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https://www.readbyqxmd.com/read/28152878/time-trends-in-opioid-use-in-cancer-and-noncancer-patients-observations-from-administrative-data
#1
Carlo DeAngelis, Craig Earle, Clare Atzema, Deborah Jane Dudgeon, Tara Gomes, Doris Howell, Amna Husain, Mary Ann O'Brien, Hsien Seow, Jonathan Sussman, Rinku Sutradhar, Anna Chu, Ying Liu
: 298 Background: Opioid prescribing has been increasingly scrutinized in the non-cancer patient population due to concerns with morbidity, mortality and diversion. Resulting regulatory changes have decreased prescribing. As an unintended consequence, we hypothesized that cancer patients might be similarly impacted. METHODS: All Ontario residents ≥ 65 years are eligible for government paid pharmacare. For each year from 2004 to 2013, Ontarians ≥ 65 years were stratified into 3 groups: no cancer history, cancer diagnosis > 5 years ago and cancer diagnosis ≤ 5 years ago...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28089852/dopamine-d1-receptor-agonist-treatment-attenuates-extinction-of-morphine-conditioned-place-preference-while-increasing-dendritic-complexity-in-the-nucleus-accumbens-core
#2
Kendra L Kobrin, Danielle T Arena, Stephen C Heinrichs, Olivia H Nguyen, Gary B Kaplan
The dopamine D1 receptor (D1R) has a role in opioid reward and conditioned place preference (CPP), but its role in CPP extinction is undetermined. We examined the effect of D1R agonist SKF81297 on the extinction of opioid CPP and associated dendritic morphology in the nucleus accumbens (NAc), a region involved with reward integration and its extinction. During the acquisition of morphine CPP, mice received morphine and saline on alternate days; injections were given immediately before each of eight daily conditioning sessions...
January 12, 2017: Behavioural Brain Research
https://www.readbyqxmd.com/read/28042391/identification-of-factors-associated-with-sedation-tolerance-in-5000-patients-undergoing-outpatient-colonoscopy-canadian-tertiary-center-experience
#3
Alexandra Shingina, George Ou, Oliver Takach, Sigrid Svarta, Ricky Kwok, Jessica Tong, Kieran Donaldson, Eric Lam, Robert Enns
AIM: To develop a prediction model aimed at identifying patients that may require higher than usual sedation doses during colonoscopy. METHODS: A retrospective chart review on 5000 patients who underwent an outpatient colonoscopy at St. Paul's Hospital from 2009 to 2010 was conducted in order to develop a model for identifying patients who will require increased doses of sedatives. Potential predictor variables including age, gender, endoscopy indication, high sedation requirements during previous endoscopies, difficulty of the procedure, bowel preparation quality, interventions, findings as well as current use of benzodiazepines, opioids and alcohol were analyzed...
December 16, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28042019/endomorphin-2-analogs-with-c-terminal-esterification-produce-potent-systemic-antinociception-with-reduced-tolerance-and-gastrointestinal-side-effects
#4
Chang-Lin Wang, Ting-Ting Qiu, Dai-Jun Yang, Bi-Yu Yuan, Feng-Tong Han, Li Li, Ning Gu
C-terminal esterification of opioid peptides may change their opioid activities due to the modified physicochemical properties. In the present study, the pharmacological activities of C-terminal esterified endomorphin-2 (EM-2) analogs 1-3 were characterized by in vitro metabolic stability and octanol/buffer distribution assays. Also, the antinociceptive profiles in the radiant heat paw withdrawal test and related side effects of these analogs were determined. Our results showed that all three analogs significantly increased the metabolic stability and lipophilicity...
December 29, 2016: Neuropharmacology
https://www.readbyqxmd.com/read/28006937/morphine-decreases-social-interaction-of-adult-male-rats-while-thc-does-not-affect-it
#5
R Šlamberová, A Mikulecká, E Macúchová, I Hrebíčková, M Ševčíková, K Nohejlová, M Pometlová
The aim of the present study was to compare effect of three low doses of morphine (MOR) and delta9-tetrahydrocannabinol (THC) on social behavior tested in Social interaction test (SIT). 45 min prior to testing adult male rats received one of the drugs or solvents: MOR (1; 2.5; 5 mg/kg); saline as a solvent for MOR; THC (0.5; 1; 2 mg/kg); ethanol as a solvent for THC. Occurrence and time spent in specific patterns of social interactions (SI) and non-social activities (locomotion and rearing) was video-recorded for 5 min and then analyzed...
December 22, 2016: Physiological Research
https://www.readbyqxmd.com/read/27746542/a-randomized-controlled-study-between-fentanyl-and-butorphanol-with-low-dose-intrathecal-bupivacaine-to-facilitate-early-postoperative-ambulation-in-urological-procedures
#6
Arvind Kumar, Ritesh Kumar, Vinod Kumar Verma, Chandrakant Prasad, Rajesh Kumar, Shashi Kant, Gunjan Kumar, Neha Singh, Rupam Kumari
INTRODUCTION: Opioids are widely used in conjunction with local anesthetics as they permit the use of lower dose of local anesthetics while providing adequate anesthesia and analgesia. It both provides adequate anesthesia as well as lower drug toxicity neuraxial administration of opioids in conjunction with local anesthetics improves the quality of intraoperative analgesia and prolongs the duration of postoperative analgesia. Bupivacaine is the most commonly used drug for subarachnoid block due to its lesser side effects...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27676695/dose-and-duration-of-opioid-use-in-patients-with-cancer-and-noncancer-pain-at-an-outpatient-hospital-setting-in-malaysia
#7
Che S Zin, Norny A Rahman, Che R Ismail, Leong W Choy
BACKGROUND: There are currently limited data available on the patterns of opioid prescribing in Malaysia. This study investigated the patterns of opioid prescribing and characterized the dosing and duration of opioid use in patients with noncancer and cancer pain. METHODS: This retrospective, cross-sectional study was conducted at an outpatient hospital setting in Malaysia. All prescriptions for opioids (dihydrocodeine, fentanyl, morphine, and oxycodone) issued between January 2013 and December 2014 were examined...
September 27, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27664442/freeze-dried-extracts-of-bidens-biternata-lour-merr-and-sheriff-show-significant-antidiarrheal-activity-in-in-vivo-models-of-diarrhea
#8
Dennis Gacigi Kinuthia, Anne W Muriithi, Peter Waweru Mwangi
ETHNOPHARMACOLOGICAL RELEVANCE OF THE STUDY: Diarrhea remains one of the main killers of children aged below five years. Traditional antidiarrheal remedies form a potentially viable source of novel low cost efficacious treatments in low resource settings. There is therefore a pressing need to scientifically evaluate these remedies. AIM OF THE STUDY: This study aimed to investigate the in vivo and in vitro antidiarrheal activity of freeze dried Bidens biternata, a herb used in traditional Ayurvedic medicine in the management of diarrhea...
December 4, 2016: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/27555136/combined-preoperative-femoral-and-sciatic-nerve-blockade-improves-analgesia-after-anterior-cruciate-ligament-reconstruction-a-randomized-controlled-clinical-trial
#9
Monica W Harbell, Joshua M Cohen, Kerstin Kolodzie, Matthias Behrends, Matthias R Braehler, Sakura Kinjo, Brian T Feeley, Pedram Aleshi
STUDY OBJECTIVE: To compare preoperative femoral (FNB) with combined femoral and sciatic nerve block (CFSNB) in patients undergoing arthroscopic anterior cruciate ligament (ACL) reconstruction. DESIGN: Prospective, randomized clinical trial. SETTING: Ambulatory surgery center affiliated with an academic medical center. PATIENTS: Sixty-eight American Society of Anesthesiology physical status I and II patients undergoing arthroscopic ACL reconstruction...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27552062/intravenous-lidocaine-infusions-in-a-multidirectional-model-of-treatment-of-neuropathic-pain-patients
#10
Anna Przeklasa-Muszyńska, Magdalena Kocot-Kępska, Jan Dobrogowski, Maciej Wiatr, Joanna Mika
BACKGROUND: Neuropathic pain, is caused by damage or disease affecting the somatosensory nervous system, leads to deterioration of the quality of life of patients. Most commonly, this deterioration is due to the inefficacy of treatment or to the adverse effects of systemic treatment. Pharmacotherapy of neuropathic pain involves the use of antiepileptic agents, antidepressants, and opioids that may lead to numerous adverse effects, particularly in elderly patients. Intravenous infusions of lidocaine may improve the efficacy of the analgesic treatment of neuropathic pain patients while not causing any significant adverse effects...
October 2016: Pharmacological Reports: PR
https://www.readbyqxmd.com/read/27532369/symptom-burden-in-mesothelioma-patients-admitted-to-home-palliative-care
#11
Sebastiano Mercadante, Daniela Degiovanni, Alessandra Casuccio
CONTEXT: Mesothelioma is a very aggressive cancer that is brought on by asbestos exposure. Because there is a long latency period between exposure to asbestos and symptoms of disease, most patients with mesothelioma present with advanced disease and survive an average of 8-12 months. Thus, best supportive care should be considered critical to optimally manage these patients. AIM: The aim of this study was to examine the epidemiological characteristics and symptom burden of mesothelioma patients when admitted to home palliative care...
December 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27524827/obstetrical-providers-management-of-chronic-pain-in-pregnancy-a-vignette-study
#12
Brownsyne Tucker Edmonds, Fatima McKenzie, MacKenzie B Austgen, Leslie Ashburn-Nardo, Marianne S Matthias, Adam T Hirsh
OBJECTIVE: Describe obstetrical providers' management of a hypothetical case on chronic pain in pregnancy and determine whether practices differ based on patient race. DESIGN AND SETTING: This was a self-administered survey at a clinical conference. SUBJECTS: Seventy-six obstetrician-gynecologists and one nurse practitioner were surveyed. METHODS: A case-vignette described a pregnant patient presenting with worsening chronic lower back pain, requesting an opioid refill and increased dosage...
August 14, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27517842/impact-of-emergency-department-care-on-outcomes-of-acute-pain-events-in-children-with-sickle-cell-disease
#13
Amanda M Brandow, Mark Nimmer, Timothy Simmons, T Charles Casper, Lawrence J Cook, Corrie E Chumpitazi, J Paul Scott, Julie A Panepinto, David C Brousseau
The impact of emergency department (ED) treatment on outcomes of sickle cell disease (SCD) acute pain hospitalizations is not well described. We investigated whether length of stay (LOS) and change in health-related quality of life (HRQL) are affected by initial opioid dose and time to administration. We conducted secondary analyses of data from the randomized-controlled Magnesium for children in Crisis (MAGiC) trial. The primary outcome was LOS. Secondary outcome was change in HRQL, assessed using PedsQL SCD Pain and Hurt and Pain Impact Domains measured in ED and at discharge...
December 2016: American Journal of Hematology
https://www.readbyqxmd.com/read/27484363/testicular-toxicity-following-separate-and-combined-administration-of-pde5-inhibitors-and-opioid-assessment-of-recovery-following-their-withdrawal
#14
V U Nna, E E Osim
We previously observed that PDE5 inhibitors and opioids were widely abused in Nigeria. Here, we examined the effect of high doses of sildenafil, tadalafil, tramadol and sildenafil + tramadol on reproductive toxicity in male rats. Rats were either administered normal saline (0.2 ml), sildenafil (10 mg/kg), tadalafil (10 mg/kg), tramadol (20 mg/kg) or sildenafil + tramadol (10 and 20 mg/kg respectively) p. o. for 8 weeks. The recovery groups were allowed 8-week recovery period before sacrifice. Results showed that body weight change, testicular and epididymal weights, epididymal sperm count and sperm viability were significantly reduced in all treated groups compared with the control...
August 3, 2016: Andrologia
https://www.readbyqxmd.com/read/27471314/clonidine-and-ketamine-for-stable-hemodynamics-in-off-pump-coronary-artery-bypass
#15
RANDOMIZED CONTROLLED TRIAL
Jigar Patel, Rajesh Thosani, Jignesh Kothari, Pankaj Garg, Himani Pandya
BACKGROUND: The current era of fast-track extubation and faster recovery after cardiac surgery requires agents that provide perioperative sedation, suppress sympathetic response, reduce opioid requirement, and maintain hemodynamic stability. METHODS: In a prospective randomized double-blind study, 75 off-pump coronary artery bypass patients were divided into 3 groups of 25 each: group A had clonidine 1 µg·kg(-1), group B had clonidine 1 µg·kg(-1) and ketamine 1 mg·kg(-1), and group C had a saline placebo...
September 2016: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/27421830/exposure-to-morphine-associated-cues-increases-mu-opioid-receptor-mrna-expression-in-the-nucleus-accumbens-of-wistar-kyoto-rats
#16
Torry S Dennis, Kevin D Beck, Tara P Cominski, Samara A M Bobzean, Eldo V Kuzhikandathil, Richard J Servatius, Linda I Perrotti
The Wistar-Kyoto (WKY) rat has been proposed as a model of anxiety vulnerability as it exhibits pronounced behavioral inhibition, passive avoidance, exaggerated startle response, enhanced HPA-axis activation, and active avoidance that is resistant to extinction. Accumulating evidence suggests that WKY rats respond differently to rewarding stimuli when compared to outbred strains of rat. Conditioned responding to drug-associated cues is linked with alterations in the activation of mu opioid receptors (MOR) and kappa opioid receptors (KOR) in the nucleus accumbens (NAc)...
October 15, 2016: Behavioural Brain Research
https://www.readbyqxmd.com/read/27417686/antinociceptive-properties-of-the-mastoparan-peptide-agelaia-mpi-isolated-from-social-wasps
#17
Jacqueline Gonçalves, Marisa Rangel, Andréia Biolchi, Eveline Alves, Karla Moreira, Luciano Silva, Márcia Mortari
Analgesic therapy is based on the sequential treatment of pain, in which opioids are drugs of last resource and known to be highly effective, but are also responsible for undesirable side effects, tolerance and addiction. There is a need for new drugs with alternative targets in order to minimize side effects and improve treatment efficacy. Mastoparans are an abundant class of peptides in wasp venom and have shown great potential as new drugs, as well as being excellent tools for the study of G-protein-coupled receptors...
September 15, 2016: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/27393461/oxycodone-physical-dependence-and-its-oral-self-administration-in-c57bl-6j-mice
#18
Rachel M Enga, Asti Jackson, M Imad Damaj, Patrick M Beardsley
Abuse of prescription opioids, such as oxycodone, has markedly increased in recent decades. While oxycodone's antinociceptive effects have been detailed in several preclinical reports, surprisingly few preclinical reports have elaborated its abuse-related effects. This is particularly surprising given that oxycodone has been in clinical use since 1917. In a novel oral operant self-administration procedure, C57BL/6J mice were trained to self-administer water before introducing increasing concentrations of oxycodone (0...
October 15, 2016: European Journal of Pharmacology
https://www.readbyqxmd.com/read/27372220/decreased-diversion-by-doctor-shopping-for-a-reformulated-extended-release-oxycodone-product-oxycontin
#19
Howard D Chilcoat, Paul M Coplan, Venkatesh Harikrishnan, Louis Alexander
BACKGROUND: Doctor-shopping (obtaining prescriptions from multiple prescribers/pharmacies) for opioid analgesics produces a supply for diversion and abuse, and represents a major public health issue. METHODS: An open cohort study assessed changes in doctor-shopping in the U.S. for a brand extended release (ER) oxycodone product (OxyContin) and comparator opioids before (July, 2009 to June, 2010) versus after (January, 2011 to June, 2013) introduction of reformulated brand ER oxycodone with abuse-deterrent properties, using IMS LRx longitudinal data covering >150 million patients and 65% of retail U...
August 1, 2016: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/27327855/the-effects-of-minimal-dose-versus-low-dose-s-ketamine-on-opioid-consumption-hyperalgesia-and-postoperative-delirium-a-triple-blinded-randomized-active-and-placebo-controlled-clinical-trial
#20
Helmar Bornemann-Cimenti, Mischa Wejbora, Kristina Michaeli, Alexander Edler, Andreas Sandner-Kiesling
BACKGROUND: Evidence confirms that perioperative ketamine administration decreases opioid usage. To reduce the risk for potential psychodysleptic side effects, however, ketamine dosing tends to be limited to low-dose regimens. We hypothesized that even lower doses of ketamine would be sufficient, with minimal side effects, when used as a component of multimodal perioperative pain management. METHODS: In this triple-blinded, randomized, active- and placebo-controlled clinical trial, patients undergoing elective major abdominal surgery were randomized to one of three treatment groups: low-dose S-ketamine (a 0...
October 2016: Minerva Anestesiologica
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