christine Sm Lau, Tanya S Vialet, Ronald S Chamberlain
INTRODUCTION: Inguinal and umbilical hernia repairs are among the most common surgical procedures performed in the US. Optimal perioperative pain control regimens remain challenging and opioid analgesics are commonly used. Preoperative nonsteroidal anti-inflammatory drug (NSAID) administration has been shown to reduce postoperative narcotic requirements. This study sought to evaluate the efficacy of perioperative intravenous (IV) ibuprofen on postoperative pain level and narcotic use in patients undergoing open or laparoscopic inguinal and/or umbilical hernia repair...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28737985/evaluation-of-patient-migration-patterns-and-related-health-care-costs-within-a-national-medicare-advantage-prescription-drug-plan-after-implementation-of-an-oxycodone-hcl-extended-release-access-restriction
#13
Chi-Chang Chen, Ajita P De, Brian Sweet, Rolin L Wade
BACKGROUND: Health plans use formulary restrictions (e.g., prior authorization, step therapy, tier change, nonformulary status) in an effort to control cost and promote quality, safety, and appropriate prescription utilization. Some Medicare payers perceive that the inclusion of certain agents, such as branded oxycodone HCl extended-release tablets (OERs), on their formularies is associated with attracting high-cost members to the plan. OBJECTIVE: To evaluate disenrollment rates, patient migration, and subsequent health care costs among OER users who disenrolled from a national Medicare Advantage Prescription Drug plan (study-MAPD) in the plan year following OER nonformulary restriction...
August 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28736104/opioid-induced-constipation-relief-of-fixed-ratio-combination-prolonged-release-oxycodone-naloxone-compared-with-oxycodone-and-morphine-for-chronic-non-malignant-pain-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#14
REVIEW
Lang Huang, Jian-Guo Zhou, Yu Zhang, Fei Wang, Yi Wang, Da-Hai Liu, Xin-Juan Li, Shui-Ping Lv, Su-Han Jin, Yu-Ju Bai, Hu Ma
BACKGROUND: Opioid-induced constipation (OIC) is one of the most frequent and severe adverse events (AEs) following treatment with opioids. Recent studies have indicated that fixed-ratio combination prolonged-release oxycodone/naloxone (OXN PR) could decrease OIC with similar pain relief compared with other opioids. OBJECTIVES: We systematically reviewed (PROSPERO registration numbers: CRD42016036244) the constipation relief of OXN PR compared with other opioids regardless of formulation, prolonged-release or extended-release used for the relief of chronic pain...
July 20, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28735847/transcutaneous-electrical-nerve-stimulation-for-postoperative-pain-relief-after-arthroscopic-rotator-cuff-repair-a-prospective-double-blinded-randomized-trial
#15
Siddharth A Mahure, Andrew S Rokito, Young W Kwon
BACKGROUND: Arthroscopic rotator cuff repair (ARCR) can be associated with significant postoperative pain. Concern for opioid abuse has led surgeons to identify alternative, efficacious methods of postoperative analgesia. To determine whether transcutaneous electrical nerve stimulation (TENS) can have a similarly beneficial effect after shoulder procedures, we conducted a prospective double-blinded randomized trial in patients undergoing outpatient ARCR. METHODS: All patients undergoing ARCR of a full-thickness rotator cuff tear by the senior authors were identified...
July 20, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28734882/opioid-prescribing-among-cancer-and-non-cancer-patients-time-trend-analysis-in-the-elderly-using-administrative-data
#16
Lisa Barbera, Rinku Sutradhar, Anna Chu, Hsien Seow, Doris Howell, Craig C Earle, Mary Ann O'Brien, Deb Dudgeon, Clare Atzema, Amna Husain, Ying Liu, Carlo DeAngelis
BACKGROUND: In 2007, Cancer Care Ontario introduced a provincial symptom screening program, which included pain, for cancer patients. Over this same time, opioid prescribing has been increasingly scrutinized among non-cancer patients. The study purpose was to see if opioid prescribing changed among older adults after 2007 in the context of changing opioid regulations, and whether effects were different among patients with a cancer history. METHODS: Ontario residents aged ≥65 were identified from 2004 to 2013...
July 19, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28731925/thoracic-paravertebral-block-for-postoperative-pain-management-after-renal-surgery-a-randomised-controlled-trial
#17
Maja Copik, Szymon Bialka, Andrzej Daszkiewicz, Hanna Misiolek
BACKGROUND: Thoracic paravertebral block (ThPVB) combined with general anaesthesia is used in thoracic and general surgery. It provides effective analgesia, reduces surgical stress response and the incidence of chronic postoperative pain. OBJECTIVE: To assess the efficacy of ThPVB in reducing opioid requirements and decreasing the intensity of pain after renal surgery. DESIGN: A randomised, open label study. SETTING: A single university hospital...
September 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28725247/novel-anesthetic-technique-for-combined-intracavitary-and-interstitial-brachytherapy-for-cervix-cancer-in-an-outpatient-setting
#18
Yiat Horng Leong, Kenneth Hock Soon Tan, Bok Ai Choo, Vicky Yaling Koh, Johann I-Hsiung Tang
PURPOSE: To determine the feasibility and safety of outpatient combined intracavitary and interstitial brachytherapy for cervix cancer with sedation and local anesthesia. MATERIAL AND METHODS: We included patients diagnosed with non-metastatic cervix cancer and have completed brachytherapy between December 2015 and December 2016. Moderate to deep sedation was achieved using intravenous midazolam, propofol, fentanyl, and oxycodone. Local anesthesia was achieved with 2% lignocaine gel and a paracervical block containing a mixture of 1% ropivacaine, 2% lignocaine, and 1 : 1,000 adrenaline...
June 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/28722116/opioids-for-cancer-related-pain-in-children-and-adolescents
#19
REVIEW
Philip J Wiffen, Tess E Cooper, Anna-Karenia Anderson, Andrew L Gray, Marie-Claude Grégoire, Gustaf Ljungman, Boris Zernikow
BACKGROUND: Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization (WHO) guidelines for pharmacological treatments for children's persisting pain acknowledge that pain in children is a major public health concern of high significance in most parts of the world. Views on children's pain have changed over time and relief of pain is now seen as important. In the past, pain was largely dismissed and was frequently left untreated, and it was assumed that children quickly forgot about painful experiences...
July 19, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28718268/oxymorphone-induced-thrombotic-microangiopathy-mimicking-atypical-haemolytic-uremic-syndrome
#20
Amibhen Gandhi, Saad Ullah, Shani Kotadia, Samer Nasser
Atypical Haemolytic Uremic Syndrome (aHUS) is a rare life threatening entity characterized by thrombocytopenia, haemolytic anaemia and renal dysfunction. It is a thrombotic microangiopathy related to genetic mutations in the alternate complement pathway and has a distinct pathophysiology which makes it harder to distinguish from other microangiopathies. We present a case of a 25-year-old male patient with history of polysubstance abuse who presented with chest pain and dyspnoea. He admitted to using injectable oxymorphone (Opana) two weeks before presentation...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
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