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Combination Opioids

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https://www.readbyqxmd.com/read/28327548/opioid-sparing-effect-of-cannabinoids-a-systematic-review-and-meta-analysis
#1
REVIEW
Suzanne Nielsen, Pamela Sabioni, Jose M Trigo, Mark A Ware, Brigid D Betz-Stablein, Bridin Murnion, Nicholas Lintzeris, Kok Eng Khor, Michael Farrell, Andrew Smith, Bernard Le Foll
Cannabinoids, when co-administered with opioids, may enable reduced opioid doses without loss of analgesic efficacy (ie an opioid-sparing effect). The aim of this study was to conduct a systematic review to determine the opioid-sparing potential of cannabinoids. Eligible studies included pre-clinical and clinical studies for which the outcome was either analgesia or opioid dose requirements. Clinical studies included controlled studies and case series. We searched Scopus, Cochrane Database of Systematic Reviews, Medline, and Embase...
March 22, 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28321300/identifying-highlighting-and-reducing-polypharmacy-in-a-uk-hospice-inpatient-unit-using-improvement-science-methods
#2
Alison Phippen, Jennie Pickard, Douglas Steinke, Matt Cope, Dai Roberts
Polypharmacy, the concurrent use of multiple medications by one individual is a growing global issue driven by an ageing population and increasing prevalence of multi-morbidity[1]. Polypharmacy can be problematic: interactions between medications, reduced adherence to medication, burden of medication to patients, administration time, increased risk of errors and increased cost. Quality improvement methods were applied to identify and highlight polypharmacy patients with the aim of reducing their average number of regular tablets/capsules per day by 25%...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28315922/superior-perioperative-analgesia-with-combined-femoral-obturator-sciatic-nerve-block-in-comparison-with-posterior-lumbar-plexus-and-sciatic-nerve-block-for-acl-reconstructive-surgery
#3
Metaxia Bareka, Michael Hantes, Eleni Arnaoutoglou, George Vretzakis
PURPOSE: The purpose of this randomized controlled study is to compare and evaluate the intraoperative and post-operative outcome of PLPS nerve block and that of femoral, obturator and sciatic (FOS) nerve block as a method of anaesthesia, in performing ACL reconstruction. METHODS: Patients referred for elective arthroscopic ACL reconstruction using hamstring autograft were divided in two groups. The first group received combined femoral-obturator-sciatic nerve block (FOS Group) under dual guidance, whereas the second group received posterior lumbar plexus block under neurostimulation and sciatic nerve block (PLPS Group) under dual guidance...
March 18, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28315644/effects-of-buprenorphine-methylnaltrexone-and-their-combination-on-gastrointestinal-transit-in-healthy-new-zealand-white-rabbits
#4
Manuel Martin-Flores, Bhupinder Singh, Courtney A Walsh, Elizabeth P Brooks, Lacic Taylor, Lisa M Mitchell
Among the many analgesic agents available, buprenorphine appears to be the analgesic used most often in rabbits. Unfortunately, deleterious side effects of opioids, such as gastrointestinal stasis and anorexia, may discourage the use of these agents. Methylnaltrexone is a peripheral opioid antagonist that ameliorates opioid-induced gastrointestinal stasis in others species yet preserves the analgesic effects of buprenorphine. We evaluated whether methylnaltrexone reversed buprenorphine-induced gastrointestinal stasis in 8 healthy male New Zealand White rabbits...
March 1, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28315267/pharmacological-modulation-of-the-sigma-1-receptor-and-the-treatment-of-pain
#5
Manuel Merlos, Javier Burgueño, Enrique Portillo-Salido, Carlos Ramón Plata-Salamán, José Miguel Vela
There is a critical need for new analgesics acting through new mechanisms of action, which could increase the efficacy with respect to existing therapies and reduce their unwanted effects. Current preclinical evidence supports the modulatory role of sigma-1 receptors (σ1R) in nociception, mainly based on the pain-attenuated phenotype of σ1R knockout mice and on the antinociceptive effect exerted by σ1R antagonists on pains of different etiologies. σ1R is highly expressed in different pain areas of the CNS and the periphery (particularly dorsal root ganglia), and interacts and modulates the functionality of different receptors and ion channels ...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28314949/tolerance-and-cross-tolerance-to-the-antinociceptive-effects-of-oxycodone-and-the-imidazoline-i2-receptor-agonist-phenyzoline-in-adult-male-rats
#6
David A Thorn, Yanan Zhang, Jun-Xu Li
RATIONALE: Emerging evidence suggests the potential utility of combining opioids with imidazoline I2 receptor agonists for chronic pain. However, chronic pain management requires prolonged pharmacotherapy, and the consequence of such combination therapy remains unclear. OBJECTIVE: This study examined the anti-hyperalgesic effect of the opioid oxycodone, the selective I2 receptor agonist phenyzoline, alone and in combination, during prolonged treatment. METHODS: Von Frey filament test was used to examine the anti-hyperalgesic effect of drugs in complete Freund's adjuvant (CFA)-induced inflammatory pain or chronic constriction injury (CCI)-induced neuropathic pain in rats...
March 17, 2017: Psychopharmacology
https://www.readbyqxmd.com/read/28306605/hyperalgesic-priming-type-ii-induced-by-repeated-opioid-exposure-maintenance-mechanisms
#7
Dioneia Araldi, Luiz F Ferrari, Jon D Levine
We previously developed a model of opioid-induced neuroplasticity in the peripheral terminal of the nociceptor that could contribute to opioid-induced hyperalgesia, type II hyperalgesic priming. Repeated administration of mu-opioid receptor (MOR) agonists, such as DAMGO, at the peripheral terminal of the nociceptor, induces long-lasting plasticity expressed, prototypically as opioid-induced hyperalgesia and prolongation of prostaglandin-E2-induced hyperalgesia. In this study, we evaluated the mechanisms involved in the maintenance of type II priming...
March 14, 2017: Pain
https://www.readbyqxmd.com/read/28301885/geburtshilfe-kombinierte-spinal-epidural-analgesie-cse
#8
Jan Wallenborn, Thorsten Artmann, Peter Kranke
Due to intrathecal application, CSE combines rapid response with adequate analgesia with the possibility of providing unlimited neuraxial obstetrical pain relief via the indwelling epidural catheter. The superiority of CSE over EDA lies above all in its rapid action, excellent analgesia, lack of motor blockade after a single intrathecal opioid administration, lower rate of unilateral blockages and less need for subsequent epidural injections. The most common side effect is pruritus, which is harmless and usually does not require any therapeutic intervention...
March 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28298770/intraperitoneal-levobupivacaine-with-or-without-clonidine-for-pain-relief-after-laparoscopic-cholecystectomy-a-randomized-double-blind-placebo-controlled-trial
#9
Nishith Govil, Parag Kumar
BACKGROUND: Irrigation of local anesthetic intraperitoneally in combination with opioids and non-opioids agents has been used to provide pain relief with varying success in laparoscopic surgeries. This randomized double blind placebo controlled study is designed to study the effect of intraperitoneal instillation of levo-bupivacaine along with clonidine for pain relief after laparascopic cholecystectomy. METHODS: 75 patients were randomized to receive 20 ml of 0...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28294636/indirect-treatment-comparison-of-two-non-invasive-patient-controlled-analgesia-treatments-for-acute-post-operative-pain-management
#10
Pablo Katz, Shweta Takyar, Pamela Palmer, Hiltrud Liedgens
OBJECTIVES: To evaluate the relative clinical efficacy, safety, and tolerability associated with two non-invasive patient-controlled analgesia (PCA) treatments, sufentanil sublingual tablet system (SSTS) and fentanyl iontophoretic patient-controlled transdermal system (PCTS). These two treatments have recently been approved in the EU for the management of acute moderate-to-severe post-operative pain in adult patients. METHODS: As no head-to-head trials comparing SSTS and PCTS currently exist, indirect treatment comparison (ITC) analyses were conducted to evaluate SSTS or PCTS versus intravenous (IV) morphine PCA...
March 15, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28293525/surgical-site-infiltration-for-abdominal-surgery-a-novel-neuroanatomical-based-approach
#11
Girish P Joshi, Jeffrey E Janis, Eric M Haas, Bruce J Ramshaw, Mikio A Nihira, Brian J Dunkin
BACKGROUND: Provision of optimal postoperative analgesia should facilitate postoperative ambulation and rehabilitation. An optimal multimodal analgesia technique would include the use of nonopioid analgesics, including local/regional analgesic techniques such as surgical site local anesthetic infiltration. This article presents a novel approach to surgical site infiltration techniques for abdominal surgery based upon neuroanatomy. METHODS: Literature searches were conducted for studies reporting the neuroanatomical sources of pain after abdominal surgery...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28293447/efficacy-and-safety-of-aceclofenac-in-osteoarthritis-a-meta-analysis-of-randomized-controlled-trials
#12
Parvati B Patel, Tejas K Patel
OBJECTIVE: To analyze the effects on pain, function, and safety of aceclofenac compared with other nonsteroidal anti-inflammatory drugs (NSAIDs) or pain relief medications in patients with osteoarthritis. MATERIAL AND METHODS: Two investigators independently searched the database. We included randomized controlled trials evaluating efficacy and/or safety of aceclofenac compared with control interventions (NSAIDs or acetaminophen) in patients with osteoarthritis...
March 2017: European Journal of Rheumatology
https://www.readbyqxmd.com/read/28292504/pharmacists-perceptions-regarding-the-impact-of-hydrocodone-rescheduling-on-prescription-volume-workflow-management-and-patient-outcomes
#13
Tyler J Varisco, Motolani E Ogunsanya, Jamie C Barner, Marc L Fleming
OBJECTIVES: To determine (1) pharmacists' perceptions of how rescheduling of hydrocodone combination products (HCPs) from Drug Enforcement Agency (DEA) Schedule III to DEA Schedule II has influenced prescription volume and revenue, pharmacy workflow management, and patient outcomes; and (2) whether perceptions differed between pharmacists who support versus those who oppose HCP rescheduling. DESIGN: A cross-sectional mail survey. SETTING: Texas community pharmacies from October to December 2015...
March 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28292491/joint-utility-estimators-in-substance-use-disorders
#14
Eve Wittenberg, Jeremy W Bray, Achamyeleh Gebremariam, Brandon Aden, Bohdan Nosyk, Bruce R Schackman
BACKGROUND: Although co-occurring conditions are common with substance use disorders (SUDs), estimation methods for joint health state utilities have not yet been tested in this context. OBJECTIVES: To compare joint health state utility estimators in SUD to inform economic evaluation. METHODS: We conducted two Internet-based surveys of US adults to collect community perspective standard gamble utilities for SUD and common co-occurring conditions...
March 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
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
#15
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/28288850/comparison-of-umbilical-cord-tissue-and-meconium-for-the-confirmation-of-in-utero-drug-exposure
#16
Jennifer M Colby
OBJECTIVES: Drug screening in neonates is traditionally performed using meconium, but cord tissue has been proposed as an alternative specimen. This study compares the detection of drugs in a large number of paired meconium and umbilical cord tissue samples from subjects at risk of in utero drug exposure. DESIGN AND METHODS: Physician-ordered toxicology results and clinical information were collected in a retrospective review of subject medical records. All toxicology testing was performed by a national reference laboratory using a combination of immunoassays and chromatography-mass spectrometry...
March 10, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28288050/pain-management-modalities-after-total-knee-arthroplasty-a-network-meta-analysis-of-170-randomized-controlled-trials
#17
Abdullah Sulieman Terkawi, Dimitris Mavridis, Daniel I Sessler, Megan S Nunemaker, Khaled S Doais, Rayan Sulieman Terkawi, Yazzed Sulieman Terkawi, Maria Petropoulou, Edward C Nemergut
BACKGROUND: Optimal analgesia for total knee arthroplasty remains challenging. Many modalities have been used, including peripheral nerve block, periarticular infiltration, and epidural analgesia. However, the relative efficacy of various modalities remains unknown. The authors aimed to quantify and rank order the efficacy of available analgesic modalities for various clinically important outcomes. METHODS: The authors searched multiple databases, each from inception until July 15, 2016...
March 13, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28287359/opioid-prescribing-patterns-and-costs-in-a-large-group-of-patients-in-colombia
#18
Jorge Enrique Machado-Alba, Andres Gaviria-Mendoza, Camila A Vargas-Mosquera, Andrés Felipe Gil-Restrepo, Luis C Romero-Zapata
The potential for development of tolerance and dependence and the risk of side effects of opioids make it necessary to monitor their prescribing patterns in order to decrease the morbidity and mortality associated with their continued use. The objective of this study was to determine prescription patterns of opioid medication in a group of patients through a cross-sectional study on a population database of 3.5 million people. Patients with three months of continuous opioid use were identified. Pharmacological, co-medication and cost variables were analyzed...
March 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28285863/low-dose-ketamine-use-in-the-emergency-department-a-new-direction-in-pain-management
#19
A Pourmand, M Mazer-Amirshahi, C Royall, R Alhawas, R Shesser
There is a need for alternative non-opioid analgesics for the treatment of acute, chronic, and refractory pain in the emergency department (ED). Ketamine is a fast acting N-methyl-d-aspartate (NMDA) receptor antagonist that provides safe and effective analgesia. The use of low dose ketamine (LDK) (<1mg/kg) provides sub-dissociative levels of analgesia and has been studied as an alternative and/or adjunct to opioid analgesics. We reviewed 11 studies using LDK either alone or in combination with opioid analgesics in the ED...
March 2, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28284867/role-of-the-sugar-moiety-on-the-opioid-receptor-binding-and-conformation-of-a-series-of-enkephalin-neoglycopeptides
#20
Mònica Rosa, Verónica Gonzalez-Nunez, Katherine Barreto-Valer, Filipa Marcelo, Julia Sánchez-Sánchez, Luis P Calle, Juan C Arévalo, Raquel E Rodríguez, Jesús Jiménez-Barbero, Gemma Arsequell, Gregorio Valencia
Glycosylation by simple sugars is a drug discovery alternative that has been explored with varying success for enhancing the potency and bioavailability of opioid peptides. Long ago we described two O-glycosides having either β-Glucose and β-Galactose of (d-Met(2), Pro(5))-enkephalinamide showing one of the highest antinociceptive activities known. Here, we report the resynthesis of these two analogs and the preparation of three novel neoglycopeptide derivatives (α-Mannose, β-Lactose and β-Cellobiose)...
February 27, 2017: Bioorganic & Medicinal Chemistry
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