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opiods for chronic pain

Andrew J Pugely, Nicholas A Bedard, Piyush Kalakoti, Nathan R Hendrickson, Jamal N Shillingford, Joseph L Laratta, Comron Saifi, Ronald A Lehman, K Daniel Riew
BACKGROUND CONTEXT: Limited or no data exist evaluating risk factors associated with prolonged opioid use following cervical arthrodesis. PURPOSE: The objectives of this study were to assess trends in postoperative narcotic use among preoperative opioid users (OUs) versus non-opioid users (NOUs) and to identify factors associated with postoperative narcotic use at 1 year following cervical arthrodesis. STUDY DESIGN/SETTING: This is a retrospective observational study...
April 10, 2018: Spine Journal: Official Journal of the North American Spine Society
Ismaliza Ismail, Suzaily Wahab, Hatta Sidi, Srijit Das, Loo Jiann Lin, Rosdinom Razali
Kratom (Mitragynaspeciosa), a natural existing plant found in South-East Asia, is tradi-tionally used as an herb to help to elevate a person's energy and also to treat numerous medical ailments. Other than the analgesic property, kratom has been used as an agent to overcome opioid withdrawal as it contains natural alkaloids, i.e. mitragynine, 7-hydroxymitragynine, and MGM-9, which has agonist affinity on the opioid receptors, including mu (μ) and kappa (κ). The role of neural reward pathway linked to μ-opioid receptors and both dopaminergic and GABA-ergic interneurons that express μ-opioid receptors were deliberated...
April 25, 2017: Current Drug Targets
Giovanni De Caridi, Mafalda Massara, Raffaele Serra, Claudia Risitano, Massimiliano Giardina, Ignazio Eduardo Acri, Pietro Volpe, Antonio David
Phantom limb pain (PLP) is a chronic condition experienced by about 80% of patients who have undergone amputation. In most patients, both the frequency and the intensity of pain attacks diminish with time, but severe pain persists in about 5-10%. Probably, factors in both the peripheral and central nervous system play a role in the occurrence and persistence of pain in the amputated lower limb. The classical treatment of PLP can be divided into pharmacologic, surgical, anesthetic, and psychological modalities...
April 2016: Annals of Vascular Surgery
F J López-Pérez, A Mínguez-Martí, E Vicario-Sánchez, A Pastor-Clérigues, J Sanfeliu-García, M P Ortega-García
BACKGROUND: The implementation of opioid switch (OS) as a strategy in non-malignant chronic pain has been scarcely proved. This article aims to evaluate the results of OS in a Pain Treatment Unit. METHODS: This is an observational retrospective study in which all patients who had been subjeted to OS for a period of 18 months were selected. All of them had been treated with opiods plus adyuvants for more than 6 months and had a visual analog scale (VAS) of at least 5, either with or without adverse effects...
September 16, 2014: Farmacia Hospitalaria
Gina Games, Amber Hutchison
With the prevalence of diabetes mellitus (DM) increasing, pathologic complications such as diabetic peripheral neuropathy (DPN) are also becoming more common. Of those diagnosed with DM, 10% to 20% of patients suffer from painful DPN. Until recently, only pregabalin and duloxetine possessed Food and Drug Administration (FDA) approval for this condition. However, FDA recently approved tapentadol-ER [extended release] (Nucynta ER) for painful DPN. Tapentadol-ER is an opioid analgesic commonly used for the treatment of moderate-to-severe chronic pain that contains a unique dual mechanism acting as both a weak mu-opiod receptor agonist and norepinephine-reuptake inhibitor...
October 2013: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Jacob N Ablin, Dan Buskila
Fibromyalgia is a syndrome characterized by the presence of chronic widespread pain, representing sensitization of the central nervous system. The pthophysiology of fibromyalgia is a complex and remains in evolution, encompassing diverse issues such as disturbed patterns of sleep, alter processing and decreased conditioned pain modulation at the spinal level, as well as increased connectivity between various pain - processing areas of the brain. This evolution is continuously uncovering potential novel therapeutic targets...
August 2013: Maturitas
B Borghi, L Aurini, P F White, A Mordenti, F Lolli, R Borghi, M Martignani, T Greggi
BACKGROUND: Chronic low back pain (LBP) and sciatica can occur without obvious structural causes and are often resistant to conventional analgesic drugs. The effect of periradicular injection of meloxicam on LBP with or without a radicular component was assessed. A secondary objective of this prospective observational study was to assess the effect of meloxicam on functional recovery. METHODS: Seventy-two patients (30 men, 42 women) with LBP and/or sciatica were followed for 90 days to six years after injecting 10 mg meloxicam in 10 mL saline at each of the involved dermatomal levels...
April 2013: Minerva Anestesiologica
Jaime Calvo-Alén
The use of opioids for benign disorders has been limited by concerns about these compounds' potential adverse events and their possible misuse. However, during the last few years an increased use in nonmalignant disorders, including rheumatologic diseases, has been observed. Herein, we review the scientific evidence for opioid therapy in three common scenarios in clinical rheumatology. Low back pain is a very frequent reason for consultation. Overall, the large majority of studies show a positive, yet rather moderate, effect of opioids in pain control, as well as in other outcomes including mood, work disability and anxiety...
October 2010: Therapeutic Advances in Musculoskeletal Disease
Andrea Furlan, Luis E Chaparro, Emma Irvin, Angela Mailis-Gagnon
BACKGROUND: An enriched enrollment randomized withdrawal (EERW) design excludes potential participants who are nonresponders or who cannot tolerate the experimental drug before random assignment. It is unclear whether EERW design has an influence on the efficacy and safety of opioids for chronic noncancer pain (CNCP). OBJECTIVES: The primary objective was to compare the results from EERW and non-EERW trials of opioids for CNCP. Secondary objectives were to compare weak versus strong opioids, subgroups of patients with different types of pain, and the efficacy of opiods compared with placebo versus other drugs...
September 2011: Pain Research & Management: the Journal of the Canadian Pain Society
Ingrid Rundshagen
Drug addicts need special anesthesiological care due to their co-morbidities, their modified need for analgesics and anesthetics and/or their specific substitution therapies. In spite of the high incidence of addiction worldwide controlled studies and evidence based recommendations for the anaesthesiological management of the patients are missing. The perioperative care is not the treatment of addiction, on the contrary the specific aspects of a chronic disease have to be accepted. Equally important perioperative treatment strategies for the management of drug addicts include: 1...
May 2010: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
J Turgeon, R Gröning, G Sathyan, J Thipphawong, U Richarz
IMPORTANCE OF THE FIELD: New formulations of opiods can provide round-the-clock pain relief to improve pain management and quality of life for patients with chronic pain. AREAS COVERED IN THIS REVIEW: Information and comments on the pharmacokinetic processes associated with a new once-daily formulation of the potent opiod hydromorphone. WHAT THE READER WILL GAIN: This review presents an overview of data from several small pharmacokinetic studies to gain a better perspective on the pharmacokinetic properties of a new long-acting formulation of hydromorphone...
January 2010: Expert Opinion on Drug Delivery
S Jagdish, D Aldington
Opioids constitute an important component of analgesic regimens and in the UK military, they are used throughout the journey of the wounded soldier. Concerns have been expressed about their usefulness and potential adverse effects when they are continued beyond the acute phase into rehabilitation. The current literature regarding opiod usage during rehabilitation is reviewed in order to provide evidence based recommendations for practice with particular relevance to recent military experience.
March 2009: Journal of the Royal Army Medical Corps
Eva Kosek, Karin B Jensen, Tina B Lonsdorf, Martin Schalling, Martin Ingvar
BACKGROUND: There is evidence from animal studies that serotonin (5-HT) can influence the antinociceptive effects of opioids at the spinal cord level. Therefore, there could be an influence of genetic polymorphisms in the serotonin system on individual variability in response to opioid treatment of pain. The serotonin transporter (5-HTT) is a key regulator of serotonin metabolism and availability and its gene harbors several known polymorphisms that are known to affect 5-HTT expression (e...
2009: Molecular Pain
Lydia Abásolo, Loreto Carmona
BACKGROUND AND OBJECTIVE: To evaluate the efficacy of major opioids in the treatment of musculoskeletal pain. MATERIAL AND METHOD: Systematic review. A sensitive search strategy was undertaken in MEDLINE and EMBASE up to April 2005. The Cochrane Library and the abstracts of the 2004-2005 meetings of the American College of Rheumatology were also hand searched. All randomized controlled trials of major opiods in patients with musculoskeletal pain were selected. An analytical review was performed and evidence tables produced...
March 3, 2007: Medicina Clínica
F Coluzzi, C Mattia
Opioids are widely used as effective analgesic therapy for cancer pain. Despite years of controversy, their use has been also accepted in chronic non-cancer pain. Oxycodone alone and in combination has been used for over 80 years in the treatment of a variety of pain syndromes. As single agent, the controlled release (CR) oxycodone's market in the USA grew from 10% in 1996 to 53% in 2000 and it has become a leading opioid in the United States. Recent data showed that the fixed-combination oxycodone/acetaminophen (5 mg/325 mg) is the most often prescribed opioid across all the different chronic pain diagnoses...
July 2005: Minerva Anestesiologica
F Gamero Ruiz, R Gabriel Sánchez, J Carbonell Abello, J Tornero Molina, I Sánchez-Magro
OBJECTIVE: To establish the prevalence and characteristics of rheumatologic pain in Spanish adult population cared in specialized rheumatology offices. DESIGN: Cross selection study in a population of patients cared in rheumatology offices of public Spanish hospitals. SUBJECTS: 1,134 patients selected through random sampling based on waiting lists of patients, during a period of 1 week, in rheumatology offices of each participating hospital...
April 2005: Revista Clínica Española
Mark S Chambers, Harris J Keene, Béla B Toth, James C Lemon, Susan C Gallagher, Charles G Martin, Jack W Martin
OBJECTIVES: Opiod- and/or radiation-induced xerostomia in cancer patients is frequently associated with elevated levels of cariogenic mutans streptococci (MS). STUDY DESIGN: In a single-center, single blind 8-week clinical trial at The University of Texas M. D. Anderson Cancer Center, and from an initial sample of 32 patients, we evaluated MS counts in 28 cancer patients receiving chronic analgesic treatment for cancer pain. All patients received escalating doses of pilocarpine (Salagen) tablets, either 2...
February 2005: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics
Shelley R Winn, Dwaine F Emerich
Spinal injections (intrathecal) of norepinephrine and/or opiod agonists are antinociceptive and when administered together may act in synergy. Spinal implants of adrenal chromaffin cells are an effective method for sustained delivery of the analgesic substances norepinephrine and enkephalin to the central nervous system (CNS). One method of packaging and implanting cell-loaded devices into the intrathecal space of recipients is by encapsulating the cell suspensions in a polymer membrane prior to implantation...
January 1, 2005: Frontiers in Bioscience: a Journal and Virtual Library
M Persoli-Gudelj
Current opinions in chronic pain treatment with opioid analgesics are presented in this review. Justified use of opioid analgesics in treatment of chronic non-malignant pain in inflammatory and degenerative processes is emphasised. Advantages of opioid analgesics compared with non-opiod analgesics are stressed. New form of opioid--a patch, Durogesic TTS, recently registered in Croatia, is described. After brief review of pharmacodynamics and pharmacokinetics of Durogesic, authors experiences in both chronic malignant pain and chronic non-malignant pain treatment with this analgesic are described...
2001: Reumatizam
S Mercadante, P Villari, F Fulfaro
Chronic opioid medication has been found to cause myoclonus in patients taking it for cancer pain. Gabapentin seemed a likely candidate for the treatment of this myoclonus and has indeed proved useful, as illustrated in this paper by two case histories.
May 2001: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
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