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Opioid conversion

Sarah F Rosen, Boram Ham, Michael Haichin, Ilana C Walters, Sarasa Tohyama, Susana G Sotocinal, Jeffrey S Mogil
The processing of pain in the central nervous system is now known to have an important immune component, including T cells of the adaptive immune system. T cells have been shown to release endogenous opioids, and although it is well known that opioids have effects on T cell populations, very little attention has been given to the converse: how T cells may affect opioid regulation. We find here that in addition to displaying significantly increased baseline pain sensitivity across various pain modalities, T cell deficient mice (CD-1 nude, Rag1 null mutant and Cd4 null mutant) exhibit pronounced deficiencies in morphine inhibition of thermal or inflammatory pain...
October 16, 2018: Pain
V H Azocar, G Sepúlveda, C Ruiz, C Aguilera, E Andrés, J A Fuentealba
Kappa opioid receptors (KOR) control dopamine (DA) levels in the striatum and contribute significantly to the progression of drug addiction. Repeated exposure to psychostimulants has been associated with up-regulated KOR activity and increased DA levels in dorsal striatum. However, it has not been tested if both processes are linked. In this work, we studied if a mechanism mediated by KOR is contributing to the increase of DA levels in the dorsolateral striatum (DLS) after amphetamine (AMPH) sensitization. The AMPH sensitization was assessed after single or repeated once-a-day AMPH injections (1mg/kg)...
October 13, 2018: Journal of Neurochemistry
Mary Beth Miller, Wai Sze Chan, Ashley F Curtis, Jeff Boissoneault, Michael Robinson, Roland Staud, Richard B Berry, Christina S McCrae
OBJECTIVE: Research documenting the impact of opioid use on sleep among individuals with chronic pain has been mixed. This study aimed to determine if pain intensity moderates the association between opioid use and insomnia symptoms among adults with comorbid symptoms of insomnia and chronic widespread pain. METHODS: Participants (N = 144; 95% female; mean age = 51.6, SD = 11.4) completed assessments of insomnia symptoms, pain and use of sleep/pain medication...
September 5, 2018: Sleep Medicine
Nathalie Michenot, Sylvie Rostaing, Laurent Baron, Sébastien Faure, Nicolas Jovenin, Philippe Hubault, Thierry Delorme, Elisabeth Collin, Marilène Filbet, Gisèle Chvetzoff, Claire Delorme, Christian Minello, Marc Magnet, Didier Ammar, Ivan Krakowski, Philippe Poulain
This paper reviewed the 2002 guidelines established by the National Federation of Cancer Centres. A group of experts nominated by the 3 French Societies involved in the treatment of cancer pain (AFSOS, SFAP, SFETD), established new guidelines ratios for morphine switching and/or changing of route of administration, in patients for whom either pain was not adequatly managed or adverse effects were unbearable. After a rapid reminder of the pharmacokinetics and metabolism properties of morphine, experts explained why the theory of opioid rotation (oxycodone, hydromorphone, fentanyl, methadone, tapentadol) using fixed equianalgesic ratios is not any more appropriate for a secure clinical practice...
September 28, 2018: Bulletin du Cancer
Allen C Dickie, Andrew M Bell, Noboru Iwagaki, Erika Polgár, Maria Gutierrez-Mecinas, Rosalind Kelly, Heather Lyon, Kirsten Turnbull, Steven J West, Alexander Etlin, Joao Braz, Masahiko Watanabe, David L H Bennett, Allan I Basbaum, John S Riddell, Andrew J Todd
Excitatory interneurons account for the majority of neurons in the superficial dorsal horn, but despite their presumed contribution to pain and itch, there is still limited information about their organisation and function. We recently identified two populations of excitatory interneuron defined by expression of gastrin-releasing peptide (GRP) or substance P (SP). Here we demonstrate that these cells show major differences in their morphological, electrophysiological and pharmacological properties. Based on their somatodendritic morphology and firing patterns, we propose that the SP cells correspond to radial cells, which generally show delayed firing...
September 20, 2018: Pain
Hironobu Yamashita, Lauren Shuman, Joshua I Warrick, Jay D Raman, David J Degraff
Opioid receptors are G protein-coupled receptors that bind opioid ligands including endorphins and enkephalins. The existence of a number of opioid receptors, including the mu-opioid receptor (OPRM1), delta-opioid receptor (OPRD1), kappa-opioid receptor (OPRK1) and zeta-opioid receptor (OGFR) have been reported. However, the potential expression and role of these receptors on human prostate carcinogenesis is unknown. In the present study, we examined opioid receptor expression in human prostate cancer cell lines and in prostate cancer tissue...
2018: American Journal of Clinical and Experimental Urology
Nicola de'Angelis, Niccoló Petrucciani, Giusy Giannandrea, Francesco Brunetti
Low-impact laparoscopic (LIL) cholecystectomy is an innovative surgical protocol that combines the use of mini-laparoscopic instruments (3-mm ports) under a low- and stable-pressure pneumoperitoneum (8 mmHg), with the aim of minimizing the surgical invasiveness and the risks related to CO2 insufflation on the peritoneal environment. In day-surgery settings, LIL may contribute to increase the surgical success due to several potential benefits in terms of postoperative pain intensity and time to full recovery...
August 29, 2018: Updates in Surgery
Travis W Grim, Scarlet Jinhong Park, Cullen L Schmid, Robert B Laprairie, Michael Cameron, Laura M Bohn
Previous reports assessing morphine effects in two bottle choice (TBC) paradigms often use taste adulterants such as sweeteners (e.g., saccharin) and/or bitterants (e.g., quinine) to demonstrate morphine preference with C57BL6 mice. The effect of these additional components on the morphine preference of C57BL6 remains poorly understood. Thus, we sought to elucidate the interrelationship of morphine and quinine in the TBC paradigm. As expected, when morphine was included in the opposite bottle from quinine, a preference for the morphine solution was observed...
October 1, 2018: Drug and Alcohol Dependence
April Hazard Vallerand, Sarah Hendry, Elizabeth Baldys, Yiqun Hu, Catherine Datto
Objective: This analysis of patient-health care provider discussions of opioid-induced constipation (OIC) evaluated the dynamics of interactions, identified communication gaps, and assessed the functional burden of opioid-induced constipation on patients' lives. Design: Retrospective analysis of a Health Insurance Portability and Accountability Act-compliant database of >120,000 patient-provider conversations. Setting: Outpatient offices in the United States...
August 13, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Matthew J A Wilson, Christine MacArthur, Catherine A Hewitt, Kelly Handley, Fang Gao, Leanne Beeson, Jane Daniels
BACKGROUND: About a third of women receiving pethidine for labour pain subsequently require an epidural, which provides effective pain relief but increases the risk of instrumental vaginal delivery. Remifentanil patient-controlled analgesia (PCA) in labour is an alternative to pethidine, but is not widely used. We aimed to evaluate epidural analgesia progression among women using remifentanil PCA compared with pethidine. METHODS: We did an open-label, multicentre, randomised controlled trial in 14 UK maternity units...
August 25, 2018: Lancet
Anupama Kotha, Beatrice A Chen, Lauren Lewis, Shannon Dunn, Katherine P Himes, Elizabeth E Krans
BACKGROUND: Many women with opioid use disorder (OUD) do not use highly effective postpartum contraception such as long-acting reversible contraception (LARC). We evaluated factors associated with prenatal intent and postpartum receipt of LARC among women receiving medication-assisted treatment (MAT) for OUD. STUDY DESIGN: This was a retrospective cohort study of 791 pregnant women with OUD on MAT who delivered at an academic institution without immediate postpartum LARC services between 2009 and 2012...
August 13, 2018: Contraception
Muhammad Asghar Ali, Samina Ismail, Muhammad Sohaib, Asiyah Aman
Background and Aims: It is a common practice to add intrathecal lipophilic opioids to local anesthetics to improve the quality of subarachnoid block. This study was designed to find a dose of intrathecal fentanyl, which can improve the quality of surgical anesthesia with minimal side effects in parturients undergoing cesarean section under spinal anesthesia with intrathecal bupivacaine. Material and Methods: In a prospective randomized double-blind study, 243 parturients undergoing cesarean section under spinal anesthesia were randomly allocated to receive 10, 15, or 25 μg of intrathecal fentanyl with 10 mg of 0...
April 2018: Journal of Anaesthesiology, Clinical Pharmacology
Keiichi Hiramoto, Yurika Yamate, Daijiro Sugiyama, Kazunari Matsuda, Yasutaka Iizuka, Tomohiko Yamaguchi
Photoaging can be induced by long-term ultraviolet (UV)A eye irradiation, but an ameliorating method for such photoaging is not known. In this study, we examined the effects of tranexamic acid (trans-4-aminomethylcyclohexanecarboxylic acid) on photoaging of the skin induced by UVA eye irradiation. We used the C57BL/6 j female mice and locally exposed their eyes to UVA at a dose of 110 kJ/m2 using an FL20SBLB-A lamp multiple times a week for one year. The plasma urocortin 2, β-endorphin, methionine enkephalin (OGF), and histamine content, as well as the expression of the corticotropin-releasing hormone receptor (CRHR) type 2, μ-opioid receptor, opioid growth factor receptor (OGFR), T-bet, and GATA3 increased in the mice subjected to UVA eye irradiation...
November 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Simone Stenekes, Jamie L Penner, Michael Harlos, Marie-Claude Proulx, Erin Shepherd, Stephen Liben, Genevieve Thompson, Grace MacConnell, Marie-Claude Grégoire, Harold Hal Siden
Perinatal palliative care is an emerging area of health care. To date, no published tools assess health-care provider's knowledge and level of comfort in providing such care. A 2-phase study was undertaken to develop and implement a survey to evaluate the self-assessed competency, attitudes, and knowledge of health-care providers working in perinatal palliative care. Phase 1 included a review of the literature and appraisal of palliative and death-related instruments to inform the initial draft of the Perinatal Palliative Care Survey (PPCS)...
July 31, 2018: Journal of Palliative Care
Kyle A Windisch, Brian Reed, Mary Jeanne Kreek
Cocaine addiction treatment is difficult due to the current lack of approved pharmacotherapuetics. Several preclinical and clinical studies have demonstrated that the mu opioid receptor (MOPr) antagonist/kappa opioid receptor (KOPr) partial agonist naltrexone (NTX) reduces the subjective effects and self-administration of cocaine. However, very limited research has examined the ability of the structurally similar MOPr antagonist/KOPr partial agonist nalmefene (NMF) to reduce cocaine reward. Here we examine the effect of low (1 mg/kg) and high (10 mg/kg) doses of NTX or NMF on cocaine place preference...
September 15, 2018: Neuropharmacology
Masashi Homma, Hideya Kokubun, Norihito Hayashi, Akifumi Kanai, Koichiro Atsuda
The objective of our study was to evaluate the efficacy and adverse effects of opioid switching to tapentadol(TP). It was a retrospective survey carried out at the Kitasato University Hospital outpatient clinic between September 2014 and May 2016. We evaluated pain intensity using the visual analogue scale and the occurrence of adverse effects before switching, at the first evaluation after switching, and during the steady state of TP administration. We included 10 patients; of these, 3 patients discontinued TP owing to uncontrolled pain...
July 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Mark A Strand, Heidi Eukel, Siri Burck
BACKGROUND: Prescription opioids are known to be highly addictive, contributing to the opioid epidemic which continues to besiege victims in the United States. Pharmacists are gatekeepers straddling the prescribers of opioids and their patients; therefore they are in the ideal position to screen for opioid misuse among patients receiving opioid prescriptions and counsel them on safe use. OBJECTIVES: The purpose of this study was to design the Opioid Misuse Risk Prevention Toolkit and then evaluate the utility of the toolkit by implementing it in community pharmacy practice sites...
July 17, 2018: Research in Social & Administrative Pharmacy: RSAP
Jennifer I Etcheson, Chukwuweike U Gwam, Nicole E George, Alexander T Caughran, Michael A Mont, Ronald E Delanois
BACKGROUND: With legislative efforts aimed at optimizing value of care, surgeons performing total knee arthroplasty (TKA) are faced with increased responsibility of optimizing patient perception of care. However, pain after TKA may negatively influence patient perception of care, as measured by Press Ganey (PG) patient satisfaction surveys. While opioid-based medications are best suited for acute pain alleviation, awareness of a growing opioid epidemic has spurred efforts to reduce its administration...
November 2018: Journal of Arthroplasty
Katherine Hadlandsmyth, Kenda R Stewart, Monica B Paez, Melissa Steffen, Molly Meth, Heather Schacht Reisinger, Hilary J Mosher
Objective: To elucidate perspectives on opioids and opioid use from hospitalized veterans with comorbid chronic pain using qualitative methods. Design: This was an analysis of individual qualitative interviews. The semistructured interview guide was developed by a hospitalist with clinical expertise in pain treatment with guidance from a medical anthropologist. Interviews aimed to understand participants' experiences of chronic pain. Setting: A Midwestern Veterans Health Administration inpatient hospital unit...
July 17, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Gabrio Bassotti, Paolo Usai-Satta, Massimo Bellini
Chronic constipation (CC) is a common gastrointestinal disorder with limited treatment options. Linaclotide is a potent peptide agonist of the guanylate cyclase-C receptor. This action activates intracellular conversion of guanosine 5-triphosphate to cyclic guanosine monophosphate resulting in the stimulation of intestinal fluid secretion. Linaclotide is a promising new agent for refractory constipation. Areas covered: All published articles regarding the development, clinical efficacy, and safety of linaclotide in treating CC were reviewed...
August 2018: Expert Opinion on Pharmacotherapy
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