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Opioid dosing

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https://www.readbyqxmd.com/read/28092666/loss-of-%C3%AE-opioid-receptor-signaling-in-nociceptors-but-not-microglia-abrogates-morphine-tolerance-without-disrupting-analgesia
#1
Gregory Corder, Vivianne L Tawfik, Dong Wang, Elizabeth I Sypek, Sarah A Low, Jasmine R Dickinson, Chaudy Sotoudeh, J David Clark, Ben A Barres, Christopher J Bohlen, Grégory Scherrer
Opioid pain medications have detrimental side effects including analgesic tolerance and opioid-induced hyperalgesia (OIH). Tolerance and OIH counteract opioid analgesia and drive dose escalation. The cell types and receptors on which opioids act to initiate these maladaptive processes remain disputed, which has prevented the development of therapies to maximize and sustain opioid analgesic efficacy. We found that μ opioid receptors (MORs) expressed by primary afferent nociceptors initiate tolerance and OIH development...
January 16, 2017: Nature Medicine
https://www.readbyqxmd.com/read/28092649/new-onset-depression-following-stable-slow-and-rapid-rate-of-prescription-opioid-dose-escalation
#2
Joanne Salas, Jeffrey F Scherrer, Frank David Schneider, Mark D Sullivan, Kathleen K Bucholz, Thomas Burroughs, Laurel A Copeland, Brian K Ahmedani, Patrick J Lustman
Recent studies suggest that longer durations of opioid use, independent of maximum morphine equivalent dose (MED) achieved, is associated with increased risk of new-onset depression (NOD). Conversely, other studies, not accounting for duration, found that higher MED increased probability of depressive symptoms. To determine whether rate of MED increase is associated with NOD, a retrospective cohort analysis of Veterans Health Administration data (2000-2012) was conducted. Eligible patients were new, chronic (>90 days) opioid users, aged 18 to 80, and without depression diagnoses for 2 years before start of follow-up (n = 7051)...
February 2017: Pain
https://www.readbyqxmd.com/read/28091830/physio-pharmacological-investigations-about-the-anti-inflammatory-and-antinociceptive-efficacy-of-limonene-epoxide
#3
Antonia Amanda Cardoso de Almeida, Renan Oliveira Silva, Lucas Antonio Duarte Nicolau, Tarcísio Vieira de Brito, Damião Pergentino de Sousa, André Luiz Dos Reis Barbosa, Rivelilson Mendes de Freitas, Luciano da Silva Lopes, Jand-Venes Rolim Medeiros, Paulo Michel Pinheiro Ferreira
D-limonene epoxidation generates (+)-limonene epoxide, an understudied compound in the pharmacologically point of view. Herein, we investigated the anti-inflammatory and antinociceptive potentialities of (+)-limonene epoxide and suggested a mechanism of action. The anti-inflammatory potential was analyzed using agents to induce paw edema, permeability, and myeloperoxidase (MPO) activity. Pro-inflammatory cytokines and cell migration of peritoneal cells were also assessed. Antinociceptive effects were evaluated by writhing test induced by acetic acid, formalin, and hot plate assays and contribution of opioid pathways...
January 16, 2017: Inflammation
https://www.readbyqxmd.com/read/28089918/cardiovascular-and-respiratory-activity-of-pk20-opioid-and-neurotensin-hybrid-peptide-in-anesthetized-and-awake-rats
#4
Katarzyna Kaczyńska, Piotr Wojciechowski, Monika Jampolska, Andrzej W Lipkowski, Patrycja Kleczkowska
AIM: Chimeric compound - PK20 despite its therapeutic activity on nociceptive and inflammatory processes may affect respiration and blood pressure. Our objective was to evaluate influence of the hybrid composed of endomorphin-2 and neurotensin fragments on ventilation, heart rate and blood pressure in anesthetized and awake rats. METHODS: The effects of PK20 (1mg/kg) were studied either after its intravenous administration in anesthetized rats or intraperitoneal injection in awake state...
January 12, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28089852/dopamine-d1-receptor-agonist-treatment-attenuates-extinction-of-morphine-conditioned-place-preference-while-increasing-dendritic-complexity-in-the-nucleus-accumbens-core
#5
Kendra L Kobrin, Danielle T Arena, Stephen C Heinrichs, Olivia H Nguyen, Gary B Kaplan
The dopamine D1 receptor (D1R) has a role in opioid reward and conditioned place preference (CPP), but its role in CPP extinction is undetermined. We examined the effect of D1R agonist SKF81297 on the extinction of opioid CPP and associated dendritic morphology in the nucleus accumbens (NAc), a region involved with reward integration and its extinction. During the acquisition of morphine CPP, mice received morphine and saline on alternate days; injections were given immediately before each of eight daily conditioning sessions...
January 12, 2017: Behavioural Brain Research
https://www.readbyqxmd.com/read/28089187/effect-of-periarticular-morphine-injection-for-total-knee-arthroplasty-a-randomized-double-blind-trial
#6
Kentaro Iwakiri, Yoshito Minami, Yoichi Ohta, Akio Kobayashi
BACKGROUND: The periarticular multimodal cocktail injection including morphine is currently commonly used to treat postoperative pain after total knee arthroplasty (TKA). Despite its analgesic effect, it is frequently reported to cause nausea and vomiting, which are adverse effects of opioids. This study aimed to assess the efficacy of morphine as a component of a multimodal cocktail injection for providing postoperative analgesia and alleviating swelling in patients who underwent TKA...
December 27, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28088507/patient-reported-outcomes-and-opioid-use-in-outpatients-with-chronic-pain
#7
Lisa R Witkin, David Zylberger, Neel Mehta, Madeleine Hindenlang, Christopher Johnson, Jacob Kean, Susan D Horn, Charles E Inturrisi
: The Weill Cornell Medical College (WCMC) Pain Registry database contains patient characteristics, treatments, and outcomes for a prospective cohort of 1159 chronic pain patients who were seen at the WCMC Pain Medicine outpatient clinic from 7/08/2011 to 12/10/2014. Patients aged 45-64 comprised 43% followed by age >=65 at 37%. Fifty-eight percent were female. Average pain intensity (Brief Pain Inventory) was reported as mild by 22.3% of patients, moderate by 34.7%, and severe by 43...
January 11, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28087496/digital-pills-to-measure-opioid-ingestion-patterns-in-emergency-department-patients-with-acute-fracture-pain-a-pilot-study
#8
Peter R Chai, Stephanie Carreiro, Brendan J Innes, Rochelle K Rosen, Conall O'Cleirigh, Kenneth H Mayer, Edward W Boyer
BACKGROUND: Nonadherence to prescribed regimens for opioid analgesic agents contributes to increasing opioid abuse and overdose death. Opioids are frequently prescribed on an as-needed basis, placing the responsibility to determine opioid dose and frequency with the patient. There is wide variability in physician prescribing patterns because of the lack of data describing how patients actually use as-needed opioid analgesics. Digital pill systems have a radiofrequency emitter that directly measures medication ingestion events, and they provide an opportunity to discover the dose, timing, and duration of opioid therapy...
January 13, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28086944/prenatal-treatment-for-opioid-dependency-observations-from-a-large-inner-city-clinic
#9
Kelley Saia, Sarah M Bagley, Elisha M Wachman, Payal P Patel, Marisa D Nadas, Susan B Brogly
BACKGROUND: The objective of this study was to review changes in the prevalence of opioid use disorder in pregnancy, and to describe the prenatal care and neonatal outcomes following the implementation of buprenorphine treatment at a large US obstetrical clinic during the on-going opioid epidemic. METHODS: We conducted a retrospective cohort study of 310 women (332 pregnancies) with opioid use disorders and their neonates delivered between June 2006 and December 2010 at an obstetrical clinic in the US...
January 13, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/28080917/results-of-the-megaverebrate-analgesia-survey-giraffe-and-hippopotamus
#10
Matthew Boothe, Jack Kottwitz, Roy Harmon, Scott B Citino, Jeffery R Zuba, Dawn M Boothe
Results of an online survey posted on the American Association of Zoo Veterinarians listserv examined the patterns of analgesic medication and pain management modalities used for captive giraffe and hippopotami. Compiled data included signalment, drugs administered, dosing regimens, subjective efficacy scores, ease of administration, and adverse events. Nineteen institutions exhibiting hippopotami ( Hippopotamus amphibious ) and pygmy hippopotami (Choeropsis liberiensis) and 45 exhibiting giraffe ( Giraffa camelopardalis spp...
December 2016: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/28078167/a-novel-strategy-for-attenuating-opioid-withdrawal-in-neonates
#11
Giovanni C Santoro, Samarth Shukla, Krishna Patel, Jakub Kaczmarzyk, Stergiani Agorastos, Sandra Scherrer, Yoon Young Choi, Christina Veith, Joseph Carrion, Rebecca Silverman, Danielle Mullin, Mohamed Ahmed, Wynne K Schiffer, Jonathan D Brodie, Stephen L Dewey
The rate of Neonatal Abstinence Syndrome (NAS) has drastically increased over the past decade. The average hospital expense per NAS patient has tripled, while the number of babies born to opioid-dependent mothers has increased to 5 in 1000 births. Current treatment options are limited to opioid replacement and tapering. Consequently, we examined the efficacy of prenatal, low-dose and short-term vigabatrin (γ-vinyl GABA, GVG) exposure for attenuating these symptoms as well as the metabolic changes observed in the brains of these animals upon reaching adolescence...
August 2016: Journal of Addiction Research & Therapy
https://www.readbyqxmd.com/read/28075433/effects-of-morphine-butorphanol-and-levomethadone-in-different-doses-on-thermal-nociceptive-thresholds-in-horses
#12
Paula Dönselmann Im Sande, Klaus Hopster, Sabine Kästner
OBJECTIVE: Various opioids are available for use in equine medicine. Studies directly comparing their analgesic effects and side effects are rare. Therefore, the aim of this study was to compare the antinociceptive effect and the duration of analgesia of two different doses of morphine, butorphanol and levomethadone in horses. MATERIAL AND METHODS: Eight adult, healthy horses were used for this randomized, placebo-controlled, blinded cross-over trail. Each horse received placebo (P = 0...
January 11, 2017: Tierärztliche Praxis. Ausgabe G, Grosstiere/Nutztiere
https://www.readbyqxmd.com/read/28073687/adverse-event-detection-using-the-fda-post-marketing-drug-safety-surveillance-system-cardiotoxicity-associated-with-loperamide-abuse-and-misuse
#13
Kimberley A Swank, Eileen Wu, Cindy Kortepeter, Jana McAninch, Robert L Levin
OBJECTIVE: The purpose of this investigation was to identify and characterize post-marketing reports of cardiotoxicity, including torsades de pointes (TdP), associated with loperamide use. METHODS: We searched the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) database for post-marketing reports of serious cardiac adverse events associated with loperamide use from December 28, 1976 (U.S. drug approval date), through December 14, 2015. We also conducted a Pubmed and Google Scholar search to identify additional published reports of cardiotoxicity associated with loperamide in the medical literature through February 11, 2016...
January 7, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28072811/evaluation-of-the-ototoxicity-potential-of-once-daily-single-entity-hydrocodone-in-patients-with-chronic-pain-results-of-two-phase-3-clinical-studies
#14
Kathleen Campbell, J Walter Kutz, Angela Shoup, Warren Wen, Shau Yu Lynch, Ellie He, Steven R Ripa
BACKGROUND: Use/misuse of the opioid combination hydrocodone-acetaminophen has been associated with permanent hearing loss. Although reports have been rare, this potential effect can have significant detrimental effect on patients' overall quality of life. To date, the ototoxic effect of hydrocodone alone has not been systematically investigated. OBJECTIVE: In this report, we aimed to evaluate the potential ototoxicity of a novel, single-entity, once-daily, extended-release hydrocodone tablet (Hysingla® ER; HYD)...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28070862/pharmacokinetic-evaluation-of-once-weekly-and-once-monthly-buprenorphine-subcutaneous-injection-depots-cam2038-versus-intravenous-and-sublingual-buprenorphine-in-healthy-volunteers-under-naltrexone-blockade-an-open-label-phase-1-study
#15
Muna Albayaty, Margareta Linden, Håkan Olsson, Markus Johnsson, Kerstin Strandgården, Fredrik Tiberg
INTRODUCTION: CAM2038 q1w (once weekly) and q4w (once monthly) are investigational buprenorphine subcutaneous (SC) formulations based on FluidCrystal(®) injection depot technology. These two drug products are being developed for opioid dependence treatment, with a target for once-weekly and once-monthly SC dosing. The rationale for developing two products with different dosing frequencies is that treatment strategies/routines, and hence different treatment preferences, can vary between patients, different stages of opioid maintenance treatment, and countries...
January 9, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28068780/long-acting-injectable-naltrexone-induction-a-randomized-trial-of-outpatient-opioid-detoxification-with-naltrexone-versus-buprenorphine
#16
Maria Sullivan, Adam Bisaga, Martina Pavlicova, C Jean Choi, Kaitlyn Mishlen, Kenneth M Carpenter, Frances R Levin, Elias Dakwar, John J Mariani, Edward V Nunes
OBJECTIVE: At present there is no established optimal approach for transitioning opioid-dependent adults to extended-release injection naltrexone (XR-naltrexone) while preventing relapse. The authors conducted a trial examining the efficacy of two methods of outpatient opioid detoxification for induction to XR-naltrexone. METHOD: Participants were 150 opioid-dependent adults randomly assigned 2:1 to one of two outpatient detoxification regimens, naltrexone-assisted detoxification or buprenorphine-assisted detoxification, followed by an injection of XR-naltrexone...
January 10, 2017: American Journal of Psychiatry
https://www.readbyqxmd.com/read/28063863/correlation-between-observational-scales-of-sedation-and-comfort-and-bispectral-index-scores-bis
#17
Michael Barbato, Greg Barclay, Jan Potter, Wilf Yeo, Joseph Chung
CONTEXT: When palliative care patients enter the phase of unconsciousness preceding death it is standard practice to initiate or continue a subcutaneous infusion of an opioid plus or minus a sedative. The doses are determined somewhat empirically and adjustments are based on clinical assessment and observational measures of sedation and comfort. Following reports that these observational measures could be misleading, this study assesses their validity by comparing them with an objective measure of sedation, the Bispectral Index score (BIS)...
January 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28063353/rationally-designed-benzopyran-fused-isoxazolidines-and-derived-%C3%AE-2-3-3-amino-alcohols-as-potent-analgesics-synthesis-biological-evaluation-and-molecular-docking-analysis
#18
Gagandeep Singh, Gurjit Singh, Rajbir Bhatti, Vivek Gupta, Ajay Mahajan, Palwinder Singh, Mohan Paul Singh Ishar
Based on structure activity analysis of morphine related opiates, we have synthesized some novel benzopyran fused isoxazolidines (2a-e) and derived conformationally constrained β(2,3,3)-amino alcohols (3a-e), which were evaluated in vivo for their anti-nociceptive activity through acetic acid induced writhing test (peripheral) and formalin induced algesia (central). Results showed that, compound 2a possesses significant opioid agonist activity. Further, molecular docking analysis reveals that compound 2a binds to δ-opioid receptor (DOR) with comparatively better D-score than to μ (MOR) and κ (KOR) receptors...
December 28, 2016: European Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28062251/opioid-suppression-of-conditioned-anticipatory-brain-responses-to-breathlessness
#19
Anja Hayen, Vishvarani Wanigasekera, Olivia K Faull, Stewart F Campbell, Payashi S Garry, Simon J M Raby, Josephine Robertson, Ruth Webster, Richard G Wise, Mari Herigstad, Kyle T S Pattinson
Opioid painkillers are a promising treatment for chronic breathlessness, but are associated with potentially fatal side effects. In the treatment of breathlessness, their mechanisms of action are unclear. A better understanding might help to identify safer alternatives. Learned associations between previously neutral stimuli (e.g. stairs) and repeated breathlessness induce an anticipatory threat response that may worsen breathlessness, contributing to the downward spiral of decline seen in clinical populations...
January 3, 2017: NeuroImage
https://www.readbyqxmd.com/read/28061485/comparison-of-the-effects-of-sufentanil-and-fentanyl-intravenous-patient-controlled-analgesia-after-lumbar-fusion
#20
Do Keun Kim, Seung Hwan Yoon, Ji Yong Kim, Chang Hyun Oh, Jong Kwon Jung, Jin Kim
OBJECTIVE: Postoperative pain is one of the major complaints of patients after lumbar fusion surgery. The authors evaluated the effects of intravenous patient controlled analgesia (IV-PCA) using fentanyl or sufentanil on postoperative pain management and pain-related complications. METHODS: Forty-two patients that had undergone surgery with lumbar instrumentation and fusion at single or double levels constituted the study cohort. Patients were equally and randomly allocated to a sufentanil group (group S) or a fentanyl group (group F) for patient controlled analgesia (PCA)...
January 1, 2017: Journal of Korean Neurosurgical Society
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