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Opioid dose ranges

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https://www.readbyqxmd.com/read/29051703/buprenorphine-naloxone-maintenance-therapy-an-observational-retrospective-report-on-the-effect-of-dose-on-18%C3%A2-months-retention-in-an-office-based-treatment-program
#1
Theodore V Parran, A G Mace, Yael J Dahan, Christopher A Adelman, Mykola Kolganov
CONTEXT AND OBJECTIVE: Buprenorphine has been available with few reports of the dose range necessary to adequately maintain patients. We report on the effect of 8 mg/d versus 16 mg/d of buprenorphine on long-term patient retention in office-based opioid maintenance (OBOMT). DESIGN SETTING AND PARTICIPANTS: Case series, at an urban hospital-based primary care clinic providing OBOMT to 157 opiate-dependent, low socioeconomic status, uninsured, nonhomeless patients...
2017: Substance Abuse: Research and Treatment
https://www.readbyqxmd.com/read/29032350/identifying-characteristics-of-the-most-severely-impaired-chronic-pain-patients-treated-at-a-specialized-inpatient-pain-clinic
#2
Eva-Britt Hysing, Lena Smith, Mans Thulin, Rolf Karlsten, Stephen Butler, Torsten Gordh
BACKGROUND AND AIMS: Patients suffering from chronic nonmalignant pain constitute a heterogeneous population in terms of clinical presentation and treatment results. Few data are available about what distinguishes different groups in this huge population of patients with chronic persistent pain (CPP). A subgroup that is poorly studied, consists of the most severely impaired chronic pain patients. At the Uppsala University Hospital Pain Clinic, there is a specialized department accepting the most complex patients for rehabilitation...
October 12, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29029049/intraoperative-naloxone-reduces-remifentanil-induced-postoperative-hyperalgesia-but-not-pain-a-randomized-controlled-trial
#3
C-H Koo, S Yoon, B-R Kim, Y J Cho, T K Kim, Y Jeon, J-H Seo
Background: Intraoperative use of a high-dose remifentanil may induce postoperative hyperalgesia. Low-dose naloxone can selectively reverse some adverse effects of opioids without compromising analgesia. We thus hypothesized that the intraoperative use of a high-dose remifentanil combined with a low-dose naloxone infusion reduces postoperative hyperalgesia compared with the use of remifentanil alone. Methods: Patients undergoing elective thyroid surgery were randomly assigned into one of three groups, depending on the intraoperative effect-site concentration of remifentanil, with or without a continuous infusion of naloxone: 4 ng ml-1 remifentanil with 0...
October 3, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29028417/opioid-prescription-trends-among-patients-with-cancer-referred-to-outpatient-palliative-care-over-a-6-year-period
#4
Ali Haider, Donna S Zhukovsky, Yee Choon Meng, Joseph Baidoo, Kimberson C Tanco, Holly A Stewart, Tonya Edwards, Manju P Joy, Leela Kuriakose, Zhanni Lu, Janet L Williams, Diane D Liu, Eduardo Bruera
INTRODUCTION: In the United States, opioid regulations have become increasingly stringent in recent years. Increased regulatory scrutiny, in part, is related to heightened awareness through literature and a recent media blitz on the opioid prescription epidemic. These regulations have the potential to impact prescription trends by health care providers. Our objective was to evaluate changes in the type and dose of opioid prescriptions among patients who are referred by oncologists to an outpatient palliative care clinic...
October 13, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29025089/oral-ketamine-for-acute-pain-management-after-amputation-surgery
#5
Asokumar Buvanendran, Jeffrey S Kroin, Arvind Rajagopal, Sherry J Robison, Mario Moric, Kenneth J Tuman
Objective: Intravenous ketamine has been shown to provide postoperative analgesia in many clinical trials, in particular to reduce opioid consumption. The primary objective of this pilot study is to determine if multiple dosing over a three-day perioperative period with oral ketamine is a safe treatment method for acute pain after amputation surgery. Methods: Three consented subjects (age 57-60 years) undergoing elective amputation of the lower extremity were included in the study (Institutional Review Board and Food and Drug Administration Investigational New Drug approved)...
September 14, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29025085/effects-of-buprenorphine-on-responses-to-emotional-stimuli-in-individuals-with-a-range-of-mood-symptomatology
#6
Anya K Bershad, Nicholas A Ruiz, Harriet de Wit
Background: The opioid drug buprenorphine has been shown to modify responses to emotional stimuli and may have antidepressant properties. In preclinical studies, it shows antidepressant-like and anxiolytic-like effects, and a handful of clinical studies suggest it may reduce symptoms of depression in patients. We have shown that low doses of buprenorphine reduce responses to negative emotional stimuli in healthy adults. Here we extended these findings to individuals with symptoms of depression and anxiety...
September 1, 2017: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28991111/an-intraplantar-hypertonic-saline-assay-in-mice-for-rapid-screening-of-analgesics
#7
Yahya I Asiri, Timothy Fung, Stephan K W Schwarz, Khalid A Asseri, Ian D Welch, Catherine A Schuppli, Alasdair M Barr, Richard A Wall, Ernest Puil, Bernard A MacLeod
BACKGROUND: Development of new analgesics is limited by shortcomings of existing preclinical screening assays such as wide variations in response, suitability for a narrow range of analgesics, and propensity to induce tissue damage. Our aim was to determine the feasibility of a new in vivo animal assay as an analgesic screen based on nociceptive responses (licking and biting) after intraplantar (i.pl.) injection of hypertonic saline (HS) in mice. METHODS: With approval from the Institutional Animal Care Committee, we conducted a randomized, investigator-blinded in vivo study in adult CD-1 mice...
October 5, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28989831/intraoperative-awareness-and-recall-a-comparative-study-of-dexmedetomidine-and-propofol-in-cardiac-surgery
#8
Tufail Ahmad, Nadeem A Sheikh, Nihida Akhter, Bashir A Dar, Riyaz Ahmad
Background Awareness during general anesthesia is undesired and unanticipated patient wakefulness during surgery or recall of intraoperative events. Incidence of awareness in patients undergoing cardiac surgery is significantly higher than the overall incidence of 1% during general surgery. Awareness during cardiac surgery can be prevented by a number of methods. One such method is the supplemental, intraoperative use of sedative agents. Propofol, a bisubstituted phenol, is an intravenous general anesthetic that has been shown to reduce the incidence of awareness...
August 5, 2017: Curēus
https://www.readbyqxmd.com/read/28970722/pharmacological-evaluation-of-nsaid-induced-gastropathy-as-a-translatable-model-of-referred-visceral-hypersensitivity
#9
Michele Hummel, Terri Knappenberger, Meghan Reilly, Garth T Whiteside
AIM: To evaluate whether non-steroidal anti-inflammatory drugs (NSAIDs)-induced gastropathy is a clinically predictive model of referred visceral hypersensitivity. METHODS: Gastric ulcer pain was induced by the oral administration of indomethacin to male, CD1 mice (n = 10/group) and then assessed by measuring referred abdominal hypersensitivity to tactile application. A diverse range of pharmacological mechanisms contributing to the pain were subsequently investigated...
September 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28953820/study-on-the-prescribing-patterns-of-antipsychotic-medication-in-a-rural-england-community-mental-health-team
#10
Madhavan Seshadri, Ahmed Elsemary, Madhusudan Deepak Thalitaya, Lawrence Chikodzore, Priya Nagalingam
INTRODUCTION: Providing comprehensive services for about 400 patients in the South Herefordshire area, the community mental health team manages cases of varying severity and complexity, ranging from Schizophrenia, to neuroses and disorders of adult personality. Antipsychotic medication remains a mainstay of treatment and management for patients under the team case load; hence a need exists for a detailed look into the prescription patterns of such medications. AIM: The aim of this study was to look into the prescribing patterns of antipsychotics for a sample of 50 patients in the South Herefordshire community team during the year of 2016 (from Jan 2016 to Dec 2016), as well as investigate whether these antipsychotics were licensed to be used for the corresponding diagnoses of these patients...
September 2017: Psychiatria Danubina
https://www.readbyqxmd.com/read/28944983/oral-prolonged-release-oxycodone-naloxone-for-managing-pain-and-opioid-induced-constipation-a-review-of-the-evidence
#11
REVIEW
Bart J Morlion, Stefan A Mueller-Lissner, Renato Vellucci, Wojciech Leppert, Benoît C Coffin, Sara L Dickerson, Tony O'Brien
BACKGROUND: Opioids provide effective relief from moderate-to-severe pain and should be prescribed as part of a multifaceted approach to pain management when other treatments have failed. Fixed-dose oxycodone/naloxone prolonged-release tablets (OXN PR) were designed to address the opioid class effect of opioid-induced constipation (OIC) by combining the analgesic efficacy of oxycodone with the opioid receptor antagonist, naloxone, which has negligible systemic availability when administered orally...
September 25, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28944554/limited-potential-of-cebranopadol-to-produce-opioid-type-physical-dependence-in-rodents
#12
Thomas M Tzschentke, Babette Y Kögel, Stefanie Frosch, Klaus Linz
Cebranopadol is a novel potent analgesic agonist at the nociceptin/orphanin FQ peptide (NOP) and classical opioid receptors. As NOP receptor activation has been shown to reduce side effects related to the activation of μ-opioid peptide (MOP) receptors, the present study evaluated opioid-type physical dependence produced by cebranopadol in mice and rats. In a naloxone-precipitated withdrawal assay in mice, a regimen of seven escalating doses of cebranopadol over 2 days produced only very limited physical dependence as evidenced by very little withdrawal symptoms (jumping) even at cebranopadol doses clearly exceeding the analgesic dose range...
September 25, 2017: Addiction Biology
https://www.readbyqxmd.com/read/28933336/bioavailability-of-oxycodone-after-administration-of-a-new-prolonged-release-once-daily-tablet-formulation-in-healthy-subjects-in-comparison-to-an-established-twice-daily-tablet%C3%A2
#13
Bernhard Scheidel, Martina A Maritz, Yves J Gschwind, Kerstin Steigerwald, Volker Guth, Peter Kovacs, Helene Rey
OBJECTIVE: To evaluate and to compare the bioavailability, the influence of food intake on the bioavailability, and the safety and tolerability of a newly-developed oxycodone once-daily (OOD) prolonged-release tablet with an established oxycodone twice-daily (OTD) prolonged-release tablet after single-dose administration under fasting or fed conditions as well as after multiple-dose administration. MATERIALS AND METHODS: Three single-center, open-label, randomized, balanced, two-treatment, two-period, two-sequence crossover studies were conducted...
September 21, 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28926159/randomized-controlled-feasibility-trial-of-intranasal-ketamine-compared-to-intranasal-fentanyl-for-analgesia-in-children-with-suspected-extremity-fractures
#14
Stacy L Reynolds, Kathleen K Bryant, Jonathan R Studnek, Melanie Hogg, Connell Dunn, Megan A Templin, Charity G Moore, James R Young, Katherine Rivera Walker, Michael S Runyon
OBJECTIVE: We compared the tolerability and efficacy of intranasal sub-dissociative ketamine to intranasal fentanyl for analgesia of children with acute traumatic pain and investigated the feasibility of a larger non-inferiority trial that could investigate the potential opioid sparing effects of intranasal ketamine. METHODS: This randomized controlled trial compared intranasal ketamine 1 mg/kg to intranasal fentanyl 1.5 μg/kg in children 4-17 years old with acute pain from suspected, isolated extremity fractures presenting to an urban level II pediatric trauma center from December 2015 to November 2016...
September 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28917801/development-of-a-quantitative-approach-in-blood-plasma-for-low-dosed-hallucinogens-and-opioids-using-lc-high-resolution-mass-spectrometry
#15
Achim T Caspar, Andreas B Kollas, Hans H Maurer, Markus R Meyer
The WHO annually reports an increasing abuse of new psychoactive substances (NPS), which are a heterogeneous group of synthetic drugs and are consumed as substitute for controlled drugs of abuse. In this work, we focused on highly potent derivatives such those of phenethylamine (2C), N-2-methoxybenzyl phenethylamine (NBOMes), lysergic acid diethylamide (LSD), and fentanyl. Severe to fatal intoxications were described due to their high potency. Therefore, they have to be taken at very low doses resulting in low blood concentration in the low ng/mL range, which is a challenge for reliable analytical detection and quantification...
January 1, 2018: Talanta
https://www.readbyqxmd.com/read/28898536/treatment-with-naloxegol-versus-placebo-pain-assessment-in-patients-with-noncancer-pain-and-opioid-induced-constipation
#16
Lynn Webster, Ulysses Diva, Raj Tummala, Mark Sostek
OBJECTIVE: To summarize results from pain and opioid use assessments with naloxegol in adults with opioid-induced constipation (OIC) and chronic noncancer pain. METHODS: Two phase 3 randomized, double-blind, 12-week studies evaluated the efficacy and safety of oral naloxegol (12.5 or 25 mg daily) in adults (18-<85 years) with confirmed OIC and chronic noncancer pain: KODIAC-04 (NCT01309841) and KODIAC-05 (NCT01323790). Pain level was assessed daily (11-point Numeric Rating Scale [NRS]; 0=no pain, 10=worst imaginable pain)...
September 12, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28888944/the-novel-dopamine-d3-receptor-antagonists-partial-agonists-cab2-015-and-bak4-54-inhibit-oxycodone-taking-and-oxycodone-seeking-behavior-in-rats
#17
Zhi-Bing You, Jun-Tao Gao, Guo-Hua Bi, Yi He, Comfort Boateng, Jianjing Cao, Eliot L Gardner, Amy Hauck Newman, Zheng-Xiong Xi
The use of prescription opioid analgesics, particularly oxycodone, has dramatically increased, and parallels escalated opioid abuse and drug-related deaths worldwide. Understanding the molecular mechanisms underlying the development of opioid dependence and expanding treatment options to counter prescription opioid abuse has become a critical public health matter. In the present study, we first evaluated the reinforcing effects of oxycodone in a rat model of self-administration and then explored the potential utility of two novel high affinity dopamine D3 receptor (D3R) antagonists/partial agonists, CAB2-015 and BAK4-54, for treatment of prescription opioid abuse and dependence...
September 6, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28882155/barriers-to-retention-in-methadone-maintenance-therapy-among-people-who-inject-drugs-in-bangkok-thailand-a-mixed-methods-study
#18
Kanna Hayashi, Lianping Ti, Prempreeda Pramoj Na Ayutthaya, Paisan Suwannawong, Karyn Kaplan, Will Small, Thomas Kerr
BACKGROUND: Methadone maintenance therapy (MMT) is a mainstay for treating opioid use disorder and preventing and managing HIV among people who inject drugs (PWID). While previous research suggested low dosing of methadone and high rates of discontinuation of MMT among PWID in Thailand, little is known about patients' lived experiences with MMT in this setting. Therefore, we conducted a mixed-methods study to examine barriers to retention in MMT among PWID in Bangkok, Thailand, with particular attention to methadone dosing...
September 7, 2017: Harm Reduction Journal
https://www.readbyqxmd.com/read/28868303/adjuvants-to-local-anesthetics-current-understanding-and-future-trends
#19
EDITORIAL
Amlan Swain, Deb Sanjay Nag, Seelora Sahu, Devi Prasad Samaddar
Although beneficial in acute and chronic pain management, the use of local anaesthetics is limited by its duration of action and the dose dependent adverse effects on the cardiac and central nervous system. Adjuvants or additives are often used with local anaesthetics for its synergistic effect by prolonging the duration of sensory-motor block and limiting the cumulative dose requirement of local anaesthetics. The armamentarium of local anesthetic adjuvants have evolved over time from classical opioids to a wide array of drugs spanning several groups and varying mechanisms of action...
August 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28866904/a-selective-review-of-medical-cannabis-in-cancer-pain-management
#20
Alexia Blake, Bo Angela Wan, Leila Malek, Carlo DeAngelis, Patrick Diaz, Nicholas Lao, Edward Chow, Shannon O'Hearn
Insufficient management of cancer-associated chronic and neuropathic pain adversely affects patient quality of life. Patients who do not respond well to opioid analgesics, or have severe side effects from the use of traditional analgesics are in need of alternative therapeutic op-tions. Anecdotal evidence suggests that medical cannabis has potential to effectively manage pain in this patient population. This review presents a selection of representative clinical studies, from small pilot studies conducted in 1975, to double-blind placebo-controlled trials conducted in 2014 that evaluated the efficacy of cannabinoid-based therapies containing tetrahydrocannabinol (THC) and cannabidiol (CBD) for reducing cancer-associated pain...
August 23, 2017: Annals of Palliative Medicine
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