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Opioid dose ranges

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https://www.readbyqxmd.com/read/28428505/-neurolysis-and-spinal-analgesia-in-cancer-pain-management
#1
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
#2
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...
April 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28393990/-restless-legs-syndrome-long-term-follow-up-of-a-series-of-patients
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/28328578/sustained-improvements-in-pain-mood-function-and-opioid-use-post-interdisciplinary-pain-rehabilitation-in-patients-weaned-from-high-and-low-dose-chronic-opioid-therapy
#9
Kelly L Huffman, Taylor E Rush, Youran Fan, Giries W Sweis, Brinder Vij, Edward C Covington, Judith Scheman, Manu Mathews
Increased prescribing of opioids for chronic non cancer pain is associated with significant social costs, including overdose and addiction. In this context, there is interest in interdisciplinary chronic pain rehabilitation programs (ICPRP) focusing on self-management and minimizing opioid use. This study examined outcomes of patients weaned from opioids in an ICPRP from 2007-2012. Participants included 413 patients on high dose (HD) chronic opioid therapy (COT; >100mg), 528 on low dose (LD) COT and 516 not on opioids (NO)...
March 21, 2017: Pain
https://www.readbyqxmd.com/read/28299720/ketamine-infusion-as-a-counter-measure-for-opioid-tolerance-in-mechanically-ventilated-children-a-pilot-study
#10
Felix Neunhoeffer, Anja Hanser, Martin Esslinger, Vanja Icheva, Matthias Kumpf, Ines Gerbig, Michael Hofbeck, Jörg Michel
BACKGROUND: Drug rotation to prevent opioid tolerance is well recognized in chronic pain management. However, ketamine infusion as a counter measure for opioid tolerance is rarely described in mechanically ventilated children developing tolerance from prolonged opioid infusion. PATIENTS AND METHODS: We performed a retrospective study in a 14-bed medical-surgical-cardiac pediatric intensive care unit. Thirty-two mechanically ventilated children who had developed tolerance from prolonged intravenous infusion of opioids received a continuous intravenous infusion of ketamine as an opioid substitute for more than 2 days, scheduled in a drug rotation protocol...
March 15, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28296524/challenges-to-opioid-treatment-programs-after-hurricane-sandy-patient-and-provider-perspectives-on-preparation-impact-and-recovery
#11
Harlan Matusow, Ellen Benoit, Luther Elliott, Eloise Dunlap, Andrew Rosenblum
Over 300,000 patients with an opioid use disorder (OUD) receive methadone maintenance therapy from opioid treatment programs (OTPs) in the United States. Large numbers of these attend OTPs located in New York and New Jersey, areas (largely but not exclusively coastal) impacted by Hurricane Sandy (Sandy) on October 29th, 2012. Disruption of methadone dispensing and other services can have severe consequences to patients (and treatment seekers) such as relapse, dropping out of treatment and resumption or increase in HIV/HCV injection risk behaviors...
March 15, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28291511/%C3%A2-intrathecal-analgesia-by-bupivacaine-is-not-enhanced-by-coadministration-of-morphine-in-patients-with-severe-cancer-related-pain-a-randomized-double-blind-cross-over-study
#12
Ingalill Reif, Anders Wincent, Carl-Olav Stiller
The objective of this randomized double blind cross-over trial was to determine if patients with severe cancer-related pain and inadequate response to systemic opioids prefer intrathecal (IT) pain relief with a combination of bupivacaine and morphine or bupivacaine only. Adult patients with cancer-related pain (n = 23) scheduled for IT analgesia at the Pain Center at the Karo-linska University Hospital Solna, Stockholm, Sweden, were included. The optimal individual flow rate of IT bupivacaine (2 mg/mL) in addition to bolus doses was titrated and maintained for 4 days...
March 14, 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28291086/opioid-type-respiratory-depressant-side-effects-of-cebranopadol-in-rats-are-limited-by-its-nociceptin-orphanin-fq-peptide-receptor-agonist-activity
#13
Klaus Linz, Wolfgang Schröder, Stefanie Frosch, Thomas Christoph
BACKGROUND: Cebranopadol is a first-in-class analgesic with agonist activity at classic opioid peptide receptors and the nociceptin/orphanin FQ peptide receptor. The authors compared the antinociceptive and respiratory depressant effects of cebranopadol and the classic opioid fentanyl and used selective antagonists to provide the first mechanistic evidence of the contributions of the nociceptin/orphanin FQ peptide and μ-opioid peptide receptors to cebranopadol's respiratory side-effect profile...
April 2017: Anesthesiology
https://www.readbyqxmd.com/read/28287356/range-of-effective-corticosteroid-doses-for-alleviating-dyspnea-in-terminal-cancer-patients-a-retrospective-review
#14
Tsuyoshi Maeda, Toru Hayakawa
This study aimed to determine the range of mean cumulative corticosteroid doses that could effectively palliate dyspnea in opioid-treated patients with terminal cancer and to investigate the demographic or biochemical factors predictive of corticosteroid responsiveness. To this end, responders and nonresponders were compared with regard to corticosteroid dose and whether they had initiated opioid use before or concomitantly with corticosteroid use. A logistic regression analysis was conducted to assess the impacts of demographic and biochemical factors on corticosteroid effectiveness...
March 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28280384/tapentadol-extended-release-for-the-management-of-chronic-neck-pain
#15
Domenico Billeci, Flaminia Coluzzi
BACKGROUND: The role of opioids in the management of chronic neck pain is still poorly investigated. No data are available on tapentadol extended release (ER). In this article, we present 54 patients with moderate-to-severe chronic neck pain treated with tapentadol ER. PATIENTS AND METHODS: Patients received tapentadol ER 100 mg/day; dosage was then adjusted according to clinical needs. The following parameters were recorded: pain; Douleur Neuropathique 4 score; Neck Disability Index score; range of motion; pain-associated sleep interference; quality of life (Short Form [36] Health Survey); Patient Global Impression of Change (PGIC); Clinician GIC; opioid-related adverse effects; and need for other analgesics...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28277866/treatment-for-chronic-low-back-pain-the-focus-should-change-to-multimodal-management-that-reflects-the-underlying-pain-mechanisms
#16
Gerhard Müller-Schwefe, Bart Morlion, Karsten Ahlbeck, Eli Alon, Stefano Coaccioli, Flaminia Coluzzi, Frank Huygen, Wolfgang Jaksch, Eija Kalso, Magdalena Kocot-Kępska, Hans-Georg Kress, Ana Cristina Mangas, Cesar Margarit Ferri, Philippe Mavrocordatos, Andrew Nicolaou, Concepción Pérez Hernández, Joseph Pergolizzi, Michael Schäfer, Patrick Sichère
Chronic low back pain: Chronic pain is the most common cause for people to utilize healthcare resources and has a considerable impact upon patients' lives. The most prevalent chronic pain condition is chronic low back pain (CLBP). CLBP may be nociceptive or neuropathic, or may incorporate both components. The presence of a neuropathic component is associated with more intense pain of longer duration, and a higher prevalence of co-morbidities. However, many physicians' knowledge of chronic pain mechanisms is currently limited and there are no universally accepted treatment guidelines, so the condition is not particularly well managed...
March 22, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28236471/erectile-dysfunction-in-patients-with-chronic-pain-treated-with-opioids
#17
Raquel Ajo, Ana Segura, María-Del-Mar Inda, César Margarit, Pura Ballester, Emi Martínez, Guillermina Ferrández, Ángel Sánchez-Barbie, Ana M Peiró
INTRODUCTION AND OBJECTIVE: Chronic pain is associated with comorbidities that have an impact on the quality of life of patients and, among others, affect their sexual functioning. One of the most relevant side effects of opioid analgesics is erectile dysfunction (ED), due in part to the inhibition of the gonadal-pituitary-hypothalamic axis and the decline in testosterone levels. To evaluate ED and effectiveness of treatment in men with chronic pain treated with long-term opioids. MATERIAL AND METHODS: Prospective observational study lasting 3 years, where the intensity of pain (visual analogue scale, 0-10cm), erectile function (IIEF-EF, range 1-30 points), quality of life (EQ-VAS, 0-100mm), quality of sexual life (MSLQ-QOL, 0-100 points), anxiety/depression (HAD, 0-21 points) and testosterone levels, was assessed in patients who reported sexual dysfunction (ED or libido modification)...
February 21, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28195856/pharmacoepidemiologic-analyses-of-opioid-use-among-oef-oif-ond-veterans
#18
Teresa J Hudson, Jacob T Painter, Bradley C Martin, Mark A Austen, James S Williams, John C Fortney, Mark D Sullivan, Mark J Edlund
There is a great deal of concern about opioid use in veterans, particularly those who served in Afghanistan (OEF) and Iraq (OIF and OND). The current study provides a detailed pharmacoepidemiologic analysis of opioid use among OEF/OIF/OND veterans from FY09 to FY12. Data from 3 data repositories from the Veterans Health Administration (VHA) were used to describe demographic, clinical, and medication characteristics associated with opioid use among OEF/OIF/OND veterans and among those with TBI. Logistic regression models were used to identify risks associated with chronic opioid use in FY12...
March 25, 2017: Pain
https://www.readbyqxmd.com/read/28182128/co-prescription-of-opioids-with-benzodiazepine-and-other-co-medications-among-opioid-users-differential-in-opioid-doses
#19
Che Suraya Zin, Fadhilah Ismail
PURPOSE: This study investigated the patterns of opioid co-prescription with benzodiazepine and other concomitant medications among opioid users. Opioid dose in each type of co-prescription was also examined. PATIENTS AND METHODS: This cross-sectional study was conducted among opioid users receiving concomitant medications at an outpatient tertiary hospital setting in Malaysia. Opioid prescriptions (morphine, fentanyl, oxycodone, dihydrocodeine and tramadol) that were co-prescribed with other medications (opioid + benzodiazepines, opioid + antidepressants, opioid + anticonvulsants, opioid + antipsychotics and opioid + hypnotics) dispensed from January 2013 to December 2014 were identified...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28170358/influence-of-ethanol-on-oxycodone-induced-respiratory-depression-a-dose-escalating-study-in-young-and-elderly-individuals
#20
Rutger van der Schrier, Margot Roozekrans, Erik Olofsen, Leon Aarts, Monique van Velzen, Merijn de Jong, Albert Dahan, Marieke Niesters
BACKGROUND: Respiratory depression is a potentially fatal complication of opioid use, which may be exacerbated by simultaneous ethanol intake. In this three-way sequential crossover dose-escalating study, the influence of coadministration of oral oxycodone and intravenous ethanol was assessed on resting ventilation, apneic events and the hypercapnic ventilatory response in healthy young and older volunteers. METHODS: Twelve young (21 to 28 yr) and 12 elderly (66 to 77 yr) opioid-naive participants ingested one 20 mg oxycodone tablet combined with an intravenous infusion of 0, 0...
March 2017: Anesthesiology
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