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https://www.readbyqxmd.com/read/29671504/buprenorphine-therapy-for-opioid-use-disorder
#1
Roger Zoorob, Alicia Kowalchuk, Maria Mejia de Grubb
Opioid misuse, including the use of heroin and the overprescribing, misuse, and diversion of opioid pain medications, has reached epidemic proportions in the United States. As a result, there has been a dramatic increase in opioid use disorder and associated overdoses and deaths. Addiction is a chronic brain disease with a genetic component that affects motivation, inhibition, and cognition. Patient characteristics associated with successful buprenorphine maintenance treatment include stable or controlled medical or psychiatric comorbidities and a safe, substance-free environment...
March 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29665978/outpatient-intravenous-multimodal-elastomeric-pump-with-methadone-in-ambulatory-surgery
#2
L Gómez-López, X Sala-Blanch, P L Gambús Cerrillo, A López Gutiérrez, M Agustí Lasús, M T Anglada Casas
BACKGROUND AND OBJECTIVE: Analgesia in Ambulatory Surgery (AS) needs to evolve in parallel with surgical complexity. We designed a study to try to improve analgesia in painful surgery using an intravenous elastomeric pump. As a novelty, methadone was included. PATIENTS AND METHODS: An observational study, physical status ASA I-II, underwent ambulatory surgeries with moderate-severe postoperative pain. Analgesia was administered for 48h by an intravenous multimodal elastomeric pump (methadone, tramadol, dexketoprofen and ondansetron at low doses)...
April 14, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29664690/methadone-as-the-initial-long-acting-opioid-in-children-with-advanced-cancer
#3
Kevin Madden, Sarah Mills, Seyedeh Dibaj, Janet L Williams, Diane Liu, Eduardo Bruera
BACKGROUND: Methadone is an attractive medication for treating children with advanced cancer with pain as it is the only long-acting opioid available as a liquid. However, it is not frequently used due to concerns about potential toxicities and side effects. OBJECTIVE: Evaluate the efficacy and safety of methadone as the first long-acting opioid in children with advanced cancer. DESIGN: Retrospective chart review of 52 consecutive patients referred to Pediatric Supportive Care for pain management started on methadone as their first long-acting opioid...
April 17, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29627201/perioperative-analgesic-effects-of-an-ultrasound-guided-transversus-abdominis-plane-block-with-a-mixture-of-bupivacaine-and-lidocaine-in-cats-undergoing-ovariectomy
#4
Despoina Skouropoulou, Luca Lacitignola, Paola Centonze, Angela Simone, Alberto M Crovace, Francesco Staffieri
OBJECTIVE: To evaluate the perioperative analgesic effects of a transversus abdominis plane (TAP) block with a mixture of lidocaine and bupivacaine administered to cats undergoing ovariectomy. STUDY DESIGN: Controlled, randomized, prospective, blinded clinical study. ANIMALS: A group of 20 healthy cats. METHODS: Robenacoxib (2 mg kg-1 ) was administered subcutaneously 0.5 hour before intramuscular (IM) administration of ketamine (5 mg kg-1 ), methadone (0...
February 3, 2018: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29607939/a-novel-method-for-determination-of-methadone-in-the-serum-by-high-performance-liquid-chromatography-with-electrochemical-detection
#5
Hideya Kokubun, Chizuko Takigawa, Kanako Miyano, Yasuhito Uezono
In March 2013, the clinical use of oral methadone tablets was initiated in Japan. There are many factors responsible for the change in blood concentrations of methadone, and its pharmacokinetics is very complex. Therefore, a simple and accurate measurement method for methadone blood concentrations was developed using HPLC/electrochemical detector (ECD). An eluent of 10 mM Na2 HPO4 /CH3 CN/CH3 OH (20 : 19 : 3) was used as the mobile phase. The column was used the XTerra® RP18, and the voltage of the ECD was set at 400 to 800 mV...
2018: Biological & Pharmaceutical Bulletin
https://www.readbyqxmd.com/read/29601303/the-opioid-epidemic-and-pregnancy-implications-for-anesthetic-care
#6
Britany L Raymond, Bradley T Kook, Michael G Richardson
PURPOSE OF REVIEW: This review summarizes evolving knowledge regarding adverse maternal, fetal, and neonatal effects of opioid exposure during pregnancy, and current treatment options for opioid use disorder (OUD). Maternal and fetal implications of maternal opioid maintenance with methadone and buprenorphine are described. Finally, acute and chronic pain management strategies in opioid-tolerant parturients are reviewed. RECENT FINDINGS: Opioid use among parturients has risen dramatically, with opioid use during pregnancy as high as 20%...
March 29, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29572653/delta-mu-opioid-receptor-interactions-in-operant-conditioning-assays-of-pain-depressed-responding-and-drug-induced-rate-suppression-assessment-of-therapeutic-index-in-male-sprague-dawley-rats
#7
Katherine Cone, Janell Lanpher, Abigail Kinens, Philomena Richard, Sarah Couture, Rebecca Brackin, Emily Payne, Kylee Harrington, Kenner C Rice, Glenn W Stevenson
RATIONALE AND OBJECTIVES: Although delta/mu receptor interactions vary as a function of behavioral endpoint, there have been no assessments of these interactions using assays of pain-depressed responding. This is the first report of delta/mu interactions using an assay of pain-depressed behavior. METHODS: A mult-cycle FR10 operant schedule was utilized in the presence of (nociception) and in the absence of (rate suppression) a lactic acid inflammatory pain-like manipulation...
March 23, 2018: Psychopharmacology
https://www.readbyqxmd.com/read/29563006/opioid-rotation-in-cancer-pain-treatment
#8
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
https://www.readbyqxmd.com/read/29527296/management-of-eight-labor-and-delivery-patients-dependent-on-buprenorphine-subutex%C3%A2-a-retrospective-chart-review
#9
Solina Tith, Garinder Bining, Laurent Bollag
Background : Opioid use during pregnancy is a growing concern in the United States. Buprenorphine has been recommended by "The American College of Obstetrics and Gynecology" as an alternative to methadone to decrease risks associated with the use of illicit opioids during pregnancy. The partial μ-opioid agonists' unique pharmacology, including its long half time and high affinity to the μ-opioid receptor, complicates patient management in a highly kinetic, and often urgent field like obstetric anesthesia...
2018: F1000Research
https://www.readbyqxmd.com/read/29516505/methadone-against-cancer-lost-in-translation
#10
REVIEW
Dirk Theile, Gerd Mikus
Recently, the opioid analgesic D,L-methadone has gained much attention as a potential antineoplastic compound, considerably triggered through lay press and media. In consequence, physicians and pharmacists are currently confronted with numerous patients willing to use D,L-methadone against their malignancies. Well-performed in vitro and in vivo models have in fact shown pro-apoptotic effects of D,L-methadone or other opioids, but also proliferation-stimulating properties. Moreover, the mechanisms of proposed opioid-stimulated apoptosis are incompletely described or contradicting...
March 8, 2018: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/29514333/buprenorphine-maintenance-subjects-are-hyperalgesic-and-have-no-antinociceptive-response-to-a-very-high-morphine-dose
#11
Peter Athanasos, Walter Ling, Felix Bochner, Jason M White, Andrew A Somogyi
Objective: Acute pain management in opioid-dependent persons is complicated because of tolerance and opioid-induced hyperalgesia. Very high doses of morphine are ineffective in overcoming opioid-induced hyperalgesia and providing antinociception to methadone-maintained patients in an experimental setting. Whether the same occurs in buprenorphine-maintained subjects is unknown. Design: Randomized double-blind placebo-controlled. Subjects were tested on two occasions, at least five days apart, once with intravenous morphine and once with intravenous saline...
March 5, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29509824/helpdesk-how-accurate-are-point-of-care-urine-drug-screens-in-patients-taking-chronic-opioid-therapy
#12
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
https://www.readbyqxmd.com/read/29498480/the-effect-of-a-combination-of-diclofenac-and-methadone-applied-as-gel-in-a-human-experimental-pain-model-a-randomized-placebo-controlled-trial
#13
Isabelle M Larsen, Asbjørn M Drewes, Anne E Olesen
Pain involves responses in which both peripheral and central mechanisms contribute to the generation of pain. Pre-clinical laboratory data have supported that a topical formulation of combined diclofenac and methadone (Diclometh) may alleviate local pain, and potentially the side effect profile should be low. We hypothesized that anti-allodynic and anti-hyperalgesic effects of Diclometh could be demonstrated in a human experimental pain model, and that Diclometh would be safe to administer. Thus, the aims were: 1) To compare two doses of Diclometh versus placebo; 2) To assess the safety profile of Diclometh...
March 2, 2018: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29497252/challenges-of-using-methadone-in-the-indian-pain-and-palliative-care-practice
#14
REVIEW
Vidya Viswanath, Gayatri Palat, Srini Chary, Ann Broderick
Palliative care providers across India lobbied to gain access to methadone for pain relief and this has finally been achieved. Palliative care activists will count on the numerous strengths for introducing methadone in India, including the various national and state government initiatives that have been introduced recognizing the importance of palliative care as a specialty in addition to improving opioid accessibility and training. Adding to the support are the Non-Governmental Organizations (NGOs), the medical fraternity and the international interactive and innovative programs such as the Project Extension for Community Health Outcome...
January 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29497251/practical-guide-for-using-methadone-in-pain-and-palliative-care-practice
#15
REVIEW
Gayatri Palat, Srini Chary
Since the 2014 Amendment to the NDPS Act methadone has been released in India for pain management. The methadone is supplied as racemic mixture with R & S methadone with benefit in pain management and associated adverse effects. Physicians need to be aware of adverse effects so that methadone can be administered safely. Similarly, patients and families need to store and use methadone carefully and experience the benefits and not increase the risk of further morbidity. Considerable amount of literature on methadone is available and sometimes conflicting, hence the article is attempting to guide a physician to use methadone safely to acquire experience and expertise over time...
January 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29497250/when-to-use-methadone-for-pain-a-case-based-approach
#16
REVIEW
Gayatri Palat, Nandini Vallath, Srini Chary, Ann Broderick
The case studies are written in this article to illustrate how methadone might be used for pain in the Indian context. These cases might be used for discussion in a multidisciplinary team, or for individual study. It is important to understand that pain requires a multidisciplinary approach as opioids will assist only with physical, i.e. neuropathic and nociceptive pain, but not emotional, spiritual, or relational pain or the pain of immobility. The social determinants of pain were included to demonstrate how emotional, relational, and psychological dimensions of pain amplify the physical aspects of pain...
January 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29497249/practical-pharmacology-of-methadone-a-long-acting-opioid
#17
REVIEW
M M Sunilkumar, Kashelle Lockman
Methadone is a naturally long-acting analgesic with unique pharmacodynamic and pharmacokinetic properties compared to other opioids, available now in India, to treat severe pain. It has the potential to dramatically relieve suffering among patients with serious illness who are living with persistent physical pain. However, clinicians must appreciate its unique pharmacologic properties and its use in clinical practice safely and effectively. The available formulation in India is a racemic mixture of the S- and R-enantiomers, and as such, it will have a propensity for drug-drug and drug-genetic interactions that can increase the risk of Torsades de Point and respiratory depression...
January 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29497248/methadone-for-pain-management-past-present-and-future
#18
REVIEW
Srini Chary
Methadone for pain management in this article describes briefly pain, methadone as a Level 3 World Health Organization ladder opioid in the context of India and rest of the world, as well as the relationship to past, present, and future possibilities of pain management. Acute pain is proportional to the injury most of the times, and such proportionality may not exist in chronic pain. Pain management over decades has changed because of knowledge and availability of molecules and compounds to reduce chronic pain...
January 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29497247/safe-use-of-methadone-for-cancer-pain-using-opioid-circle-of-safety
#19
EDITORIAL
Sushma Bhatnagar
No abstract text is available yet for this article.
January 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29497246/methadone-is-now-available-in-india-is-the-long-battle-over
#20
EDITORIAL
M R Rajagopal
Context: Morphine and fentanyl had so far been the only available opioids in India in step three of the World Health Organization analgesic ladder. Especially for those not tolerating morphine and particularly for those developing neurotoxicity, an inexpensive alternative was essential. Many years of advocacy by palliative care activists have resulted in methadone being now available for sale in India for pain management. However, the characteristic pharmacokinetics and pharmacodynamics of methadone raise potential issues of safety...
January 2018: Indian Journal of Palliative Care
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