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Pain opioids

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https://www.readbyqxmd.com/read/28214219/perpetuating-stigma-or-reducing-risk-perspectives-from-naloxone-consumers-and-pharmacists-on-pharmacy-based-naloxone-in-2-states
#1
Traci C Green, Patricia Case, Haley Fiske, Janette Baird, Shachan Cabral, Dina Burstein, Victoriana Schwartz, Nathan Potter, Alexander Y Walley, Jeffrey Bratberg
OBJECTIVES: Little is known about attitudes of pharmacists and consumers to pharmacy naloxone. We examined perceptions and experiences of pharmacy naloxone from people with opioid use disorder, patients taking chronic opioids for pain, caregivers of opioid users, and pharmacists from 2 early pharmacy naloxone adopter states: Massachusetts and Rhode Island. DESIGN: Eight focus groups (4 per state) were held in October to December 2015. SETTING AND PARTICIPANTS: Participants were recruited from pharmacies, health clinics, and community organizations; pharmacists were recruited from professional organizations and pharmacy colleges...
February 14, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28214183/-misuse-and-dependence-on-prescription-opioids-prevention-identification-and-treatment
#2
B Rolland, D Bouhassira, N Authier, M Auriacombe, V Martinez, P Polomeni, G Brousse, R Schwan, P Lack, J Bachellier, S Rostaing, P Bendimerad, P Vergne-Salle, M Dematteis, S Perrot
Since the 1990s, the use of prescription opioids has largely spread, which has brought a real progress in the treatment of pain. The long-term use of prescription opioid is sometimes required, and may lead to pharmacological tolerance and withdrawal symptoms, i.e. pharmacological dependence on prescription opioids. Occasionally, this may also lead to misuse of prescription opioids (MPO). MPO preferentially occurs in vulnerable individuals, i.e., those with a young age, history of other addictive or psychiatric disorders, especially anxious and depressive disorders...
February 14, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28214095/whether-preventive-low-dose-magnesium-sulphate-infusion-has-an-influence-on-postoperative-pain-perception-and-the-level-of-serum-beta-endorphin-throughout-the-total-abdominal-hysterectomy
#3
K Haryalchi, M Abedinzade, K Khanaki, M M Ghanaie, F M Zadeh
OBJECTIVE: Due to the known role of preventive low dose magnesium sulphate on postoperative pain management, in this randomized, double-blinded, placebo-controlled study, we tried to investigate the possible relationship between low dose intra-operative magnesium sulphate infusion, postoperative analgesia and the level of serum beta-endorphin during total abdominal hysterectomy under general anesthesia. METHODS: Forty women undergoing total abdominal hysterectomy were randomly allocated into 2 groups (20 in each arm)...
February 14, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28213891/opioids-and-the-immune-system-friend-or-foe
#4
REVIEW
Lisanne Mirja Plein, Heike L Rittner
Systemically administered opioids are among the most powerful analgesics for treating severe pain. Several negative side-effects (respiratory depression, addiction, nausea, confusion) and the risk of opioid-induced hyperalgesia accompany opioid administration. One other side effect is the potential of opioids to suppress the immune response and thereby to increase the vulnerability for infections. Several studies have investigated the link between opioids and immunosuppression in vitro, in vivo as well as in patients with divergent results: Exogenous opioids such as morphine and fentanyl can impair macrophage and natural killer cell as well as T cell function and weaken the gut barrier in vitro and in animal studies...
February 18, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28213817/breakthrough-cancer-pain-and-rational-drug-use
#5
Juan Manuel Núñez Olarte
Recent data indicate that there are large disparities in the use of opioid analgesics to control breakthrough cancer pain (BTcP) in Europe and worldwide. While it is clear that affordability is a key factor, it is certainly not the only one, and other factors, such as cultural differences and overall awareness, are undoubtedly responsible. More work remains to be done to overcome barriers in the use of these medications when warranted. When prescribing a medication for BTcP, it must be considered that its time profile is different from chronic persistent pain...
February 18, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28213593/randomised-double-blind-parallel-group-placebo-controlled-study-to-evaluate-the-analgesic-efficacy-and-safety-of-vvz-149-injections-for-postoperative-pain-following-laparoscopic-colorectal-surgery
#6
Srdjan S Nedeljkovic, Darin J Correll, Xiaodong Bao, Natacha Zamor, Jose L Zeballos, Yi Zhang, Mark J Young, Johanna Ledley, Jessica Sorace, Kristen Eng, Carlyle P Hamsher, Rajivan Maniam, Jonathan W Chin, Becky Tsui, Sunyoung Cho, Doo H Lee
INTRODUCTION: In spite of advances in understanding and technology, postoperative pain remains poorly treated for a significant number of patients. In colorectal surgery, the need for developing novel analgesics is especially important. Patients after bowel surgery are assessed for rapid return of bowel function and opioids worsen ileus, nausea and constipation. We describe a prospective, double-blind, parallel group, placebo-controlled randomised controlled trial testing the hypothesis that a novel analgesic drug, VVZ -149, is safe and effective in improving pain compared with providing opioid analgesia alone among adults undergoing laparoscopic colorectal surgery...
February 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28213205/sensory-trigeminal-ulf-tens-stimulation-reduces-hrv-response-to-experimentally-induced-arithmetic-stress-a-randomized-clinical-trial
#7
Monaco Annalisa, Cattaneo Ruggero, Ortu Eleonora, Constantinescu Marian Vladimir, Pietropaoli Davide
Ultra Low Frequency Transcutaneous Electric Nervous Stimulation (ULF-TENS) is extensively used for pain relief and for the diagnosis and treatment of temporomandibular disorders (TMD). In addition to its local effects, ULF-TENS acts on the autonomic nervous system (ANS), with particular reference to the periaqueductal gray (PAG), promoting the release of endogenous opioids and modulating descending pain systems. It has been suggested that the PAG participates in the coupling between the emotional stimulus and the appropriate behavioral autonomic response...
February 14, 2017: Physiology & Behavior
https://www.readbyqxmd.com/read/28212204/1-2-4-dibromophenyl-3-6-6-trimethyl-1-5-6-7-tetrahydro-4h-indazol-4-one-a-novel-opioid-receptor-agonist-with-less-accompanying-gastrointestinal-dysfunction-than-morphine
#8
Po-Kuan Chao, Shau-Hua Ueng, Li-Chin Ou, Teng-Kuang Yeh, Wan-Ting Chang, Hsiao-Fu Chang, Shu-Chun Chen, Pao-Luh Tao, Ping-Yee Law, Horace H Loh, Ming-Fu Cheng, Jian-Ying Chuang, Chiung-Tong Chen, Chuan Shih, Shiu-Hwa Yeh
BACKGROUND: The authors investigated the pharmacology and signaling pathways of the opioid receptors modulated by compound 1, 1-(2,4-dibromophenyl)-3,6,6-trimethyl-1,5,6,7-tetrahydro-4H-indazol-4-one. METHODS: In vitro studies of compound 1 were assessed by using a radioligand-binding assay (n = 3), a cyclic adenosine monophosphate assay (n = 3), a β-arrestin assay (n = 3), an internalization assay (n = 3), and an immunohistochemistry (n = 8). In vivo studies of compound 1 were characterized using a tail-flick test (n = 5 to 6), tail-clip test (n = 7), von Frey hair test (n = 5), and charcoal meal test (n = 5)...
February 17, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28212183/cxcl12-cxcr4-signaling-contributes-to-the-pathogenesis-of-opioid-tolerance-a-translational-study
#9
Chih-Peng Lin, Kai-Hsiang Kang, Huang-Ju Tu, Ming-Yueh Wu, Tzu-Hung Lin, Houng-Chi Liou, Wei-Zen Sun, Wen-Mei Fu
BACKGROUND: Long-term opioid therapy for chronic pain may lead to analgesic tolerance, especially when administered intrathecally, thus preventing adequate pain relief. Discovering drug targets to treat opioid tolerance using a mechanism-based approach targeting opioid-induced neuroinflammation provides new therapeutic opportunities. In this study, we provide translational evidence that CXCL12/CXCR4 signaling contributes to the pathogenesis of opioid tolerance. METHODS: The CXCL12 levels in the cerebrospinal fluid of opioid-tolerant patients were compared with those of opioid-naive subjects...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28212147/monitoring-hospitalized-adult-patients-for-opioid-induced-sedation-and-respiratory-depression
#10
Carla R Jungquist, Kirsten Smith, Kelly L Wiltse Nicely, Rosemary C Polomano
: Opioid analgesics are commonly administered to hospitalized patients to treat acute pain, but these drugs put patients at risk for serious adverse events, such as unintended advancing sedation, respiratory depression, and death. Nurses play an important role in keeping patients safe by making clinical decisions about the frequency and intensity with which patients receiving IV and epidural opioids should be monitored. To make sound clinical judgments, nurses must be aware of the factors that place patients at elevated risk for adverse opioid-related effects and know how to screen and assess patients for these risks...
March 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28211895/electroacupuncture-attenuates-cfa-induced-inflammatory-pain-by-suppressing-nav1-8-through-s100b-trpv1-opioid-and-adenosine-pathways-in-mice
#11
Hsien-Yin Liao, Ching-Liang Hsieh, Chun-Ping Huang, Yi-Wen Lin
Pain is associated with several conditions, such as inflammation, that result from altered peripheral nerve properties. Electroacupuncture (EA) is a common Chinese clinical medical technology used for pain management. Using an inflammatory pain mouse model, we investigated the effects of EA on the regulation of neurons, microglia, and related molecules. Complete Freund's adjuvant (CFA) injections produced a significant mechanical and thermal hyperalgesia that was reversed by EA or a transient receptor potential V1 (TRPV1) gene deletion...
February 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28210646/pain-assessment-after-anterior-cruciate-ligament-reconstruction-bone-patellar-tendon-bone-versus-hamstring-tendon-autograft
#12
Kelechi R Okoroha, Robert A Keller, Edward K Jung, Lafi Khalil, Nathan Marshall, Patricia A Kolowich, Vasilios Moutzouros
BACKGROUND: Anterior cruciate ligament (ACL) reconstruction is a common outpatient procedure that is accompanied by significant postoperative pain. PURPOSE: To determine differences in acute pain levels between patients undergoing ACL reconstruction with bone-patellar tendon-bone (BTB) versus hamstring tendon (HS) autograft. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: A total of 70 patients who underwent primary ACL reconstruction using either BTB or HS autografts consented to participate...
December 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28210635/combined-spinal-epidural-for-vaginal-delivery-in-a-parturient-with-takayasu-s-arteritis
#13
Sean Patrick Clifford, Paul Brian Mick, Brian Matthew Derhake
Takayasu's arteritis is a rare, progressive panendarteritis involving all layers of the arterial wall. This disease includes variable involvement of the aorta and its major branches. The most common complication with this condition is severe, uncontrolled hypertension, often leading to end organ dysfunction. We describe the management of a 27-year-old woman diagnosed with Takayasu's arteritis that presented in labor with intense pain and underwent a combined spinal-epidural for anesthetic management. Per literature review, a combined spinal-epidural technique for planned vaginal delivery has not been described for a laboring Takayasu patient...
October 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28210502/a-single-perioperative-injection-of-dexamethasone-decreases-nausea-vomiting-and-pain-after-laparoscopic-donor-nephrectomy
#14
Shigeyoshi Yamanaga, Andrew Mark Posselt, Chris Earl Freise, Takaaki Kobayashi, Mehdi Tavakol, Sang-Mo Kang
Background. A single dose of perioperative dexamethasone (8-10 mg) reportedly decreases postoperative nausea, vomiting, and pain but has not been widely used in laparoscopic donor nephrectomy (LDN). Methods. We performed a retrospective cohort study of living donors who underwent LDN between 2013 and 2015. Donors who received a lower dose (4-6 mg)  (n = 70) or a higher dose (8-14 mg) of dexamethasone (n = 100) were compared with 111 donors who did not receive dexamethasone (control). Outcomes and incidence of postoperative nausea, vomiting, and pain within 24 h after LDN were compared before and after propensity-score matching...
2017: Journal of Transplantation
https://www.readbyqxmd.com/read/28209260/use-of-the-pasero-opioid-induced-sedation-scale-poss-in-pediatric-patients
#15
Ann Quinlan-Colwell, Gayle Thear, Emily Miller-Baldwin, Andrea Smith
The Pasero Opioid-induced Sedation Scale (POSS) is a valid, reliable tool used to assess sedation when administering opioid medications to manage pain. The POSS is endorsed by The Joint Commission and the American Society for Pain Management Nursing to help prevent adverse opioid-related respiratory events. Although the POSS is used to assess sedation in pediatric patients at some hospitals, prior to this study, it was not formally evaluated in the pediatric population. This study used a quasi-experimental design with a convenience sample of pediatric patients admitted to a large regional medical center in southeastern North Carolina...
February 10, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28207592/a-reply-to-epidural-local-anesthetics-versus-opioid-based-analgesic-regimens-for-postoperative-gastrointestinal-paralysis-vomiting-and-pain-after-abdominal-surgery-a-cochrane-review
#16
Ellis Muggleton, Tülin Muggleton
No abstract text is available yet for this article.
February 15, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28204957/insights-into-the-role-of-opioid-receptors-in-the-gi-tract-experimental-evidence-and-therapeutic-relevance
#17
James J Galligan, Catia Sternini
Opioid drugs are prescribed extensively for pain treatment but when used chronically they induce constipation that can progress to opioid-induced bowel dysfunction. Opioid drugs interact with three classes of opioid receptors: mu opioid receptors (MORs), delta opioid receptors (DOR), and kappa opioid receptors (KORs), but opioid drugs mostly target the MORs. Upon stimulation, opioid receptors couple to inhibitory Gi/Go proteins that activate or inhibit downstream effector proteins. MOR and DOR couple to inhibition of adenylate cyclase and voltage-gated Ca(2+) channels and to activation of K(+) channels resulting in reduced neuronal activity and neurotransmitter release...
February 16, 2017: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/28204792/problematic-use-of-prescription-opioids-and-medicinal-cannabis-among-patients-suffering-from-chronic-pain
#18
Daniel Feingold, Itay Goor-Aryeh, Silviu Bril, Yael Delayahu, Shaul Lev-Ran
No abstract text is available yet for this article.
February 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28203541/anesthetic-considerations-in-robotic-mitral-valve-surgery
#19
Kent H Rehfeldt, J Valery Andre, Matthew J Ritter
The robotic approach to cardiac surgery offers patients numerous potential advantages compared with a traditional sternotomy approach including shorter hospital length of stay, reduced pain, fewer blood transfusions, and a quicker return to normal daily activities. At the same time, robotic cardiac surgery requires that the anesthesiologist employs several subspecialty skillsets in order to provide optimal care for these patients. Multiple different regional anesthesia techniques may be used to improve analgesia, reduce opioid dosages, and facilitate rapid extubation at the conclusion of the case...
January 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28203021/-comparision-for-clinical-efficiency-of-continuous-adductor-canal-block-and-femoral-nerve-block-in-total-knee-arthroplasty
#20
M W Zhao, N Wang, L Zeng, M Li, Z K Zhao, H Zhang, H Tian
OBJECTIVE: To compare the pain control efficiency of continuous adductor canal block (ACB) and femoral nerve block (FNB) in total knee arthroplasty. METHODS: From April to September 2016, patients with severe knee osteoarthritis undergoing primary unilateral total knee arthroplasty (TKA) were prospectively observed, and all the patients were randomized received ultrasound-guided continuous ACB or FNB after surgery. Numeric pain rating scales(NPRS)pain scores in rest and activity 2, 6, 12, 24 and 48 h after surgery were collected, and the preoperative and postoperative quadriceps strength at 24 and 48 h were analyzed...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
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