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Opioid dose ranges

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https://www.readbyqxmd.com/read/28542675/analgesic-effects-of-intravenous-acetaminophen-vs-placebo-for-endoscopic-sinus-surgery-and-postoperative-pain-a-randomized-clinical-trial
#1
Matthew A Tyler, Kent Lam, Faramarz Ashoori, Chunyan Cai, Joshua J Kain, Samer Fakhri, Martin J Citardi, Davide Cattano, Amber Luong
Importance: Intravenous acetaminophen is a commonly prescribed analgesic for the prevention and treatment of postsurgical pain. Its efficacy in the context of endoscopic sinus surgery (ESS) has yielded mixed results. Objective: To compare the efficacy of perioperative intravenous acetaminophen (IVAPAP) with that of placebo in improving early postoperative pain after endoscopic sinus surgery (ESS). Design, Setting, and Participants: A prospective, randomized clinical trial including 62 patients undergoing ESS for chronic rhinosinusitis in a single tertiary referral hospital...
May 25, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28516342/pharmacokinetic-bioequivalence-studies-of-an-extended-release-oxycodone-hydrochloride-tablet-in-healthy-japanese-subjects-under-fasting-and-fed-conditions-without-an-opioid-antagonist
#2
Kaoru Toyama, Hidetoshi Furuie, Kana Kuroda, Hitoshi Ishizuka
Oxycodone is a semisynthetic opioid used for the treatment of moderate to severe pain. Two separate studies were conducted to assess the pharmacokinetic bioequivalence of a newly formulated oxycodone hydrochloride extended-release tablet to a marketed oxycodone product in Japan under fasting and fed conditions. Each study was a randomized, open-label, single-dose, single-center, two-period, two-way crossover study. Healthy male Japanese subjects received the oxycodone 10-mg products under fasting and fed conditions...
May 17, 2017: Drugs in R&D
https://www.readbyqxmd.com/read/28514508/methadone-for-neuropathic-pain-in-adults
#3
REVIEW
Ewan D McNicol, McKenzie C Ferguson, Roman Schumann
BACKGROUND: This review replaces an earlier review, "Methadone for chronic non-cancer pain in adults". This review serves to update the original and includes only studies of neuropathic pain. Methadone belongs to a class of analgesics known as opioids, that are considered the cornerstone of therapy for moderate-to-severe postsurgical pain and pain due to life-threatening illnesses; however, their use in neuropathic pain is controversial. Methadone has many characteristics that differentiate it from other opioids, which suggests that it may have a different efficacy and safety profile...
May 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28510996/tramadol-with-or-without-paracetamol-acetaminophen-for-cancer-pain
#4
REVIEW
Philip J Wiffen, Sheena Derry, R Andrew Moore
BACKGROUND: Tramadol is an opioid analgesic licensed for use in moderate to severe pain. It is considered as a low risk for abuse, so control regulations are not as stringent as for 'strong' opioids such as morphine. It has a potential role as a step 2 option of the World Health Organization (WHO) analgesic ladder. OBJECTIVES: To assess the benefits and adverse effects of tramadol with or without paracetamol (acetaminophen) for cancer-related pain. SEARCH METHODS: We searched the following databases using a wide range of search terms: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and LILACS...
May 16, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28502631/a-brain-targeted-ampakine-compound-protects-against-opioid-induced-respiratory-depression
#5
Wei Dai, Dian Xiao, Xiang Gao, Xin-Bo Zhou, Tong-Yu Fang, Zheng Yong, Rui-Bin Su
The use of opioid drugs for pain relief can induce life-threatening respiratory depression. Although naloxone effectively counteracts opioid-induced respiratory depression, it diminishes the efficacy of analgesia. Our studies indicate that ampakines, in particular, a brain-targeted compound XD-8-17C, are able to reverse respiratory depression without affecting analgesia at relatively low doses. Mice and rats were subcutaneously or intravenously injected with the opioid agonist TH-030418 to induce moderate or severe respiratory depression...
May 11, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28489639/evaluation-of-analgesia-tolerance-and-the-mechanism-of-action-of-morphine-6-o-sulfate-across-multiple-pain-modalities-in-sprague-dawley-rats
#6
Jai Shankar K Yadlapalli, Navdeep Dogra, Anqi W Walbaum, William D Wessinger, Paul L Prather, Peter A Crooks, Maxim Dobretsov
BACKGROUND: Morphine-6-O-sulfate (M6S) is a mixed μ/δ-opioid receptor (OR) agonist and potential alternative to morphine for treatment of chronic multimodal pain. METHODS: To provide more support for this hypothesis, the antinociceptive effects of M6S and morphine were compared in tests that access a range of pain modalities, including hot plate threshold (HPT), pinprick sensitivity threshold (PST) and paw pressure threshold tests. RESULTS: Acutely, M6S was 2- to 3-fold more potent than morphine in HPT and PST tests, specifically, derived from best-fit analysis of dose-response relationships of morphine/M6S half-effective dose (ED50) ratios (lower, upper 95% confidence interval [CI]) were 2...
May 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28489478/continuous-intravenous-lidocaine-infusion-for-the-management-of-pain-uncontrolled-by-opioid-medications
#7
David J Reeves, Alexandra E Foster
Limited data exist describing the outcomes of patients receiving continuous lidocaine infusions. The objective of this study was to evaluate the effect of use of continuous lidocaine infusions for pain management at a community teaching hospital. A retrospective chart review was performed that included adult patients receiving continuous systemic lidocaine infusions for the treatment of pain. Twenty-one patients were included in the analysis. Dosing ranged from 0.25 to 2.8 mg/kg/h, with a median infusion time of 64 hours...
May 10, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28488361/clonidine-for-sedation-and-analgesia-for-neonates-receiving-mechanical-ventilation
#8
REVIEW
Olga Romantsik, Maria Grazia Calevo, Elisabeth Norman, Matteo Bruschettini
BACKGROUND: Although routine administration of pharmacologic sedation or analgesia during mechanical ventilation in preterm neonates is not recommended, its use in clinical practice remains common. Alpha-2 agonists, mainly clonidine and dexmedetomidine, are used as adjunctive (or alternative) sedative agents alongside opioids and benzodiazepines. Clonidine has not been systematically assessed for use in neonatal sedation during ventilation. OBJECTIVES: To assess whether clonidine administered to term and preterm newborn infants receiving mechanical ventilation reduces morbidity and mortality rates...
May 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28488261/use-of-tramadol-in-psychiatric-care-a-comprehensive-review-and-report-of-two-cases
#9
Ansgar Rougemont-Bücking, Franziska Gamma, Jaak Panksepp
Tramadol is widely prescribed for treating acute and chronic forms of pain. It is a weak mu-receptor opioid agonist and also increases concentrations of serotonin and noradrenaline within the limbic system of the brain. The therapeutic range of tramadol is relatively wide. Compared with other opioid agonists, there is little risk for developing tolerance and for abuse. Recent models of depression emphasise the subjective experience of a depressive mood as being, in part, a psychologically painful state. It is well established that psychological stress due to social separation/loss, disruption or be-trayal of pre-existent significant interpersonal bonds is mediated by the activation of the mammalian PANIC (separation-distress) system...
May 10, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28468568/impact-of-low-dose-ketamine-on-the-usage-of-continuous-opioid-infusion-for-the-treatment-of-pain-in-adult-mechanically-ventilated-patients-in-surgical-intensive-care-units
#10
Jessica L Buchheit, Daniel Dante Yeh, Matthias Eikermann, Hsin Lin
BACKGROUND: Ketamine at subanesthetic doses has been shown to provide analgesic effects without causing respiratory depression and may be a viable option in mechanically ventilated patients to assist with extubation. The aim of this study was to evaluate the effects of low-dose ketamine on opioid consumption in mechanically ventilated adult surgical intensive care unit (ICU) patients. METHODS: A retrospective review of mechanically ventilated adult patients receiving low-dose ketamine continuous infusion (1-5 µcg/kg/min) for adjunctive pain control admitted to surgical ICUs was conducted...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28467329/a-novel-association-to-treat-pain-tramadol-dexketoprofen-the-first-drug-of-a-new-pharmacological-class
#11
D Fornasari, M Allegri, S Gerboni, Guido Fanelli
 Acute and chronic pain have an important socio-economical impact. In order to help physicians to choose the appropriate drug, especially for cancer pain, in 1986 WHO has developed a three-step analgesic "ladder" for cancer pain relief in adults. Later it has also been used for acute pain and chronic non-cancer pain. In step I nonsteroidal anti-inflammatory drugs (NSAIDs) are considered with or without adjuvants, in step II the use of weak opioids for mild-moderate pain, with or without NSAIDs and adjuvant, is suggested, while the step III is reserved to strong opioids for moderate-severe pain with or without non-opioids or adjuvants...
April 28, 2017: Acta Bio-medica: Atenei Parmensis
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
#12
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...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28428505/-neurolysis-and-spinal-analgesia-in-cancer-pain-management
#13
Seiji Hattori, Junko Tachibana
Cancer pain appears as a complex pain and often progressive.WhenWHO pain management strategy and/or palliative care failed to relieve their pain, patients are given high dose opioids or anonymous adjuvant drugs and have no chance to meet specialized pain treatment. This section briefly covers the outline of neurolysis and spinal analgesia for these cancer patients with severe pain. Purpose of nerve block and neurolysis are to block the incoming signal of pain in order to reduce pain, reduce analgesic dose, recover ADL, and finally to be discharged from the hospital...
April 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28419679/assessing-the-survival-impact-of-perioperative-opioid-consumption-in-children-and-adolescents-undergoing-cytoreductive-surgery-with-hyperthermic-intraperitoneal-chemotherapy
#14
Pascal Owusu-Agyemang, Andrea Hayes-Jordan, Antoinette Van Meter, Uduak U Williams, Acsa M Zavala, Ravish Kapoor, Shannon M Popovich, Elizabeth Rebello, Lei Feng, Juan P Cata
BACKGROUND: Several studies in adult patients have suggested an unfavorable association between opioid consumption and cancer progression. AIMS: This study investigated the impact of opioid consumption on the survival of children and adolescents undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy. METHODS: A retrospective study of patients <19 years who had undergone cytoreductive surgery with hyperthermic intraperitoneal chemotherapy was performed...
June 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28393990/-restless-legs-syndrome-long-term-follow-up-of-a-series-of-patients
#15
Marcelo Miranda C, Lorena Hudson A
BACKGROUND: Restless legs syndrome (RLS) affects 10% of the general population. AIM: To analyze a series of patients with a minimum follow-up period of four years, treated during an interval of 14 years. MATERIAL AND METHODS: Retrospective analysis of medical records of 200 patients assessed and followed by the authors at a private outpatient clinic. RESULTS: Fifty patients aged 25 to 90 years (34 females), who had a mean follow-up of 6,3 years (range 4-14 years), were selected...
December 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28392133/patients-at-risk-large-opioid-prescriptions-after-total-knee-arthroplasty
#16
Nicholas M Hernandez, Joshua A Parry, Michael J Taunton
BACKGROUND: Opioids are an effective, and often necessary, treatment of postoperative pain after total knee arthroplasty (TKA). However, it is often difficult to know how much medication patients will need after discharge. The purpose of this study was to determine if patients discharged with greater quantities of opioids after TKA are more likely to request refills. METHODS: This is a retrospective review of 105 primary TKAs performed with at least 1 year of follow-up...
March 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28379504/low-risk-of-producing-an-opioid-use-disorder-in-primary-care-by-prescribing-opioids-to-prescreened-patients-with-chronic-noncancer-pain
#17
Martin D Cheatle, Rollin M Gallagher, Charles P O'Brien
Objective. : To examine the risk of developing aberrant behaviors that might lead to a substance use disorder (addiction) when prescribing opioids for the relief of chronic noncancer pain in primary care settings. Design. : Longitudinal, prospective, descriptive design with repeated measures. Setting. : Private community-based internal medicine and family medicine clinics. Subjects. : Patients with chronic musculoskeletal pain...
March 31, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28370746/low-dose-naltrexone-and-opioid-consumption-a-drug-utilization-cohort-study-based-on-data-from-the-norwegian-prescription-database
#18
Guttorm Raknes, Lars Småbrekke
PURPOSE: Low-dose naltrexone (LDN) is used in a wide range of conditions, including chronic pain and fibromyalgia. Because of the opioid antagonism of naltrexone, LDN users are probably often warned against concomitant use with opioids. In this study, based on data from the Norwegian prescription database, we examine changes in opioid consumption after starting LDN therapy. METHODS: We included all Norwegian patients (N = 3775) with at least one recorded LDN prescription in 2013 and at least one dispensed opioid prescription during the 365 days preceding the first LDN prescription...
March 29, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28353467/safety-of-a-rapidly-dissolving-buprenorphine-naloxone-sublingual-tablet-bnx-rdt-for-treatment-of-opioid-dependence-a-multicenter-open-label-extension-study
#19
Kent Hoffman, Marvin L Peyton, Michael Sumner
OBJECTIVE: To assess the safety of rapidly dissolving buprenorphine/naloxone sublingual tablets (BNX-RDT) in opioid-dependent patients. METHODS: This open-label, 24-week extension study enrolled patients who completed primary trials of BNX-RDT. Daily tablet doses ranged from 5.7 to 17.1 mg. The primary endpoint was safety; secondary assessments included opioid cravings, addiction severity, health-related quality of life (QOL), and workplace productivity at screening (final day of the primary trials) through study end, with changes measured from baseline of the primary trials...
March 28, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28339928/opioid-use-in-chronic-pain-patients-with-chronic-kidney-disease-a-systematic-review
#20
Vittal R Nagar, Pravardhan Birthi, Sara Salles, Paul A Sloan
Objectives. : To investigate the prevalence of chronic pain and opioid management among patients with chronic kidney disease (CKD). Design.:  Systematic review. Methods.:  A systematic search was performed, including citations from 1960 to May 2015. The review highlights methodological quality assessment of the selected studies; prevalence of pain; type, dose, and reason for opioid use; effectiveness of pain control and associated adverse effects of opioids in CKD patients...
March 2, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
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