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Opioid pharmacology

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https://www.readbyqxmd.com/read/29922156/ibogaine-detoxification-transitions-opioid-and-cocaine-abusers-between-dependence-and-abstinence-clinical-observations-and-treatment-outcomes
#1
Deborah C Mash, Linda Duque, Bryan Page, Kathleen Allen-Ferdinand
Ibogaine may be effective for transitioning opioid and cocaine dependent individuals to sobriety. American and European self-help groups provided public testimonials that ibogaine alleviated drug craving and opioid withdrawal symptoms after only a single dose administration. Preclinical studies in animal models of addiction have provided proof-of-concept evidence in support of these claims. However, the purported therapeutic benefits of ibogaine are based on anecdotal reports from a small series of case reports that used retrospective recruitment procedures...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29913911/buprenorphine-clinically-useful-but-often-misunderstood
#2
Stephen Butler
Background There are a number of false myths about buprenorphine based on unconfirmed animal data, even from isolated animal organs, and early clinical research. These myths came into textbooks on pharmacology and pain about 30 years ago and have been difficult to eradicate. Animal models of pain and pain relief are notoriously unreliable as predictors of human clinical effects. The fact is that in clinical practice there is NO bell-shaped dose-response curve, there is NO plateau on the dose-response curve, and there is NO antagonist effect from buprenorphine on other mu-opioid agonists...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29913873/postherpetic-neuralgia-new-hopes-in-prevention-with-adult-vaccination-and-in-treatment-with-a-concentrated-capsaicin-patch
#3
Ewa Gawecka, Oddbjørn Viken
Background and purpose Postherpetic neuralgia (PHN) is a complication of acute herpes zoster (HZ). The evidence base for management of PHN has increased by recent publications. Therefore, we reviewed incidence of HZ, prevalence, risk factors, and mechanism of PHN pain, prevention and treatment of PHN with special interest in studies on adult vaccination and topical application of lidocaine and concentrated capsaicin patch. Methods We searched databases with an English language restriction: MEDLINE 1944-2011, EMBASE 1988-2011, PubMed, and the Cochrane Controlled Trial Register and Cochrane Library (2011)...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29913756/predictive-validity-of-pharmacologic-interventions-in-animal-models-of-neuropathic-pain
#4
Per Hartvig Honoré, Anna Basnet, Pernille Kristensen, Lene Munkholm Andersen, Signe Neustrup, Pia Møllgaard, Laila Eljaja, Ole J Bjerrum
Introduction The pathophysiologic and neurochemical characteristics of neuropathic pain must be considered in the search for new treatment targets. Breakthroughs in the understanding of the structural and biochemical changes in neuropathy have opened up possibilities to explore new treatment paradigms. However, long term sequels from the damage are still difficult to treat. Aim of the study To examine the validity of pharmacological treatments in humans and animals for neuropathic pain. Method An overview from the literature and own experiences of pharmacological treatments employed to interfere in pain behavior in different animal models was performed...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29913015/comparison-of-safety-and-efficacy-of-methadone-vs-morphine-for-treatment-of-neonatal-abstinence-syndrome-a-randomized-clinical-trial
#5
Jonathan M Davis, Jeffrey Shenberger, Norma Terrin, Janis L Breeze, Mark Hudak, Elisha M Wachman, Peter Marro, Erica L Oliveira, Karen Harvey-Wilkes, Adam Czynski, Barbara Engelhardt, Karen D'Apolito, Debra Bogen, Barry Lester
Importance: Although opioids are used to treat neonatal abstinence syndrome (NAS), the best pharmacologic treatment has not been established. Objective: To compare the safety and efficacy of methadone and morphine in NAS. Design, Setting, and Participants: In this randomized, double-blind, intention-to-treat trial, term infants from 8 US newborn units whose mothers received buprenorphine, methadone, or opioids for pain control during pregnancy were eligible...
June 18, 2018: JAMA Pediatrics
https://www.readbyqxmd.com/read/29912084/ibuprofen-for-pain-control-in-children-new-value-for-an-old-molecule
#6
Dimitri Poddighe, Ilaria Brambilla, Amelia Licari, Gian Luigi Marseglia
BACKGROUND: Acute pain is one of the major complaints reported in pediatric emergency departments and general wards. Recently, both the US Food and Drug Administration and European Medicine Agency emitted some warnings regarding the use of opioids, including codeine, in children. OBJECTIVE: The aims of this study were summarizing the main pharmacological aspects of ibuprofen, discussing the current evidence about the use of ibuprofen in different and specific clinical settings, and providing a comparison with acetaminophen and/or codeine, according to available studies...
June 14, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29911684/insurance-companies-fighting-the-peer-review-empire-without-any-validity-the-case-for-addiction-and-pain-modalities-in-the-face-of-an-american-drug-epidemic
#7
K Blum, W Jacobs, E J Modestino, N DiNubile, D Baron, T McLaughlin, D Siwicki, I Elman, M Moran, E R Braverman, P K Thanos, R D Badgaiyan
The United States are amid an opioid overdose epidemic; we are challenged to provide non-addicting/non-pharmacological alternatives to assist in pain attenuation. There are proven strategies available to manage chronic pain effectively without opioids. Utilization review providers for insurance companies often ignore medicine based scientific peer-reviewed studies that warn against the chronic use of opioid medications, as well as the lack of evidence to support long-term use of opioids for pain. This paradigm must change if we are to indeed change the drug-embracing culture in American chronic pain management...
October 4, 2018: SEJ surgery and pain
https://www.readbyqxmd.com/read/29907456/state-of-the-art-analgesia-recent-developments-in-pharmacological-approaches-to-acute-pain-management-in-dogs-and-cats-part-1
#8
REVIEW
C A Bradbrook, L Clark
There has been considerable interest in acute pain management over recent years, focusing on pain assessment, pharmacological and non-pharmacological interventions. The evidence base for our clinical decision making and treatment of patients is increasing and becoming more robust. There is still a tendency to base some aspects of pain management on poor quality evidence and this requires further input in years to come. With new literature come new ideas and this review will detail the current knowledge base behind pharmacological management of acute pain in dogs and cats...
June 6, 2018: Veterinary Journal
https://www.readbyqxmd.com/read/29903752/what-place-is-there-for-tramadol-dexketoprofen
#9
(no author information available yet)
No single analgesic provides effective pain relief in all patients and increasing the dose of an analgesic may increase its unwanted effects.1 In addition, pain frequently results from multiple mechanisms that may respond to different pharmacological interventions.2 One suggested approach is to combine analgesics with different modes of action, with the aim of delivering better analgesia using lower doses of each drug.1 Skudexa (A. Menarini Farmaceutica Internazionale SRL), a combination of tramadol hydrochloride (a synthetic opioid analgesic that is a partial agonist at the μ, δ and κ opioid receptors) and dexketoprofen (a NSAID), is licensed for short term treatment of moderate to severe acute pain in adults...
June 2018: Drug and Therapeutics Bulletin
https://www.readbyqxmd.com/read/29894151/dark-classics-in-chemical-neuroscience-fentanyl
#10
S Mallory Burns, Christopher W Cunningham, Susan L Mercer
Fentanyl rose to prominence as an alternative analgesic to morphine nearly 50 years ago; today, fentanyl has re-emerged as a dangerous recreational substance. The increased potency and analgesic effect of fentanyl are advantageous in the treatment of pain but are also responsible for the rise in unintentional opioid overdose deaths. In response to this crisis, fentanyl, its analogues, and even precursors are under heightened regulatory scrutiny. Despite this controversial history, derivatization of fentanyl has resulted in numerous synthetic analogues that provide valuable insights into opioid receptor binding and signaling events...
June 12, 2018: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/29893624/developmental-disorders-and-medical-complications-among-infants-with-subclinical-intrauterine-opioid-exposures
#11
Eric S Hall, Jennifer M McAllister, Scott L Wexelblatt
The objective was to compare diagnosis rates representing developmental outcomes and medical complications between infants with intrauterine opioid exposures who did not receive pharmacologic treatment for neonatal abstinence syndrome at the time of birth and infants for whom no exposure to substances of abuse were detected. This retrospective, descriptive study included approximately 95% of Hamilton County, Ohio resident births in 2014 and 2015. Universal maternal drug test results, performed at the time of birth, were documented and linked to electronic health records representing pediatric primary and subspecialty follow-up care as well as urgent care, emergency care, and inpatient services provided by Cincinnati Children's Hospital Medical Center through 2017, when all children were at least 24 months old...
June 12, 2018: Population Health Management
https://www.readbyqxmd.com/read/29885638/low-dose-naltrexone-ldn-a-promising-treatment-in-immune-related-diseases-and-cancer-therapy
#12
Zijian Li, Yue You, Noreen Griffin, Juan Feng, Fengping Shan
Naltrexone, a non-selective antagonist of opioid receptors, is mainly used as rehabilitation therapy for discharged opiate addicts to eliminate addiction in order to maintain a normal life and prevent or reduce relapse. In recent years, there have been some novel and significant findings on the off-label usage of naltrexone. Within a specific dosage window, LDN can act as an immunomodulator in multiple autoimmune diseases and malignant tumors as well as alleviate the symptoms of some mental disorders. The results of increasing studies indicate that LDN exerts its immunoregulatory activity by binding to opioid receptors in or on immune cells and tumor cells...
June 6, 2018: International Immunopharmacology
https://www.readbyqxmd.com/read/29883731/a-voxel-based-analysis-of-neurobiological-mechanisms-in-placebo-analgesia-in-rats
#13
Ying Zeng, Di Hu, Wei Yang, Emi Hayashinaka, Yasuhiro Wada, Yasuyoshi Watanabe, Qunli Zeng, Yilong Cui
Placebo analgesia is the beneficial effect that follows despite a pharmacologically inert treatment. Modern neuroimaging studies in humans have delineated the hierarchical brain regions involved in placebo analgesia. However, because of the lack of proper approaches to perform molecular and cellular manipulations, the detailed molecular processes behind it have not been clarified. To address this issue, we developed an animal model of placebo analgesia in rats and analyzed the placebo analgesia related brain activity using small-animal neuroimaging method...
June 5, 2018: NeuroImage
https://www.readbyqxmd.com/read/29882358/pathophysiology-of-chronic-pain-in-cerebral-palsy-implications-for-pharmacological-treatment-and-research
#14
REVIEW
James A Blackman, Camilla I Svensson, Serge Marchand
The high prevalence of chronic pain in individuals with cerebral palsy (CP) across the lifespan has been well documented, as has its negative impact on quality of life. However, without an understanding of the underlying (possibly unique) pathophysiology of pain in CP, identification of more effective management options, such as innovative and individualized pharmacological approaches to non-opioid pain treatment, will be significantly hindered. We review, briefly, what is known about chronic pain in CP and present what we need to know with respect to the neurobiology of pain and new developments in pain treatment research that might be applied to CP...
June 7, 2018: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/29873472/advances-in-the-pharmacological-management-of-acute-and-chronic-pain
#15
Felicia Cox
Effective management of acute and chronic pain is an important aspect of nursing practice. Relieving patients' pain requires nurses to have an understanding of the latest evidence-based approaches, which will enable them to assess pain, implement appropriate management strategies and monitor their effectiveness. This article outlines the developments in evidence-based guidelines and recommendations for the pharmacological management of acute and chronic pain, including migraine, and in the use of analgesics such as opioids...
June 6, 2018: Nursing Standard
https://www.readbyqxmd.com/read/29871372/cooled-radiofrequency-neurotomy-of-the-articular-sensory-branches-of-the-obturator-and-femoral-nerves-combined-approach-using-fluoroscopy-and-ultrasound-guidance-technical-report-and-observational-study-on-safety-and-efficacy
#16
Leonardo Kapural, Suneil Jolly, Joao Mantoan, Harish Badhey, Ty Ptacek
BACKGROUND: Chronic hip joint pain is a common condition with an estimated prevalence of 7% in men and 10% in women, in a population sample aged over 45. Conservative treatment can include physical therapy, weight loss, a variety of pharmacologic agents ranging from nonsteroidal antiinflammatory drugs (NSAIDS) to opioids, and intraarticular injections with various substances. Definitive treatment of hip pain, however, has primarily centered on hip arthroplasty. OBJECTIVE: We describe a novel anterior approach to cooled radiofrequency (RF) hip denervation under combined ultrasound (US) and fluoroscopy guidance to avoid the neurovascular femoral bundle and reach proper landmarks...
May 2018: Pain Physician
https://www.readbyqxmd.com/read/29870574/parenteral-opioids-for-maternal-pain-management-in-labour
#17
REVIEW
Lesley A Smith, Ethel Burns, Anna Cuthbert
BACKGROUND: Parenteral opioids (intramuscular and intravenous drugs including patient-controlled analgesia) are used for pain relief in labour in many countries throughout the world. This review is an update of a review first published in 2010. OBJECTIVES: To assess the effectiveness, safety and acceptability to women of different types, doses and modes of administration of parenteral opioid analgesia in labour. A second objective is to assess the effects of opioids in labour on the baby in terms of safety, condition at birth and early feeding...
June 5, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29867498/the-somatostatin-receptor-4-agonist-j-2156-alleviates-mechanical-hypersensitivity-in-a-rat-model-of-breast-cancer-induced-bone-pain
#18
Priyank A Shenoy, Andy Kuo, Nemat Khan, Louise Gorham, Janet R Nicholson, Laura Corradini, Irina Vetter, Maree T Smith
In the majority of patients with breast cancer in the advanced stages, skeletal metastases are common, which may cause excruciating pain. Currently available drug treatments for relief of breast cancer-induced bone pain (BCIBP) include non-steroidal anti-inflammatory drugs and strong opioid analgesics along with inhibitors of osteoclast activity such as bisphosphonates and monoclonal antibodies such as denosumab. However, these medications often lack efficacy and/or they may produce serious dose-limiting side effects...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29864600/in-vitro-metabolism-of-desomorphine
#19
Jessica Winborn, Donovan Haines, Sarah Kerrigan
Desomorphine is reported to be the principal pharmacologically active opioid in Krokodil, a homemade injectable drug that is perceived to be a cheaper alternative to heroin. There have been limited studies regarding its pharmacology or detection in biological matrices. The goal of this study was to contribute further knowledge regarding its metabolism. Recombinant human cytochrome P450 enzymes (rCYPs) and recombinant uridine 5'-diphospho-glucuronosyltransferases (rUGTs) were used to investigate the biotransformational pathways involved...
May 18, 2018: Forensic Science International
https://www.readbyqxmd.com/read/29861097/a-model-of-%C3%AE-9-tetrahydrocannabinol-self-administration-and-reinstatement-that-alters-synaptic-plasticity-in-nucleus-accumbens
#20
Sade Spencer, Daniela Neuhofer, Vivian C Chioma, Constanza Garcia-Keller, Danielle J Schwartz, Nicholas Allen, Michael D Scofield, Tara Ortiz-Ithier, Peter W Kalivas
BACKGROUND: Cannabis is the most widely used illicit drug, but knowledge of the neurological consequences of cannabis use is deficient. Two primary components of cannabis are Δ9 -tetrahydrocannabinol (THC) and cannabidiol (CBD). We established a THC+CBD model of self-administration and reinstated drug seeking to determine if, similar to other addictive drugs, cannabis produces enduring synaptic changes in nucleus accumbens core (NAcore) thought to contribute vulnerability to drug reinstatement...
May 3, 2018: Biological Psychiatry
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