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https://www.readbyqxmd.com/read/29471504/anodyne-by-design-measuring-the-prevalence-of-esoteric-designer-opioids-in-pain-management-patients
#1
Melissa M Goggin, Stephanie D Gozum, Anna Miller, Gregory C Janis
The recent increase in illicit opioids sold on the black market, cut into heroin and masqueraded as prescription pills prompts a significant public health concern. Most designer opioids possess unknown potencies and unknown pharmacokinetics and their unregulated, variable dosages lead to rashes of overdoses. Additionally, many of the designer opioids, especially the fentanyl analogs are significantly more potent than heroin. High-profile cases involving overdoses of U-47700 and carfentanil have been reported in the media; however, the true prevalence of these and other designer opioids is unknown...
February 17, 2018: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/29470801/episodic-breathlessness-in-patients-with-advanced-cancer-characteristics-and-management
#2
REVIEW
Sebastiano Mercadante
The aim of this review is to present the way in which episodic breathlessness (EB) has been recognized over the years, with regard to definition, characteristics, and management of these acute episodes that have serious consequences for patients. EB is characterized by a sudden increase in intensity of dyspnea over a short duration of time, leading to high levels of anxiety. A significant aggravation of dyspnea may occur in patients with a background of dyspnea or intermittently even without basal breathlessness...
February 22, 2018: Drugs
https://www.readbyqxmd.com/read/29470605/considering-the-context-social-factors-in-responses-to-drugs-in-humans
#3
REVIEW
Harriet de Wit, Michael Sayette
BACKGROUND: Drugs are typically used in social settings. Here, we consider two factors that may contribute to this observation: (i) the presence of other people may enhance the positive mood effects of a drug, and conversely, (ii) drugs may enhance the value of social stimuli. METHODS: We review evidence from controlled laboratory studies with human volunteers, which investigated either of these interactions between social factors and responses to drugs. We examine the bidirectional effects of social stimuli and single doses of alcohol, stimulants, opioids, and cannabis...
February 22, 2018: Psychopharmacology
https://www.readbyqxmd.com/read/29470180/opioid-abuse-or-dependence-increases-30-day-readmission-rates-after-major-operating-room-procedures-a-national-readmissions-database-study
#4
Atul Gupta, Junaid Nizamuddin, Dalia Elmofty, Sarah L Nizamuddin, Avery Tung, Mohammed Minhaj, Ariel Mueller, Jeffrey Apfelbaum, Sajid Shahul
BACKGROUND: Although opioids remain the standard therapy for the treatment of postoperative pain, the prevalence of opioid misuse is rising. The extent to which opioid abuse or dependence affects readmission rates and healthcare utilization is not fully understood. It was hypothesized that surgical patients with a history of opioid abuse or dependence would have higher readmission rates and healthcare utilization. METHODS: A retrospective cohort analysis was performed of patients undergoing major operating room procedures in 2013 and 2014 using the National Readmission Database...
February 22, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29470146/towards-an-effective-peripheral-visceral-analgesic-responding-to-the-national-opioid-crisis
#5
Michael Camilleri
This is an editorial summarizing recent new developments in visceral analgesics. This promising field is important as a new approach to address abdominal pain with peripheral visceral analgesics is considered a key approach to addressing the current opioid crisis. Some of the novel compounds address peripheral pain mechanisms through modulation of opioid receptors through biased ligands, nociceptin/orphanin FQ opioid peptide (NOP) receptor or dual action on NOP and μ-opioid receptor, buprenorphine and morphiceptin analogs...
February 22, 2018: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/29470104/association-between-utilization-of-chiropractic-services-for-treatment-of-low-back-pain-and-use-of-prescription-opioids
#6
James M Whedon, Andrew W J Toler, Justin M Goehl, Louis A Kazal
OBJECTIVE: Pain relief resulting from services delivered by doctors of chiropractic may allow patients to use lower or less frequent doses of opioids, leading to reduced risk of adverse effects. The objective of this investigation was to evaluate the association between utilization of chiropractic services and the use of prescription opioid medications. DESIGN: The authors used a retrospective cohort design to analyze health insurance claims data. SETTING: The data source was the all payer claims database administered by the State of New Hampshire...
February 22, 2018: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/29469195/postoperative-ileus-following-major-colorectal-surgery
#7
REVIEW
S J Chapman, A Pericleous, C Downey, D G Jayne
BACKGROUND: Postoperative ileus (POI) is characterized by delayed gastrointestinal recovery following surgery. Current knowledge of pathophysiology, clinical interventions and methodological challenges was reviewed to inform modern practice and future research. METHODS: A systematic search of MEDLINE and Embase databases was performed using search terms related to ileus and colorectal surgery. All RCTs involving an intervention to prevent or reduce POI published between 1990 and 2016 were identified...
February 22, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29468854/differential-effects-of-oxycodone-and-venlafaxine-on-resting-state-functional-connectivity-a-randomized-placebo-controlled-magnetic-resonance-imaging-study
#8
Tine M Hansen, Dina Lelic, Anne E Olesen, Asbjørn Mohr Drewes, Jens B Frøkjaer
AIM: Different mechanisms may be involved in the antinociceptive effects of oxycodone (opioid) and venlafaxine (serotonin-norepinephrine reuptake inhibitor), and the aim of this study was to investigate the effect of these drugs on brain functional connectivity. METHODS: Resting state functional magnetic resonance imaging was acquired in 20 healthy volunteers before and after a 5-day treatment with oxycodone, venlafaxine, or placebo in a randomized, double-blind, crossover study...
February 21, 2018: CNS Neuroscience & Therapeutics
https://www.readbyqxmd.com/read/29468760/it-is-premature-to-expand-access-to-medicinal-cannabis-in-hopes-of-solving-the-us-opioid-crisis
#9
EDITORIAL
Wayne Hall, Robert West, John Marsden, Keith Humphreys, Jo Neale, Nancy Petry
No abstract text is available yet for this article.
February 22, 2018: Addiction
https://www.readbyqxmd.com/read/29468702/identifying-optimal-dosage-regimes-under-safety-constraints-an-application-to-long-term-opioid-treatment-of-chronic-pain
#10
Eric B Laber, Fan Wu, Catherine Munera, Ilya Lipkovich, Salvatore Colucci, Steve Ripa
There is growing interest and investment in precision medicine as a means to provide the best possible health care. A treatment regime formalizes precision medicine as a sequence of decision rules, one per clinical intervention period, that specify if, when and how current treatment should be adjusted in response to a patient's evolving health status. It is standard to define a regime as optimal if, when applied to a population of interest, it maximizes the mean of some desirable clinical outcome, such as efficacy...
February 21, 2018: Statistics in Medicine
https://www.readbyqxmd.com/read/29468561/chronic-pain-in-medullary-sponge-kidney-a-rare-and-never-described-clinical-presentation
#11
G Gambaro, D S Goldfarb, R Baccaro, J Hirsch, N Topilow, S D'Alonzo, G Gambassi, P M Ferraro
Medullary sponge kidney (MSK) is a cause of nephrocalcinosis, associated with hematuria, renal colic, pyelonephritis. There are rare and atypical MSK cases characterized by chronic severe pain (CP), whose features are unknown, in particular the relationship with the stone disease activity. This study analyzes a cohort of MSK-CP patients belonging to three North-America self-support Facebook groups. Patients had to self-administer an on-line questionnaire (on intensity, progression and MSK-associated conditions, stone-related disease, pain features, drug use), the Brief Pain Inventory, the Fatigue Severity Score, and Wisconsin Quality of Life (WQL) in stone formers questionnaires...
February 21, 2018: Journal of Nephrology
https://www.readbyqxmd.com/read/29468508/ultrasound-guided-bilateral-superficial-cervical-block-and-preemptive-single-dose-oral-tizanidine-for-post-thyroidectomy-pain-a-randomized-controlled-double-blind-study
#12
Ali Ahiskalioglu, Ahmet Murat Yayik, Elif Oral Ahiskalioglu, Aysenur Dostbil, Omer Doymus, Erdem Karadeniz, Muhammet Ali Ari, Furkan Sengoz, Haci Ahmet Alici, Erkan Cem Celik
PURPOSES: The postoperative analgesic effect of tizanidine has not yet been evaluated sufficiently. The role of bilateral superficial cervical plexus block (BSCPB) for postoperative analgesia after thyroidectomy remains questionable. We aimed to evaluate the analgesic effect of combined use of BSCPB and a single-dose oral tizanidine in patients undergoing elective thyroid surgery. METHODS: Sixty patients undergoing thyroidectomy were randomized into 3 groups. The control group (Group C, n = 20) received BSCPB with 0...
February 21, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29467238/ethanol-reversal-of-oxycodone-tolerance-in-dorsal-root-ganglia-neurons
#13
Joanna C Jacob, Kensuke Sakakibara, Ryan A Mischel, Graeme Henderson, William L Dewey, Hamid I Akbarali
Oxycodone is a semi-synthetic opioid compound that is widely prescribed, used and abused today, and has a well-established role in shaping the current opioid epidemic. Previously we have shown that tolerance develops to the antinociceptive and respiratory depressive effects of oxycodone in mice, and that a moderate dose of acute ethanol or a PKC inhibitor reversed that tolerance. To investigate further if tolerance was occurring through neuronal mechanisms, our aims for this study were to assess the effects of acute and prolonged oxycodone in isolated dorsal root ganglia (DRG) neurons and to determine if this tolerance was reversed by either ethanol or a PKC inhibitor...
February 21, 2018: Molecular Pharmacology
https://www.readbyqxmd.com/read/29467148/controlling-postoperative-use-of-i-v-acetaminophen-at-an-academic-medical-center
#14
William R Vincent, Paul Huiras, Jennifer Empfield, Kevin J Horbowicz, Keith Lewis, David McAneny, David Twitchell
PURPOSE: Results of an interprofessional formulary initiative to decrease postoperative prescribing of i.v. acetaminophen are reported. SUMMARY: After a medical center added i.v. acetaminophen to its formulary, increased prescribing of the i.v. formulation and a 3-fold price increase resulted in monthly spending of more than $40,000, prompting an organizationwide effort to curtail that cost while maintaining effective pain management. The surgery, anesthesia, and pharmacy departments applied the Institute for Healthcare Improvement's Model for Improvement to implement (1) pharmacist-led enforcement of prescribing restrictions, (2) retrospective evaluation of i...
February 21, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29467000/ginsenoside-re-protects-methamphetamine-induced-dopaminergic-neurotoxicity-in-mice-via-upregulation-of-dynorphin-mediated-%C3%AE%C2%BA-opioid-receptor-and-downregulation-of-substance-p-mediated-neurokinin-1-receptor
#15
Duy-Khanh Dang, Eun-Joo Shin, Dae-Joong Kim, Hai-Quyen Tran, Ji Hoon Jeong, Choon-Gon Jang, Seung-Yeol Nah, Jung Hwan Jeong, Jae Kyung Byun, Sung Kwon Ko, Guoying Bing, Jau-Shyong Hong, Hyoung-Chun Kim
BACKGROUND: We previously reported that ginsenoside Re (GRe) attenuated against methamphetamine (MA)-induced neurotoxicity via anti-inflammatory and antioxidant potentials. We also demonstrated that dynorphin possesses anti-inflammatory and antioxidant potentials against dopaminergic loss, and that balance between dynorphin and substance P is important for dopaminergic neuroprotection. Thus, we examined whether GRe positively affects interactive modulation between dynorphin and substance P against MA neurotoxicity in mice...
February 21, 2018: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29466977/the-rotterdam-elderly-pain-observation-scale-repos-is-reliable-and-valid-for-non-communicative-end-of-life-patients
#16
Anniek D Masman, Monique van Dijk, Joost van Rosmalen, Frans P M Baar, Dick Tibboel, Anneke A Boerlage
BACKGROUND: In palliative care, administration of opioids is often indispensable for pain treatment. Pain assessment may help recognize pain and guide treatment in non-communicative patients. In the Netherlands the Rotterdam Elderly Pain Observation Scale (REPOS) is recommended to this aim, but not yet validated. Therefore the objective of this study was to validate the REPOS in non-communicative or unconscious end-of-life patients. METHODS: In this observational study, the primary researcher applied the REPOS, while both the researcher and a nurse applied the Numeric Rating Scale (NRS)...
February 21, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29466721/insights-from-molecular-dynamics-simulations-to-exploit-new-trends-for-the-development-of-improved-opioid-drugs
#17
REVIEW
Marta Filizola
Having accidental deaths from opioid overdoses almost quadrupled over the past fifteen years, there is a strong need to develop new, non-addictive medications for chronic pain to stop one of the deadliest epidemics in American history. Given their potentially fewer on-target overdosing risks and other adverse effects compared to classical opioid drugs, attention has recently shifted to opioid allosteric modulators and G protein-biased opioid agonists as likely drug candidates to prevent and/or reverse opioid overdoses...
February 18, 2018: Neuroscience Letters
https://www.readbyqxmd.com/read/29466446/the-cannabinoid-1-receptor-is-abundantly-expressed-in-striatal-striosomes-and-striosome-dendron-bouquets-of-the-substantia-nigra
#18
Margaret I Davis, Jill R Crittenden, Austin Y Feng, David A Kupferschmidt, Alipi Naydenov, Nephi Stella, Ann M Graybiel, David M Lovinger
Presynaptic cannabinoid-1 receptors (CB1-R) bind endogenous and exogenous cannabinoids to modulate neurotransmitter release. CB1-Rs are expressed throughout the basal ganglia, including striatum and substantia nigra, where they play a role in learning and control of motivated actions. However, the pattern of CB1-R expression across different striatal compartments, microcircuits and efferent targets, and the contribution of different CB1-R-expressing neurons to this pattern, are unclear. We use a combination of conventional techniques and novel genetic models to evaluate CB1-R expression in striosome (patch) and matrix compartments of the striatum, and in nigral targets of striatal medium spiny projection neurons (MSNs)...
2018: PloS One
https://www.readbyqxmd.com/read/29466151/controlling-the-swing-of-the-opioid-pendulum
#19
George Comerci, Joanna Katzman, Daniel Duhigg
No abstract text is available yet for this article.
February 22, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29466048/effects-of-dexmedetomidine-combined-with-commonly-administered-opioids-on-clinical-variables-in-dogs
#20
Lilian T Nishimura, Adam Auckburally, Juliana Santilli, Beatriz H B Vieira, Debora O Garcia, Cristiane S Honsho, Ewaldo de Mattos-Junior
OBJECTIVE To evaluate cardiopulmonary, sedative, and antinociceptive effects of dexmedetomidine combined with commonly administered opioids in dogs. ANIMALS 8 healthy Beagles. PROCEDURES Dogs were sedated by IM administration of each of 7 treatments. Treatments comprised dexmedetomidine (0.01 mg/kg; Dex) and the same dose of dexmedetomidine plus butorphanol (0.15 mg/kg; Dex-But), meperidine (5 mg/kg; Dex-Mep), methadone (0.5 mg/kg; Dex-Meth), morphine (0.5 mg/kg; Dex-Mor), nalbuphine (0.5 mg/kg; Dex-Nal), or tramadol (5 mg/kg; Dex-Tram)...
March 2018: American Journal of Veterinary Research
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