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https://www.readbyqxmd.com/read/29683378/pharmacokinetic-properties-of-intranasal-and-injectable-formulations-of-naloxone-for-community-use-a-systematic-review
#1
Shawn A Ryan, Robert B Dunne
AIM: To assess the pharmacokinetic properties of community-use formulations of naloxone for emergency treatment of opioid overdose. METHODS: Systematic literature review based on searches of established databases and congress archives. RESULTS: Seven studies met inclusion criteria: two of US FDA-approved intramuscular (im.)/subcutaneous (sc.) auto-injectors, one of an FDA-approved intranasal spray, two of unapproved intranasal kits (syringe with atomizer attachment) and two of intranasal products in development...
April 23, 2018: Pain Management
https://www.readbyqxmd.com/read/29681795/delta-opioid-receptor-signaling-promotes-resilience-to-stress-under-the-repeated-social-defeat-paradigm-in-mice
#2
Mathilde S Henry, Kanchan Bisht, Nathalie Vernoux, Louis Gendron, Angélica Torres-Berrio, Guy Drolet, Marie-Ève Tremblay
The adaptation to chronic stress is highly variable across individuals. Resilience to stress is a complex process recruiting various brain regions and neurotransmitter systems. The aim of this study was to investigate the involvement of endogenous opioid enkephalin (ENK) signaling in the development of stress resilience in mice. The translational model of repeated social defeat (RSD) stress was selected to mimic the unpredictable disruptions of daily life and induce resilience or vulnerability to stress. As in humans, adult C57BL/6J mice demonstrated a great variability in their response to stress under this paradigm...
2018: Frontiers in Molecular Neuroscience
https://www.readbyqxmd.com/read/29681324/expectancy-modulation-of-opioid-neurotransmission
#3
Marta Pecina, Jon-Kar Zubieta
Expectancies are powerful modulators of cognitive and emotional experiences, as well as the neurobiological responses linked to these processes. In medicine, placebo effects are a clear example of how expectancies activate opioid neurotransmission in a treatment context, leading to the experience of analgesia and the improvement of emotional states, among other symptoms. Molecular neuroimaging techniques using positron emission tomography (PET) and the selective μ-opioid receptor tracer [11 C]carfentanil have significantly contributed to our understanding of the neurobiological systems involved in the formation of placebo effects...
2018: International Review of Neurobiology
https://www.readbyqxmd.com/read/29680678/concomitant-use-of-buprenorphine-for-medication-assisted-treatment-of-opioid-use-disorder-and-benzodiazepines-using-the-prescription-behavior-surveillance-system
#4
Yanmin Zhu, D Tyler Coyle, Mohamed Mohamoud, Esther Zhou, Efe Eworuke, Catherine Dormitzer, Judy Staffa
BACKGROUND: Despite clinical guidelines discouraging the practice, it is well-documented that the concomitant use of benzodiazepines and opioid analgesics occurs regularly. Information on concomitant use of buprenorphine for medication-assisted treatment (MAT) of opioid use disorder (OUD) and benzodiazepines, however, is limited. Thus, we aimed to describe real-world drug dispensing patterns for the concomitant use of buprenorphine products approved for MAT and benzodiazepines. METHODS: We examined concomitant use of buprenorphine for MAT and benzodiazepines using the 2013 Prescription Behavior Surveillance System data from eight states...
April 10, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29680426/willis-ekbom-disease-restless-legs-syndrome-in-patients-with-opioid-withdrawal
#5
Ravi Gupta, Ramjan Ali, Rajat Ray
INTRODUCTION: Many patients with opioid use disorder report symptoms similar to restless legs syndrome (RLS) during withdrawal. However, whether these symptoms are true RLS, their predictors and effect of treatment with pregabalin are still unknown. METHOD: A total of 19 consecutive patients with opioid use disorder who were admitted for detoxification were included in this study after obtaining informed consent. Information regarding addiction was noted, and they were screened for RLS every morning and evening...
May 2018: Sleep Medicine
https://www.readbyqxmd.com/read/29680327/clinical-characteristics-of-patients-with-newly-developed-acute-cholecystitis-after-admission-to-the-intensive-care-unit
#6
Soo Jung Kim, Seok Jeong Lee, Su Hwan Lee, Jin Hwa Lee, Jung Hyun Chang, Yon Ju Ryu
INTRODUCTION: Critical care patients have many risk factors for acute cholecystitis (AC). However, less data are available regarding newly developed AC in critically ill patients. OBJECTIVES: To investigate the clinical features of AC occurring in critically ill patients after admission to an intensive care unit (ICU). METHODS: We performed a retrospective cohort study from January 2006 to August 2016 at a tertiary care university hospital...
April 18, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29679681/inhibition-of-protein-kinase-a-and-girk-channel-reverses-fentanyl-induced-respiratory-depression
#7
Xiaonan Liang, Zheng Yong, Ruibin Su
Opioid-induced respiratory depression is a major obstacle to improving the clinical management of moderate to severe chronic pain. Opioids inhibit neuronal activity via various pathways, including calcium channels, adenylyl cyclase, and potassium channels. Currently, the underlying molecular pathway of opioid-induced respiratory depression is only partially understood. This study aimed to investigate the mechanisms of opioid-induced respiratory depression in vivo by examining the effects of different pharmacological agents on fentanyl-induced respiratory depression...
April 18, 2018: Neuroscience Letters
https://www.readbyqxmd.com/read/29678771/prenatal-ethanol-induces-an-anxiety-phenotype-and-alters-expression-of-dynorphin-nociceptin-orphanin-fq-genes
#8
Aranza Wille-Bille, Roberto Sebastián Miranda-Morales, Mariangela Pucci, Fabio Bellia, Claudio D'Addario, Ricardo Marcos Pautassi
Animal models have suggested that prenatal ethanol exposure (PEE) alters the κ opioid receptor system. The present study investigated the brain expression of dynorphin and nociceptin/orphanin FQ related genes and assessed anxiety-like behavior in the light-dark box (LDB), shelter-seeking and risk-taking behaviors in the concentric square field (CSF) test, and ethanol-induced locomotion in the open field (OF), in infant or adolescent Wistar rats that were exposed to PEE (0.0 or 2.0 g/kg, intragastrically, gestational days 17-20)...
April 17, 2018: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/29677442/synthesis-and-pharmacological-evaluation-of-novel-c-8-substituted-tetrahydroquinolines-as-balanced-affinity-mu-delta-opioid-ligands-for-the-treatment-of-pain
#9
Anthony F Nastase, Nicholas W Griggs, Jessica P Anand, Thomas J Fernandez, Aubrie A Harland, Tyler J Trask, Emily M Jutkiewicz, John R Traynor, Henry I Mosberg
The use of opioids for the treatment of pain, while largely effective, is limited by detrimental side effects including analgesic tolerance, physical dependence, and euphoria, which may lead to opioid abuse. Studies have shown that compounds with a -opioid receptor (MOR) agonist/-opioid receptor (DOR) antagonist profile reduce or eliminate some of these side effects including development of tolerance and dependence. Herein we report the synthesis and pharmacological evaluation of a series of tetrahydroquinoline-based peptidomimetics with substitutions at the C-8 position...
April 20, 2018: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/29677413/survey-assessing-medical-student-and-physician-knowledge-and-attitudes-regarding-the-opioid-crisis
#10
Skyler Chouinard, Aman Prasad, Randall Brown
BACKGROUND: There is a national opioid misuse and overdose crisis. Consensus guidelines seek to inform practice and reduce risk; however, effect on clinician attitudes and knowledge remains unclear. METHODS: We surveyed 228 medical students and physicians in Wisconsin to assess their knowledge regarding at-risk patients, alternatives to opioids, and best treatment practices for opioid addiction. We also assessed attitudes about prescribing naloxone, relapse likelihood, and responsibility for the crisis...
March 2018: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29677062/opioid-oversupply-after-joint-and-spine-surgery-a-prospective-cohort-study
#11
Mark C Bicket, Elizabeth White, Peter J Pronovost, Christopher L Wu, Myron Yaster, G Caleb Alexander
BACKGROUND: Many patients receive prescription opioids at hospital discharge after surgery, yet little is known regarding how often these opioids go unused. We estimated the prevalence of unused opioids, use of nonopioid analgesics, and storage and disposal practices after same-day and inpatient surgery. METHODS: In this prospective cohort study at a large, inner-city tertiary care hospital, we recruited individuals ≥18 years of age undergoing elective same-day or inpatient joint and spine surgery from August to November 2016...
April 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29676839/analgesic-consumption-trajectories-in-8-975-patients-1-year-after-fast-track-total-hip-or-knee-arthroplasty
#12
C C Jørgensen, M Petersen, H Kehlet, E K Aasvang
BACKGROUND: Persistent or increased long-term opioid consumption has previously been described following total hip- (THA) and knee arthroplasty (TKA). However, detailed information on postoperative analgesic consumption trajectories and risk factors associated with continued need of analgesics in fast-track THA and TKA is sparse. METHODS: Descriptive multicenter study in primary unilateral fast-track THA or TKA with prospective data on patient characteristics and information on reimbursement entitled dispensed prescriptions of paracetamol, non-steroidal anti-inflammatory drugs, opioids, anticonvulsants, and antidepressants one month preoperatively and one year postoperatively...
April 20, 2018: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29676241/antagonist-treatment-is-just-as-effective-as-replacement-therapy-for-opioid-addiction-but-neither-is-used-often-enough
#13
Stephen M Stahl
One of the most malignant illnesses in psychiatry is opioid addiction. This disorder has resulted in a current epidemic of addiction, overdose, and death that continues in large part because of the lack of robust treatments and the surprising lack of utilization of the treatments that are available.
April 2018: CNS Spectrums
https://www.readbyqxmd.com/read/29675943/relationship-of-anxiety-with-joint-pain-and-its-management-a-population-survey
#14
Lauren A Barnett, Mark G Pritchard, John J Edwards, Ebenezer K Afolabi, Kelvin P Jordan, Emma L Healey, Andrew G Finney, Carolyn A Chew-Graham, Christian D Mallen, Krysia S Dziedzic
OBJECTIVES: The aims of the present study was to examine the associations between the severity of pain and anxiety in a community population reporting joint pain, and to investigate the management of joint pain in the presence of comorbid anxiety. METHODS: A population survey was carried out of people aged ≥45 years, registered with eight general practices in Cheshire, Shropshire and Staffordshire, UK. Respondents were asked to report pain intensity in their hands, hips, knees and feet (on a numerical rating scale), anxiety symptoms (Generalized Anxiety Disorder seven-item [GAD-7] scale) and guideline-recommended treatments used to manage pain...
April 20, 2018: Musculoskeletal Care
https://www.readbyqxmd.com/read/29675893/characteristics-of-opioid-maintained-clients-smoking-fentanyl-patches-the-importance-of-confirmatory-drug-analysis-illustrated-by-a-case-series-and-mini-review
#15
Andreas Kimergård, Jacklyn Dunne, Anette Bøgen, Peter Hindersson, Torben Breindahl
The increase in opioid prescribing in many European countries over the last decade has raised concerns about associated diversion, overdose and mortality. Fentanyl is one of these synthetic opioids that is typically prescribed as a transdermal patch for pain that requires continuous pain relief and has been the focus of investigations due to reports of overdose and death. We report a case series of 14 drug addiction treatment entrants who entered treatment in one service located in the region of Southern Denmark from August 2015 to December 2015 for smoking fentanyl patches...
April 19, 2018: Drug Testing and Analysis
https://www.readbyqxmd.com/read/29675582/multifunctional-opioid-ligands
#16
Jessica P Anand, Deanna Montgomery
The opioid receptor system plays a major role in the regulation of mood, reward, and pain. The opioid receptors therefore make attractive targets for the treatment of many different conditions, including pain, depression, and addiction. However, stimulation or blockade of any one opioid receptor type often leads to on-target adverse effects that limit the clinical utility of a selective opioid agonist or antagonist. Literature precedent suggests that the opioid receptors do not act in isolation and that interactions among the opioid receptors and between the opioid receptors and other proteins may produce clinically useful targets...
April 20, 2018: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/29674362/implementation-of-an-evidence-based-model-of-care-for-low-back-pain-in-emergency-departments-protocol-for-the-sydney-health-partners-emergency-department-shaped-trial
#17
Gustavo C Machado, Bethan Richards, Chris Needs, Rachelle Buchbinder, Ian A Harris, Kirsten Howard, Kirsten McCaffery, Laurent Billot, James Edwards, Eileen Rogan, Rochelle Facer, David Lord Cowell, Chris G Maher
INTRODUCTION: Patients with low back pain often seek care in emergency departments, but the problem is that many patients receive unnecessary or ineffective interventions and at the same time miss out on the basics of care, such as advice on self-management. This pattern of care has important consequences for the healthcare system (expensive and inefficient) and for patients (poor health outcomes). We hypothesised that the implementation of an evidence-based model of care for low back pain will improve emergency care by reducing inappropriate overuse of tests and treatments and improving patient outcomes...
April 19, 2018: BMJ Open
https://www.readbyqxmd.com/read/29673974/randomized-controlled-trial-of-nurse-delivered-cognitive-behavioral-therapy-versus-supportive-psychotherapy-telehealth-interventions-for-chronic-back-pain
#18
Thomas Rutledge, J Hampton Atkinson, Rachael Holloway, Tatiana Chircop-Rollick, John D'Andrea, Steven R Garfin, Shetal Patel, Donald B Penzien, Mark Wallace, Anne L Weickgenant, Mark Slater
This study evaluated a nurse-delivered, telehealth intervention of cognitive behavioral therapy versus supportive psychotherapy for chronic back pain. Participants (N=61) had chronic back pain (pain "daily" ≥ 6 months at an intensity ≥4/10 scale) and were randomized to an 8-week, 12-session, Cognitive Behavioral Therapy (CBT) or to Supportive Care (SC) matched for frequency, format, and time, with each treatment delivered by a primary care nurse. The primary outcome was the Roland Morris Disability Questionnaire (RMDQ)...
April 16, 2018: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29673369/challenges-in-implementing-opioid-agonist-therapy-in-lebanon-a-qualitative-study-from-a-user-s-perspective
#19
Ali Ghaddar, Sanaa Khandaqji, Zeinab Abbass
BACKGROUND: Opioid agonist therapy (OAT) has been implemented for the treatment of individuals with opioid use disorders in Lebanon since 2011, but has not been evaluated yet. The aim of the study is to describe the implementation of the first pilot OAT program in Lebanon from the users' perspective. METHODS: Data collectors gathered data from male participants during June 2016-July 2016. Eighty-one out of 94 patients agreed to participate in the study. Data regarding access to treatment, satisfaction with the treatment protocol and treatment outcomes, patient-provider relationship, and misuse and diversion was collected through semi-structured qualitative interviews...
April 19, 2018: Substance Abuse Treatment, Prevention, and Policy
https://www.readbyqxmd.com/read/29672985/the-impact-of-buprenorphine-and-methadone-on-mortality-a-primary-care-cohort-study-in-the-united-kingdom
#20
Matthew Hickman, Colin Steer, Kate Tilling, Aaron G Lim, John Marsden, Tim Millar, John Strang, Maggie Telfer, Peter Vickerman, John Macleod
AIMS: To estimate whether opioid substitution treatment (OST) with buprenorphine or methadone is associated with a greater reduction in the risk of all-cause mortality (ACM) and opioid drug-related poisoning (DRP) mortality. DESIGN: Cohort study with linkage between clinical records from Clinical Practice Research Datalink and mortality register. SETTING: UK primary care. PARTICIPANTS: A total of 11 033 opioid-dependent patients who received OST from 1998 to 2014, followed-up for 30 410 person-years...
April 19, 2018: Addiction
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