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Opioid dosing

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https://www.readbyqxmd.com/read/28453469/use-of-analgesics-opioids-and-nonsteroidal-anti-inflammatory-drugs-and-dementia-related-neuropathology-in-a-community-based-autopsy-cohort
#1
Sascha Dublin, Rod L Walker, Shelly L Gray, Rebecca A Hubbard, Melissa L Anderson, Onchee Yu, Thomas J Montine, Paul K Crane, Josh A Sonnen, Eric B Larson
BACKGROUND: Opioids may influence the development of Alzheimer's disease (AD). Some studies have observed AD pathology in the brains of opioid abusers. No study has examined the association between prescription opioid use and dementia-related neuropathologic changes. OBJECTIVE: To examine the relationship between prescription opioid or NSAID use and dementia-related neuropathologic changes. METHODS: Within a community-based autopsy cohort (N = 420), we ascertained opioid and nonsteroidal anti-inflammatory drug (NSAID) use over a 10-year period from automated pharmacy data and calculated total standardized daily doses (TSDDs)...
April 25, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28448772/the-effect-of-a-federal-controlled-substance-act-schedule-change-on-hydrocodone-combination-products-claims-in-a-medicaid-population
#2
Stephanie Tran, Pavel Lavitas, Karen Stevens, Bonnie C Greenwood, Karen Clements, Caroline J Alper, Kimberly Lenz, Mylissa Price, Tasmina Hydery, Jennifer L Arnold, Mito Takeshita, Rachel Bacon, Justin P Peristere, Paul L Jeffrey
BACKGROUND: In 2012, hydrocodone combination products (HCPs) were the most prescribed medications in the United States. Under the Controlled Substance Act of 1970, hydrocodone alone was classified as a Schedule II drug, while HCPs were classified as Schedule III, indicating a lower risk for abuse and misuse. However, according to a Drug Enforcement Agency analysis, the addition of nonopioids has not been shown to diminish abuse potential of hydrocodone. In response to concerns for drug abuse and overdose, the Drug Enforcement Agency rescheduled HCPs to Schedule II in October 2014, with the intent of limiting overprescribing and increasing awareness of their abuse potential...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28448397/prophylactic-pentazocine-reduces-the-incidence-of-pruritus-after-cesarean-delivery-under-spinal-anesthesia-with-opioids-a-prospective-randomized-clinical-trial
#3
Masato Hirabayashi, Katsushi Doi, Noritaka Imamachi, Tomomune Kishimoto, Yoji Saito
BACKGROUND: The incidence of pruritus after cesarean delivery under spinal anesthesia with opioids is high, ranging from 50% to 100%. Pruritus is difficult to prevent; however, pentazocine has been shown to be an effective treatment. Despite this, the prophylactic effect of pentazocine on pruritus has not been defined. This randomized double-blind trial aimed to evaluate the effect of intraoperative IV pentazocine on the incidence of opioid-induced pruritus within the first 24 hours after administration of neuraxial opioids...
April 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28447766/supervised-dosing-with-a-long-acting-opioid-medication-in-the-management-of-opioid-dependence
#4
REVIEW
Rosella Saulle, Simona Vecchi, Linda Gowing
BACKGROUND: Opioid dependence (OD) is an increasing clinical and public health problem worldwide. International guidelines recommend opioid substitution treatment (OST), such as methadone and buprenorphine, as first-line medication treatment for OD. A negative aspect of OST is that the medication used can be diverted both through sale on the black market, and the unsanctioned use of medications. Daily supervised administration of medications used in OST has the advantage of reducing the risk of diversion, and may promote therapeutic engagement, potentially enhancing the psychosocial aspect of OST, but costs more and is more restrictive on the client than dispensing for off-site consumption...
April 27, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28446883/in-vitro-and-in-vivo-profile-of-ppl-101-and-ppl-103-mixed-opioid-partial-agonist-analgesics-with-low-abuse-potential
#5
Taline V Khroyan, Andrea Cippitelli, Nicholas Toll, John A Lawson, William Crossman, Willma E Polgar, Lawrence Toll
Opiates are still the most effective and widely used treatments for acute and chronic pain. However, the problems associated with morphine and other standard opioid analgesics severely limit their effectiveness in the clinic. PPL-101 and PPL-103 derived from morphine and morphinan ring systems contain a chiral N-substituent, which confers it with a unique combination of high-binding affinities and partial agonist activities at mu, delta, and kappa opioid receptors, leading to unique in vivo pharmacology compared to other conventional opioids...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28446134/assessment-of-perioperative-minute-ventilation-in-obese-versus-non-obese-patients-with-a-non-invasive-respiratory-volume-monitor
#6
Jaideep H Mehta, Davide Cattano, Jordan B Brayanov, Edward E George
BACKGROUND: Monitoring the adequacy of spontaneous breathing is a major patient safety concern in the post-operative setting. Monitoring is particularly important for obese patients, who are at a higher risk for post-surgical respiratory complications and often have increased metabolic demand due to excess weight. Here we used a novel, noninvasive Respiratory Volume Monitor (RVM) to monitor ventilation in both obese and non-obese orthopedic patients throughout their perioperative course, in order to develop better monitoring strategies...
April 26, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28445097/phase-iib-randomized-double-blind-placebo-controlled-study-of-naldemedine-for-the-treatment-of-opioid-induced-constipation-in-patients-with-cancer
#7
Nobuyuki Katakami, Koji Oda, Katsunori Tauchi, Ken Nakata, Katsunori Shinozaki, Takaaki Yokota, Yura Suzuki, Masaru Narabayashi, Narikazu Boku
Purpose This randomized, double-blind, multicenter study aimed to determine the dose of naldemedine, a peripherally-acting μ-opioid receptor antagonist, for future trials by comparing the efficacy and safety of three doses of naldemedine versus placebo in patients with cancer and opioid-induced constipation. Methods Patients ≥ 18 years old with cancer, an Eastern Cooperative Oncology Group performance status ≤ 2, who had been receiving a stable regimen of opioid analgesics for ≥ 2 weeks, had at least one constipation symptom despite laxative use, and no more than five spontaneous bowel movements (SBMs) during the past 14 days, were randomly assigned (1:1:1:1) to oral, once-daily naldemedine 0...
April 26, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28444856/pharmacokinetics-after-a-single-dose-of-naloxone-administered-as-a-nasal-spray-in-healthy-volunteers
#8
E Vanky, L Hellmundt, U Bondesson, S Eksborg, S Lundeberg
BACKGROUND: There is increasing interest in the use of intranasal naloxone to reverse adverse opioid effects during management of procedural pain in children and in adults after overdose. There are limited data on the pharmacokinetics of intranasal naloxone so in this study we aimed to detail the pharmacokinetic profile of the commercially marketed injectable solution of naloxone 0.4 mg/ml when administered as an intranasal spray. METHODS: Twenty healthy volunteers received naloxone as an intranasal spray at a dose of 10 μg/kg...
April 25, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28442955/no-preemptive-analgesic-effect-of-preoperative-ketorolac-administration-following-total-abdominal-hysterectomy-a-randomized-study
#9
Beatriz Nistal-Nuño
BACKGROUND: Experimental models using short-duration noxious stimuli have led to the concept of preemptive analgesia. Ketorolac, a nonsteroidal anti-inflammatory drug, has been shown to have a postoperative narcotic-sparing effect when given preoperatively and alternatively to not have this effect. This study was undertaken to determine whether a single intravenous (IV) dose of ketorolac would result in decreased postoperative pain and narcotic requirements. METHODS: In a double-blind, randomized controlled trial, 48 women undergoing abdominal hysterectomy were studied...
April 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28442581/sigma-receptor-effects-of-n-substituted-benztropine-analogs-implications-for-antagonism-of-cocaine-self-administration
#10
Takato Hiranita, Weimin C Hong, Theresa Kopajtic, Jonathan L Katz
Several N-substituted benztropine (BZT) analogs are atypical dopamine transport inhibitors as they have affinity for the dopamine transporter (DAT), but have minimal cocaine-like pharmacological effects and can block numerous effects of cocaine including its self-administration. Among these compounds, N-methyl (AHN1-055), N-allyl (AHN2-005), and N-butyl (JHW007) analogs of 3α-[bis(4'-fluorophenyl)methoxy]-tropane were more potent in antagonizing self-administration of cocaine and d-methamphetamine than in decreasing food-maintained responding...
April 25, 2017: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/28442580/ethanol-reversal-of-tolerance-to-the-antinociceptive-effects-of-oxycodone-and-hydrocodone
#11
Joanna C Jacob, Justin L Poklis, Hamid I Akbarali, Graeme Henderson, William L Dewey
This study compared the development of tolerance and its reversal by ethanol of two orally-bioavailable prescription opioids, oxycodone and hydrocodone, to that of morphine. Oxycodone (s.c) was significantly more potent in the mouse tail withdrawal assay than either morphine or hydrocodone. Oxycodone was also significantly more potent in this assay than hydrocodone when administered orally. Tolerance was seen following chronic subcutaneous administration of each of the three drugs and by the chronic administration of oral oxycodone, but not following the chronic oral administration of hydrocodone...
April 25, 2017: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/28441707/fentanyl-inhibits-tumorigenesis-from-human-breast-stem-cells-by-inducing-apoptosis
#12
Nadir Kocak, Filiz Ozen, Ibrahim Halil Yildirim, Yagmur Duran
Fentanyl is an opioid analgesic that it is widely used in cancer patients. Since there have been reports of effects of analgesic medications on the recurrence and development of resistance to treatment, influences of of fentanyl on MCF-7 and HEK293 cells were evaluated. Cell viability and apoptosis were assessed by MTT assay and flow cytometry, respectively. Gene expression analysis was performed by quantitative real-time PCR assay for the Oct4, Sox2 and Nanog genes as stem cell markers and Bax, Bcl2, and p53 genes as apoptosis markers...
March 1, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/28438777/preference-for-an-opioid-benzodiazepine-mixture-over-an-opioid-alone-using-a-concurrent-choice-procedure-in-rhesus-monkeys
#13
Peter F Weed, Charles P France, Lisa R Gerak
Increased opioid abuse is contributing to a dramatic rise in overdose deaths. Benzodiazepines are frequently coabused with opioids, possibly because they increase the potency and/or effectiveness of opioids. This study used a concurrent choice procedure to determine whether monkeys would choose to self-administer a mixture of the opioid remifentanil and the benzodiazepine midazolam over remifentanil alone. Initially, three monkeys could respond on one lever for saline and on a second lever for either remifentanil alone or midazolam alone...
April 24, 2017: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/28435667/neuraxial-opioids-as-analgesia-in-labour-and-postoperative-after-caesarean-section-and-hysterectomy-a-questionnaire-survey-in-sweden
#14
Anette Hein, Caroline Gillis-Haegerstrand, Jan G Jakobsson
Background: Neuraxial opioids improve labour analgesia and analgesia after caesarean section (CS) and hysterectomy. Undesirable side effects and difficulties in arranging postoperative monitoring might influence the use of these opioids. The aim of the present survey was to assess the use of intrathecal and epidural morphine in gynaecology and obstetrics in Sweden. Methods: A questionnaire was sent to 47 anaesthesiologists at obstetric units in Sweden concerning the use and postoperative monitoring of morphine, sufentanil and fentanyl in spinal/epidural anaesthesia...
2017: F1000Research
https://www.readbyqxmd.com/read/28435316/subanesthetic-ketamine-for-pain-management-in-hospitalized-children-adolescents-and-young-adults-a-single-center-cohort-study
#15
Kathy A Sheehy, Caroline Lippold, Amy L Rice, Raissa Nobrega, Julia C Finkel, Zenaide Mn Quezado
BACKGROUND: Subanesthetic doses of ketamine, an N-methyl-d-aspartate receptor antagonist used as an adjuvant to opioid for the treatment of pain in adults with acute and chronic pain, have been shown, in some instances, to improve pain intensity and to decrease opioid intake. However, less is known about the role of ketamine in pain management in children, adolescents, and young adults. PURPOSE: We examined the effects of subanesthetic ketamine on pain intensity and opioid intake in children, adolescents, and young adults with acute and chronic pain syndromes treated in an inpatient setting...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28434097/impact-of-a-complementary-integrative-medicine-program-on-the-need-for-supportive-cancer-care-related-medications
#16
Ilanit Shalom-Sharabi, Noah Samuels, Efraim Lev, Ofer Lavie, Lital Keinan-Boker, Elad Schiff, Eran Ben-Arye
OBJECTIVE: Despite the growing evidence supporting the use of complementary/integrative medicine (CIM) in the treatment of chemotherapy-induced toxicities, little is known on CIM impact of these therapies regarding the use of medications for supportive cancer care. In this study, we examined the impact of CIM on the need for supportive cancer care-related medications. PATIENTS AND METHODS: Patients with breast or gynecological cancer referred to and attending an integrative physician (IP) consultation for gastrointestinal (GI) concerns were designated as the treatment group; those not attending as controls...
April 22, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28430384/pharmacokinetics-of-concentrated-naloxone-nasal-spray-over-first-30%C3%A2-minutes-post-dosing-analysis-of-suitability-for-opioid-overdose-reversal
#17
Gill Mundin, Rebecca McDonald, Kevin Smith, Stephen Harris, John Strang
BACKGROUND AND AIMS: Lack of non-injectable naloxone formulations has impeded widespread take-home provision for the prevention of heroin/opioid overdose deaths. For non-injectable formulations that are finally being investigated, rapid onset of action and sufficient bioavailability will be vital. We present analysis of data from a study of concentrated naloxone nasal spray formulations. Our aims are: to assess 1) pharmacokinetic properties and 2) suitability for overdose reversal in terms of naloxone absorption within 30 minutes post-dosing...
April 21, 2017: Addiction
https://www.readbyqxmd.com/read/28430016/the-use-of-intravenous-lidocaine-for-the-management-of-acute-pain-secondary-to-traumatic-ankle-injury
#18
Billy Sin, Diana Gritsenko, Grace Tam, Kimberly Koop, Eva Mok
Sports-related injuries are a frequent cause of visits to the emergency department (ED) across the United States. A majority of these injuries affect the lower extremities with the ankle as the most frequently reported site. Most sports-related injuries are not severe enough to require inpatient hospitalization; however, they often lead to acute distress and pain which require prompt treatment with analgesics. Approximately 22% of patients who presented to the ED required pharmacotherapy for acute pain management...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28429337/from-acute-to-chronic-pain-tapentadol-in-the-progressive-stages-of-this-disease-entity
#19
F Coluzzi, D Fornasari, J Pergolizzi, P Romualdi
OBJECTIVE: Chronic pain is now recognized as a neural disease, which results from a maladaptive functional and structural transformation process occurring over time. In its chronic phase, pain is not just a symptom but also a disease entity. Therefore, pain must be properly addressed, as many patients still report unsatisfactory pain control despite on-going treatment. The selection of the therapy - taking into account the pathophysiological mechanisms of pain - and the right timing can result in a successful analgesic outcome...
April 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28429311/improving-animal-welfare-using-continuous-nalbuphine-infusion-in-a-long-term-rat-model-of-sepsis
#20
Victor Jeger, Mattia Arrigo, Florian F Hildenbrand, Daniel Müller, Paulin Jirkof, Till Hauffe, Burkhardt Seifert, Margarete Arras, Donat R Spahn, Dominique Bettex, Alain Rudiger
BACKGROUND: Sepsis research relies on animal models to investigate the mechanisms of the dysregulated host response to infection. Animal welfare concerns request the use of potent analgesics for the Refinement of existing sepsis models, according to the 3Rs principle. Nevertheless, adequate analgesia is often missing, partly because the effects of analgesics in this particular condition are unknown. We evaluated the use of nalbuphine, an opioid with kappa agonistic and mu antagonistic effects, in rats with and without experimental sepsis...
December 2017: Intensive Care Medicine Experimental
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