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Opioid dose ranges

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https://www.readbyqxmd.com/read/27896019/naloxone-and-metabolites-quantification-in-cord-blood-of-prenatally-exposed-newborns-and-correlations-with-maternal-concentrations
#1
Samantha L Wiegand, Madeleine J Swortwood, Marilyn A Huestis, John Thorp, Hendreé E Jones, Neeta L Vora
Objective To quantify naloxone and metabolite concentrations in newborns prenatally exposed to sublingual buprenorphine/naloxone and to correlate neonatal and maternal metabolite concentrations. Methods This is a prospective observational cohort study. Eleven pregnant women treated for opioid use disorder with sublingual buprenorphine/naloxone were enrolled. Maternal and newborn blood was collected and analyzed for naloxone, buprenorphine, and metabolites via liquid chromatography tandem mass spectrometry...
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/27870477/ascending-single-dose-double-blind-placebo-controlled-safety-study-of-noribogaine-in-opioid-dependent-patients
#2
Paul Glue, Gavin Cape, Donna Tunnicliff, Michelle Lockhart, Fred Lam, Noelyn Hung, C Tak Hung, Sarah Harland, Jane Devane, R S Crockett, John Howes, Borje Darpo, Meijian Zhou, Holger Weis, Lawrence Friedhoff
Ibogaine is a psychoactive substance that may reduce opioid withdrawal symptoms. This was the first clinical trial of noribogaine, ibogaine's active metabolite, in patients established on methadone opioid substitution therapy (OST). In this randomized, double-blind, placebo-controlled single ascending-dose study, we evaluated the safety, tolerability, and pharmacokinetics of noribogaine in 27 patients seeking to discontinue methadone OST who had been switched to morphine during the previous week. Noribogaine doses were 60, 120, or 180 mg (n = 6/dose level) or matching placebo (n = 3/dose level)...
November 2016: Clinical Pharmacology in Drug Development
https://www.readbyqxmd.com/read/27855148/notes-from-the-field-cardiac-dysrhythmias-after-loperamide-abuse-new-york-2008-2016
#3
William Eggleston, Jeanna M Marraffa, Christine M Stork, Maria Mercurio-Zappala, Mark K Su, Rachel S Wightman, Karen R Cummings, Joshua G Schier
Loperamide is an over-the-counter antidiarrheal with opioid-receptor agonist properties. Recommended over-the-counter doses (range = 2-8 mg daily) do not produce opioid effects in the central nervous system because of poor oral bioavailability and P-glycoprotein efflux* of the medication (1); recent reports suggest that large doses (50-300 mg) of loperamide produce euphoria, central nervous system depression, and cardiotoxicity (2-4). Abuse of loperamide for its euphoric effect or for self-treatment of opioid withdrawal is increasing (5)...
November 18, 2016: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/27849111/pharmacological-interventions-for-pruritus-in-adult-palliative-care-patients
#4
REVIEW
Waldemar Siemens, Carola Xander, Joerg J Meerpohl, Sabine Buroh, Gerd Antes, Guido Schwarzer, Gerhild Becker
BACKGROUND: This is an update of the original Cochrane review published in 2013 (Issue 6). Pruritus occurs in patients with disparate underlying diseases and is caused by different pathologic mechanisms. In palliative care patients, pruritus is not the most prevalent but is one of the most puzzling symptoms. It can cause considerable discomfort and affects patients' quality of life. OBJECTIVES: To assess the effects of different pharmacological treatments for preventing or treating pruritus in adult palliative care patients...
November 16, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27829810/effect-of-tramadol-on-metamizol-pharmacokinetics-and-pharmacodynamics-after-single-and-repeated-administrations-in-arthritic-rats
#5
Luis Alfonso Moreno-Rocha, Francisco Javier López-Muñoz, José Raúl Medina-López, Adriana Miriam Domínguez-Ramírez
Combined administration of certain doses of opioid compounds with a non-steroidal anti-inflammatory drug can produce additive or supra-additive effects while reducing unwanted effects. We have recently reported that co-administration of metamizol with tramadol produces antinociceptive effect potentiation, after acute treatment. However, none information about the effect produced by the combination after chronic or repeated dose administration exists. The aims of this study were to investigate whether the antinociceptive synergism produced by the combination of metamizol and tramadol (177...
November 2016: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
https://www.readbyqxmd.com/read/27826213/management-of-moderate-to-severe-chronic-low-back-pain-with-buprenorphine-buccal-film-using-novel-bioerodible-mucoadhesive-technology
#6
REVIEW
Joseph V Pergolizzi, Robert B Raffa, Charles Fleischer, Gianpietro Zampogna, Robert Taylor
With a global prevalence of ~9%-12%, low back pain (LBP) is a serious public health issue, associated with high costs for treatment and lost productivity. Chronic LBP (cLBP) involves central sensitization, a neuropathic pain component, and may induce maladaptive coping strategies and depression. Treating cLBP is challenging, and current treatment options are not fully satisfactory. A new BioErodible MucoAdhesive (BEMA(®)) delivery system for buprenorphine has been developed to treat cLBP. The buccal buprenorphine (BBUP) film developed for this product (Belbuca™) allows for rapid delivery and titration over a greater range of doses than was previously available with transdermal buprenorphine systems...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27799763/prescription-of-opioids-for-breathlessness-in-end-stage-copd-a-national-population-based-study
#7
Zainab Ahmadi, Eva Bernelid, David C Currow, Magnus Ekström
BACKGROUND: Low-dose opioids can relieve breathlessness but may be underused in late-stage COPD due to fear of complications, contributing to poor symptom control. OBJECTIVES: We aimed to study the period prevalence and indications of opioids actually prescribed in people with end-stage COPD. METHODS: The study was a longitudinal, population-based study of patients starting long-term oxygen therapy (LTOT) for COPD between October 1, 2005 and June 30, 2009 in Sweden...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27779775/clonidine-for-sedation-and-analgesia-and-withdrawal-in-critically-ill-infants-and-children
#8
Amanda C Capino, Jamie L Miller, Peter N Johnson
The need for sedation and analgesia and treatment of iatrogenic drug withdrawal is common in critically ill children. First-line therapy typically includes opioid agonists. However, clonidine, a central alpha2 agonist, has been suggested as a treatment option for sedation and analgesia and iatrogenic drug withdrawal. Therefore, we conducted a literature search to identify articles evaluating the use of enteral and transdermal clonidine in critically ill infants and children for sedation and analgesia and treatment of iatrogenic drug withdrawal...
October 25, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27779356/oral-morphine-dosing-predictions-based-on-single-dose-in-healthy-children-undergoing-surgery
#9
Joy M Dawes, Erin M Cooke, Jacqueline A Hannam, Katherine A Brand, Pamela Winton, Ricardo Jimenez-Mendez, Katarina Aleksa, Gillian R Lauder, Bruce C Carleton, Gideon Koren, Michael J Rieder, Brian J Anderson, Carolyne J Montgomery
BACKGROUND: Oral morphine has been proposed as an effective and safe alternative to codeine for after-discharge pain in children following surgery but there are few data guiding an optimum safe oral dose. AIMS: The aim of this study was to characterize the absorption pharmacokinetics of enteral morphine in order to simulate time-concentration profiles in children given common oral morphine dose regimens. METHODS: Children (2-6 years, n = 34) undergoing elective surgery and requiring opioid analgesia were randomized to receive preoperative oral morphine (100 mcg·kg(-1) , 200 mcg·kg(-1) , 300 mcg·kg(-1) )...
October 25, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27767117/single-dose-oral-analgesics-for-postoperative-pain-have-few-adverse-events
#10
Yin J Wong
Data sourcesThe Cochrane Database of Systematic Reviews on the Cochrane Library.Study selectionAll Cochrane reviews of RCTs between 1999 to 2015, conducted in adults examining the adverse events associated with single dose oral analgesics used for acute post-operative pain were considered.Data extraction and synthesisStudies were searched, reviewed and assessed independently by two reviewers and standard data items extracted. Methodological quality was assessed using criteria adapted from AMSTAR (Assessing the Methodological Quality of Systematic Reviews)...
September 2016: Evidence-based Dentistry
https://www.readbyqxmd.com/read/27715007/dopamine-d3-d2-receptor-antagonist-pf-4363467-attenuates-opioid-drug-seeking-behavior-without-concomitant-d2-side-effects
#11
Travis T Wager, Thomas A Chappie, David Horton, Ramalakshmi Y Chandrasekaran, Brian M Samas, Elizabeth Dunn-Sims, Cathleen Hsu, Nawshaba Nawreen, Michelle A Vanase-Frawley, Rebecca E O'Connor, Christopher Schmidt, Keith Dlugolenski, Nancy C Stratman, Mark J Majchrzak, Bethany L Kormos, David Nguyen, Aarti Sawant-Basak, Andy N Mead
Dopamine receptor antagonism is a compelling molecular target for the treatment of a range of psychiatric disorders, including substance use disorders. From our corporate compound file we identified a structurally unique D3 receptor (D3R) antagonist scaffold, 1. Through a hybrid approach, we merged key pharmacophore elements from 1 and D3 agonist 2 to yield the novel D3R/D2R antagonist PF-4363467 (3). Compound 3 was designed to possess CNS drug-like properties as defined by its CNS MPO desirability score (≥4/6)...
October 7, 2016: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/27703360/delirium-as-a-complication-of-the-surgical-intensive-care
#12
Rostislav Horacek, Barbora Krnacova, Jan Prasko, Klara Latalova
BACKGROUND: The aim of this study was to examine the impact of somatic illnesses, electrolyte imbalance, red blood cell count, hypotension, and antipsychotic and opioid treatment on the duration of delirium in Central Intensive Care Unit for Surgery. PATIENTS AND METHODS: Patients who were admitted to the Department of Central Intensive Care Unit for Surgery in the University Hospital Olomouc from February 2004 to November 2008 were evaluated using Riker sedation-agitation scale...
2016: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/27700049/pharmacodynamic-relationships-between-duration-of-action-of-jdtic-like-kappa-opioid-receptor-antagonists-and-their-brain-and-plasma-pharmacokinetics-in-rats
#13
S Michael Owens, Gerald T Pollard, James L Howard, Timothy R Fennell, Rodney W Snyder, F Ivy Carroll
JDTic is a potent and selective κ-opioid receptor (KOR) antagonist that reverses U50,488-induced diuresis in rats. It partitions into brain with a duration of action lasting for weeks. In a search for KOR antagonists that do not accumulate in the brain, we compared single doses of five methylated JDTic analogs (RTI-97, -194, -212, -240, and -241) for reversal of U50,488 diuresis and pharmacokinetic (PK) properties. All six compounds showed potent and selective KOR antagonism in a [(35)S]GTPγS binding assay...
October 4, 2016: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/27696218/analgesic-drug-prescription-patterns-on-five-international-paediatric-wards
#14
Sebastian Botzenhardt, Asia N Rashed, Ian C K Wong, Stephen Tomlin, Antje Neubert
AIM: Analgesic and anti-inflammatory drugs are frequently prescribed in paediatrics. Prescribing and dosing patterns in hospitalised children are not well known. This study explores analgesic drug utilisation on five paediatric wards and discusses its findings in comparison with World Health Organization (WHO) guidelines. METHOD: A sub-analysis of a prospective, multicentre, observational cohort study was undertaken. Prescription data of children aged up to ≤18 years were collected between October 2008 and December 2009 on paediatric general medical wards in five hospitals in Australia, Germany, the United Kingdom (UK), Hong Kong (HK) and Malaysia...
December 2016: Paediatric Drugs
https://www.readbyqxmd.com/read/27687397/analgesic-efficacy-of-pregabalin-in-acute-postmastectomy-pain-placebo-controlled-dose-ranging-study
#15
Diab Fuad Hetta, Montaser A Mohamed, Mohammad Farouk Mohammad
STUDY OBJECTIVE: We hypothesized that oral administration of a single dose of pregabalin 2 hours before modified radical mastectomy (MRM) would produce dose-related reduction in postoperative opioid consumption. DESIGN: Prospective randomized controlled clinical trial. SETTING: Postanesthesia care unit. PATIENTS: One hundred twenty adult women scheduled for unilateral (MRM) with axillary evacuation. INTERVENTIONS: Patients were randomized to receive either, placebo capsule, pregabalin 75 mg, pregabalin 150 mg, or pregabalin 300 mg...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27687344/dose-ranging-effect-of-systemic-diphenhydramine-on-postoperative-quality-of-recovery-after-ambulatory-laparoscopic-surgery-a-randomized-placebo-controlled-double-blinded-clinical-trial
#16
Gildasio S De Oliveira, Jane Bialek, R-J Marcus, Robert McCarthy
STUDY OBJECTIVE: Diphenhydramine is an antihistamine with previously demonstrated analgesic and antiemetic properties. However, it is unknown if the beneficial perioperative properties of diphenhydramine can translate to a better quality of postsurgical recovery. The main objective of the current investigation was to investigate dose-ranging effects of diphenhydramine on quality of recovery after surgery. SETTING: Tertiary hospital in the United States. DESIGN: A prospective, randomized, double-blind trial...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27673505/ultra-low-dose-naloxone-as-an-adjuvant-to-patient-controlled-analgesia-pca-with-morphine-for-postoperative-pain-relief-following-lumber-discectomy-a-double-blind-randomized-placebo-controlled-trial
#17
Abolfazl Firouzian, Afshin Gholipour Baradari, Abbas Alipour, Amir Emami Zeydi, Alieh Zamani Kiasari, Seyed Abdollah Emadi, Behrooz Kheradmand, Kaveh Hadadi
BACKGROUND: Lumbar discectomy is one of the most commonly performed neurosurgical procedures. Many patients experience postoperative pain after lumbar discectomy. This study evaluated the effect of ultra-low-dose naloxone infusion on pain intensity after lumbar discectomy in individuals receiving patient-controlled analgesia (PCA) with morphine. MATERIALS AND METHODS: In a double-blind, randomized, controlled trial, a total of 80 patients scheduled for open discectomy was randomly assigned to receive naloxone (group N) or placebo (group P)...
September 26, 2016: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/27631771/wide-variation-and-excessive-dosage-of-opioid-prescriptions-for-common-general-surgical-procedures
#18
Maureen V Hill, Michelle L McMahon, Ryland S Stucke, Richard J Barth
OBJECTIVE: To examine opioid prescribing patterns after general surgery procedures and to estimate an ideal number of pills to prescribe. BACKGROUND: Diversion of prescription opioids is a major contributor to the rising mortality from opioid overdoses. Data to inform surgeons on the optimal dose of opioids to prescribe after common general surgical procedures is lacking. METHODS: We evaluated 642 patients undergoing 5 outpatient procedures: partial mastectomy (PM), partial mastectomy with sentinel lymph node biopsy (PM SLNB), laparoscopic cholecystectomy (LC), laparoscopic inguinal hernia repair (LIH), and open inguinal hernia repair (IH)...
September 14, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27619237/discovery-of-stable-non-opioid-dynorphin-a-analogues-interacting-at-the-bradykinin-receptors-for-the-treatment-of-neuropathic-pain
#19
Sara M Hall, Lindsay LeBaron, Cyf Ramos-Colon, Chaoling Qu, Jennifer Yanhua Xie, Frank Porreca, Josephine Lai, Yeon Sun Lee, Victor J Hruby
Dynorphin A (Dyn A) is a unique endogenous ligand that possesses well-known neuroinhibitory effects via opioid receptors with a preference for the kappa receptor but also neuroexcitatory effects, which cause hyperalgesia. We have shown that the neuroexcitatory effects are mediated through bradykinin (BK) receptors and that intrathecal (i.th.) administration of our lead ligand 1, [des-Arg(7)]-Dyn A-(4-11), which shows good binding affinity (IC50 = 150 nM) at the BK receptors, blocks Dyn A-induced hyperalgesia in naïve animals and reverses thermal and tactile hypersensitivities in a dose-dependent manner in nerve-injured animals...
September 27, 2016: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/27613475/feasibility-of-monomodal-analgesia-with-iv-alfentanil-during-burn-dressing-changes-at-bedside-in-spontaneously-breathing-non-intubated-patients
#20
Mathieu Fontaine, Jacques Latarjet, Jacqueline Payre, Jean-Charles Poupelin, François Ravat
INTRODUCTION: The severe pain related to repeated burn dressing changes at bedside is often difficult to manage. However these dressings can be performed at bedside on spontaneously breathing non-intubated patients using powerful intravenous opioids with a quick onset and a short duration of action such as alfentanil. The purpose of this study is to demonstrate the efficacy and safety of the protocol which is used in our burn unit for pain control during burn dressing changes. PATIENTS AND METHODS: Cohort study began after favorable opinion from local ethic committee has been collected...
September 6, 2016: Burns: Journal of the International Society for Burn Injuries
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