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Chang Ju Hwang, Sung Soo Chung, Kyu-Yeol Lee, Jae Hyup Lee, Seong-Hwan Moon, Jin-Hyok Kim, Kyu-Jung Cho, Jae-Sung Ahn, Dong-Soo Kim, Ye-Soo Park, Hye-Jeong Park
Background: A prolonged-release formulation of oxycodone/naloxone has been shown to be effective in European populations for the management of chronic moderate to severe pain. However, no clinical data exist for its use in Korean patients. The objective of this study was to assess efficacy and safety of prolonged-release oxycodone/naloxone in Korean patients for management of chronic moderate-to-severe pain. Methods: In this multicenter, single-arm, open-label, phase IV study, Korean adults with moderate-to-severe spinal disorder-related pain that was not satisfactorily controlled with weak opioids and nonsteroidal anti-inflammatory drugs received prolonged-release oral oxycodone/naloxone at a starting dose of 10/5 mg/day (maximum 80/40 mg/day) for 8 weeks...
March 2018: Clinics in Orthopedic Surgery
Michael Schuster, Oliver Bayer, Florian Heid, Rita Laufenberg-Feldmann
BACKGROUND: Rotating several different WHO level III opioid drugs is a therapeutic option for patients with chronic cancer-related pain who suffer from inadequate analgesia and/or intolerable side effects. The evidence favoring opioid rotation is controversial, and the current guidelines in Germany and other countries contain only weak recommendations for it. METHODS: This review is based on pertinent publications retrieved by a systematic review of the literature on opioid rotation for adult patients with chronic cancerrelated pain who are regularly taking WHO level III opioids by the oral or trans - dermal route...
March 2, 2018: Deutsches Ärzteblatt International
Tali Capua, Zohar Bar Kama, Ayelet Rimon
BACKGROUND: The emergency department (ED) setting is an environment where children may experience intense physical pain and emotional stress. This study sought to determine the availability of pain and anxiety management practices in all Israeli emergency departments which accept children, specifically looking for differences between accredited pediatric emergency medicine departments and others. METHODS: A cross-sectional survey of all Israeli emergency departments that accept children was performed...
March 21, 2018: Israel Journal of Health Policy Research
Jamie R Santistevan, Brian R Sharp, Azita G Hamedani, Scott Fruhan, Andrew W Lee, Brian W Patterson
Introduction: Opioid prescribing patterns have come under increasing scrutiny with the recent rise in opioid prescriptions, opioid misuse and abuse, and opioid-related adverse events. To date, there have been limited studies on the effect of default tablet quantities as part of emergency department (ED) electronic order entry. Our goal was to evaluate opioid prescribing patterns before and after the removal of a default quantity of 20 tablets from ED electronic order entry. Methods: We performed a retrospective observational study at a single academic, urban ED with 58,000 annual visits...
March 2018: Western Journal of Emergency Medicine
Megan Grabenauer, Katherine N Moore, Nichole D Bynum, Robert M White, John M Mitchell, Eugene D Hayes, Ronald Flegel
Recent advances in analytical capabilities allowing for the identification and quantification of drugs and metabolites in small volumes at low concentrations have made oral fluid a viable matrix for drug testing. Oral fluid is an attractive matrix option due to its relative ease of collection, reduced privacy concerns for observed collections and difficulty to adulterate. The work presented here details the development and validation of a liquid chromatography tandem mass spectrometry (LC-MS-MS) method for the quantification of codeine, morphine, 6-acetylmorphine, hydrocodone, hydromorphone, oxycodone and oxymorphone in neat oral fluid...
March 15, 2018: Journal of Analytical Toxicology
Brian J Piper, Dipam T Shah, Olapeju M Simoyan, Kenneth L McCall, Stephanie D Nichols
INTRODUCTION: The U.S. is experiencing an opioid epidemic which is at least partially iatrogenic and fueled by both prescription and illicit misuse. This study provides a nationwide examination of opioid distribution patterns during the last decade. METHODS: Data were obtained from the U.S. Drug Enforcement Administration's Automation of Reports and Consolidated Orders System for 2006-2016. Analyses include quantities of ten opioids legally dispensed nationwide by weight and converted to Morphine Milligram Equivalents...
March 9, 2018: American Journal of Preventive Medicine
Wei Wang, Jie Lv, Qi Wang, Lei Yang, Wanyou Yu
Objective This study was performed compare the effectiveness of oxycodone and fentanyl in reducing the incidence and severity of etomidate-induced myoclonus. Methods In total, 162 patients with an American Society of Anesthesiologists physical status of I or II were assigned at random to three groups. Patients assigned to Group O received 0.1 mg/kg of oxycodone (n = 54), those assigned to Group F were given 1 µg/kg of fentanyl (n = 54), and those assigned to Group S were given an equal volume of saline intravenously 2 minutes prior to administration of 0...
January 1, 2018: Journal of International Medical Research
Michael D Raleigh, Megan Laudenbach, Federico Baruffaldi, Samantha J Peterson, Michaela J Roslawski, Angela K Birnbaum, Frank I Carroll, Scott P Runyon, Scott Winston, Paul R Pentel, Marco Pravetoni
Heroin and oxycodone abuse occurs over a wide range of drug doses and by various routes of administration characterized by differing rates of drug absorption. The current study addressed the efficacy of a heroin vaccine (M-KLH) or oxycodone vaccine (OXY-KLH) for reducing drug distribution to brain after i.v. heroin or oxycodone, or s.c. oxycodone. Rats immunized with M-KLH or KLH control received an i.v. bolus dose of 0.26 or 2.6 mg/kg heroin. Vaccination with M-KLH increased retention of heroin and its active metabolites 6-acetylmorphine (6-AM) and morphine in plasma compared to KLH controls, and reduced total opioid (heroin + 6-AM + morphine) distribution to brain but only at the lower heroin dose...
March 13, 2018: Journal of Pharmacology and Experimental Therapeutics
Tetsusuke Yoshimoto, Emi Ryu, Shiro Tomiyasu, Minoru Hojo, Hideya Kokubun, Motohiro Matoba
Pure oxycodone injection became increasingly necessary after oral oxycodone was launched in Japan in 2003. However, trials clarifying the efficacy and safety of injection are rare. Therefore, a multicenter open study on injection was designed and carried out in 2010, resulting in the launch of injection therapy in 2012. As published domestic case reports on efficacy already show widespread prescription, this study aimed to provide useful information for cancer pain relief in Japan and other countries. Our oxycodone injection study consisted of two trials, one of intravenous (S#9131) and the other of subcutaneous (S#9132) administration...
March 10, 2018: Biological & Pharmaceutical Bulletin
Angelo Antonini, Michele Tinazzi, Giovanni Abbruzzese, Alfredo Berardelli, K Ray Chaudhuri, Giovanni Defazio, Joaquim Ferreira, Pablo Martinez-Martin, Claudia Trenkwalder, Olivier Rascol
BACKGROUND: Pain is one of the most common and troublesome non-motor symptoms of Parkinson's disease; it can appear at any time during the disease, and it is often present before diagnosis. However, there is little or no consensus on its definition. METHODS: An expert group of clinicians with relevant research experience met to review the existing evidence, and to identify gaps in our understanding towards an optimized therapy of pain in Parkinson's disease. RESULTS: Key findings from epidemiologic, neurophysiologic, neuroimaging and clinical studies are reviewed...
March 9, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Lin Zhou, Yahui Hu, Chengyuan Li, Yunyi Yan, Luyao Ao, Boyang Yu, Weirong Fang, Jihua Liu, Yunman Li
Vincristine is a commonly used chemotherapeutic drug that can produce painful peripheral neuropathy. The chemokine (C-X-C motif) ligand 1 (CXCL1) and its receptor chemokine (C-X-C motif) receptor 2 (CXCR2) may mediate the resolution of this inflammation. In this study, we investigated whether and how CXCL1 contributes to vincristine-induced pain and the underlying mechanisms of levo-corydalmine (l-CDL, a tetrahydroprotoberberine). Oxycodone hydrochloride (a semisynthetic opioid analgesic) was used as positive control in vivo experiments...
March 5, 2018: Neuropharmacology
Karima Hider-Mlynarz, Philippe Cavalié, Patrick Maison
AIMS: To describe consumption trends of three groups of analgesics (non-opioids, mild and strong opioids) between 2006 and 2015 in France, and compare this pattern of use with six European countries in 2015. METHODS: Annual drugs sales were extracted from the French national authority's consumption database and from the IMS-MIDAS and national databases for European countries. RESULTS: The use of mild opioids in France decreased by 53% during the last 10 years due to the declining use of dextropropoxyphene combinations, along with an increase in the use of non-opioids and strong opioids (from 72 to 93 and 2 to 2...
March 7, 2018: British Journal of Clinical Pharmacology
Erin E Krebs, Amy Gravely, Sean Nugent, Agnes C Jensen, Beth DeRonne, Elizabeth S Goldsmith, Kurt Kroenke, Matthew J Bair, Siamak Noorbaloochi
Importance: Limited evidence is available regarding long-term outcomes of opioids compared with nonopioid medications for chronic pain. Objective: To compare opioid vs nonopioid medications over 12 months on pain-related function, pain intensity, and adverse effects. Design, Setting, and Participants: Pragmatic, 12-month, randomized trial with masked outcome assessment. Patients were recruited from Veterans Affairs primary care clinics from June 2013 through December 2015; follow-up was completed December 2016...
March 6, 2018: JAMA: the Journal of the American Medical Association
Brooke Hall, Sarah Daly
In adults treated with opioids for chronic pain, point-of-care urine drug screens (immunoassays) for detecting opioids show a false-negative rate of 1.9%, a sensitivity of 92%, and a specificity of 93% compared with the gold-standard liquid chromatography tandem mass spectrometry. Oxycodone has the highest rate of false-negative results at 25%; methadone has the lowest rate at 4% to 6% (strength of recommendation: A, 2 blinded diagnostic accuracy studies with similar results).
March 2018: Journal of Family Practice
Ioannis D Gkegkes, Evelyn Eleni Minis, Christos Iavazzo
BACKGROUND: The role of analgesia is crucial in the management of postoperative pain. Different combinations of oral analgesics have been proposed in the past. The oxycodone/naloxone (OXN) combination is a recent addition and is being used by different surgical specialties. The aim of our study was to clarify the possible role, advantages, and disadvantages of OXN in the pain management of surgical patients. METHOD: The authors retrieved the included studies after performing a systematic search in PubMed and Scopus...
January 2018: Journal of Opioid Management
Bjug Borgundvaag, Shelley McLeod, Wayne Khuu, Catherine Varner, Mina Tadrous, Tara Gomes
BACKGROUND: Emergency physicians provide primary care to patients and often prescribe opioids for acutely painful self-limiting conditions. The objective of this study was to describe patterns of opioid prescribing by emergency physicians and family physicians and to explore the relation between setting of initiation of opioid treatment and adverse events over the subsequent 2 years. METHODS: This was a population-based cohort study using administrative data from Ontario...
March 1, 2018: CMAJ Open
Yosuke Sugiyama, Tomoya Kataoka, Yoshihiko Tasaki, Yuki Kondo, Noriko Sato, Taku Naiki, Nobuhiro Sakamoto, Tatsuo Akechi, Kazunori Kimura
Background: Cancer-related neuropathic pain is sometimes unresponsive to multidrug treatment. Novel drugs are required to treat such severe pain without necessitating the use of adjuvant analgesics. Tapentadol is a new drug that has a dual mechanism as both an opioid agonist and noradrenalin reuptake inhibitor. The study objective was to investigate the effectiveness of oral tapentadol for relieving cancer-related neuropathic pain. Methods: A retrospective, single-center, open, non-randomized study was conducted at the Nagoya City University Hospital...
March 1, 2018: Japanese Journal of Clinical Oncology
David E Moody, Yueqiao Fu, Wenfang B Fang
The purpose of this study was to test the hypothesis that skeletal muscle relaxants could inhibit the in vitro metabolism of common co-medications opioids buprenorphine, methadone and oxycodone. The compounds (solubility-limited concentration (μM) studied) were: baclofen (1000), carisoprodol (200), its metabolite meprobamate (1000), chlorzoxazone (200), cyclobenzaprine (1000), metaxalone (50), methocarbamol (1000), orphenadrine (1000) and tizanidine (1000). Compounds were first incubated with human liver microsomes (HLM) ± pre-incubation, screened with pathway-specific cDNA-expressed cytochrome P450s (rCYP), and then IC50 values determined using either 8-concentration tests for those where the rCYP screen suggested an IC50 was achievable, or a 3-concentration test with downward extrapolation if screen suggested 50% inhibition was not achievable...
March 5, 2018: Basic & Clinical Pharmacology & Toxicology
Ellen M Raney, Harold J P van Bosse, Kevin G Shea, Joshua M Abzug, Richard M Schwend
INTRODUCTION: The opioid epidemic in the United States has reached crisis proportions. Urgent response is needed. Hydrocodone in combination with acetaminophen is the most prescribed drug in the United States. The most common source of opioids available for misuse is the unused portions of postoperative prescriptions. Among high school seniors, 80% of those who reported nonmedical use of prescription opioids previously had legitimate prescriptions but recreationally used leftover doses...
February 27, 2018: Journal of Pediatric Orthopedics
Alexander M Ponizovsky, Eli Marom, Abraham Weizman, Eyal Schwartzberg
PURPOSE: The purpose of the study is to assess opioid (morphine, methadone, oxycodone, pethidine, and fentanyl) consumption in Israel during 2009 to 2016 and identify recent trends. METHODS: Data for all treatment settings, private and public, for the years 2009 to 2016, were extracted from the Israel Ministry of Health's Pharmaceutical Administration database. The data were used to calculate defined daily doses (DDD) per 1000 inhabitants per day, of the various drugs...
February 28, 2018: Pharmacoepidemiology and Drug Safety
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