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Alfentanil

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https://www.readbyqxmd.com/read/29803320/plasma-concentration-based-response-surface-model-predict-better-than-effect-site-concentration-based-model-for-wake-up-time-during-gastrointestinal-endoscopy-sedation
#1
Jing-Yang Liou, Mei-Yung Tsou, Shinju Obara, Lu Yu, Chien-Kun Ting
BACKGROUND: Sedation for esophagogastroduodenoscopy (EGD) and colonoscopy is characterized by rapid patient induction and emergence. The drugs midazolam and alfentanil have long been used for procedural sedation; however, the relationship between plasma or effect-site concentrations (Cp or Ce, respectively) and emergence remains unclear. The aim of this study is to develop patient wake-up prediction models for both Cp and Ce using response surface modeling, a pharmacodynamics tool for assessing patients' responses...
May 23, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/29793588/adaptation-of-non-linear-mixed-amount-with-zero-amount-response-surface-model-for-analysis-of-concentration-dependent-synergism-and-safety-with-midazolam-alfentanil-and-propofol-sedation
#2
J-Y Liou, C-K Ting, W-N Teng, M S Mandell, M-Y Tsou
BACKGROUND: The non-linear mixed amount with zero amounts response surface model can be used to describe drug interactions and predict loss of response to noxious stimuli and respiratory depression. We aimed to determine whether this response surface model could be used to model sedation with the triple drug combination of midazolam, alfentanil and propofol. METHODS: Sedation was monitored in 56 patients undergoing gastrointestinal endoscopy (modelling group) using modified alertness/sedation scores...
June 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29776952/activity-based-concept-to-screen-biological-matrices-for-opiates-and-synthetic-opioids
#3
Annelies Cannaert, Lakshmi Vasudevan, Melissa Friscia, Amanda L A Mohr, Sarah M R Wille, Christophe P Stove
BACKGROUND: Detection of new highly potent synthetic opioids is challenging as new compounds enter the market. Here we present a novel screening method for the detection of opiates and (synthetic) opioids based on their activity. METHODS: A cell-based system was set up in which activation of the μ -opioid receptor (MOR) led to recruitment of β-arrestin 2, resulting in functional complementation of a split NanoLuc luciferase and allowing readout via bioluminescence...
May 18, 2018: Clinical Chemistry
https://www.readbyqxmd.com/read/29726847/opioid-induced-hyperalgesia-in-the-nonsurgical-setting-a-systematic-review
#4
David Z Yang, Billy Sin, Joshua Beckhusen, Dawei Xia, Rebecca Khaimova, Ilia Iliev
BACKGROUND: Opioid-induced hyperalgesia (OIH) is a phenomenon that causes an increased pain sensitization and perception of pain to noxious stimuli secondary to opioid exposure. While this clinical effect has been described in the surgical setting, it is unclear if OIH occurs in the nonsurgical setting. STUDY QUESTION: To review the available literature which evaluated OIH in nonsurgical settings. DATA SOURCES: A comprehensive literature search was performed using PubMed (January 1946-July 2017) using a variety of keywords for OIH...
January 31, 2018: American Journal of Therapeutics
https://www.readbyqxmd.com/read/29498950/benefit-versus-severe-side-effects-of-opioid-analgesia-novel-utility-functions-of-probability-of-analgesia-and-respiratory-depression
#5
Margot Roozekrans, Rutger van der Schrier, Leon Aarts, Elise Sarton, Monique van Velzen, Marieke Niesters, Albert Dahan, Erik Olofsen
BACKGROUND: Previous studies integrated opioid benefit and harm into one single function-the utility function-to determine the drug toxicity (respiratory depression) in light of its wanted effect (analgesia). This study further refined the concept of the utility function using the respiratory and analgesic effects of the opioid analgesic alfentanil as example. METHODS: Data from three previous studies in 48 healthy volunteers were combined and reanalyzed using a population pharmacokinetic-pharmacodynamic analysis to create utility probability functions...
May 2018: Anesthesiology
https://www.readbyqxmd.com/read/29399650/lc-ms-ms-based-method-for-the-multiplex-detection-of-24-fentanyl-analogues-and-metabolites-in-whole-blood-at-sub-ng-ml-1-concentrations
#6
Kraig E Strayer, Heather M Antonides, Matthew P Juhascik, Raminta Daniulaityte, Ioana E Sizemore
The United States and numerous other countries worldwide are currently experiencing a public health crisis due to the abuse of illicitly manufactured fentanyl (IMF) and its analogues. This manuscript describes the development of a liquid chromatography-tandem mass spectrometry-based method for the multiplex detection of N = 24 IMF analogues and metabolites in whole blood at concentrations as low as 0.1-0.5 ng mL-1 . These available IMFs were fentanyl, norfentanyl, furanyl norfentanyl, remifentanil acid, butyryl norfentanyl, remifentanil, acetyl fentanyl, alfentanil, AH-7921, U-47700, acetyl fentanyl 4-methylphenethyl, acrylfentanyl, para -methoxyfentanyl, despropionyl fentanyl (4-ANPP), furanyl fentanyl, despropionyl para -fluorofentanyl, carfentanil, (±)- cis -3-methyl fentanyl, butyryl fentanyl, isobutyryl fentanyl, sufentanil, valeryl fentanyl, para -fluorobutyryl fentanyl, and para -fluoroisobutyryl fentanyl...
January 31, 2018: ACS Omega
https://www.readbyqxmd.com/read/29367034/systematic-review-of-anaesthetic-medication-for-ercp-based-on-a-network-meta-analysis
#7
REVIEW
Shuangxi Li, Guotao Sheng, Yishan Teng, Min Sun
AIMS: We performed a systematic review of various anaesthetic medications for endoscopic retrograde cholangiopancreatography (ERCP) and aimed to make a comprehensive comparison based on a network meta-analysis. METHODS: We searched globally recognized electronic databases, including PubMed, Cochrane Central and EMBASE, to retrieve relevant randomized controlled trials (RCTs) of anaesthetic medications for ERCP. Network meta-analysis was conducted by evaluating the procedure time, adverse effects and drug requirements...
March 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29216524/multiple-fatalities-in-the-north-of-england-associated-with-synthetic-fentanyl-analogue-exposure-detection-and-quantitation-a-case-series-from-early-2017
#8
Laura Hikin, Paul R Smith, Eleanor Ringland, Simon Hudson, Stephen R Morley
BACKGROUND: Synthetic fentanyl analogues are highly potent opioid drugs which have no pharmaceutical use in humans. We detected the synthetic fentanyl analogues; carfentanil, butyryl fentanyl, fluorobutyrylfentanyl, furanylfentanyl, and alfentanil as well as fentanyl itself in 25 cases in early 2017. There have been no previous reports of synthetic fentanyl deaths in the United Kingdom (UK). METHODS: Cases in which the history clearly stated drug use but where a post mortem blood morphine concentration was lower than would be expected to explain the sudden death, were referred for further analysis by high resolution accurate mass (HRAM) mass spectrometry...
January 2018: Forensic Science International
https://www.readbyqxmd.com/read/29181095/quantitation-of-fentanyl-analogs-in-dried-blood-spots-by-flow-through-desorption-coupled-to-online-solid-phase-extraction-tandem-mass-spectrometry
#9
Rebecca L Shaner, Nicholas D Schulze, Craig Seymour, Elizabeth I Hamelin, Jerry D Thomas, Rudolph C Johnson
An automated dried blood spot (DBS) elution coupled with solid phase extraction and tandem mass spectrometric analysis for multiple fentanyl analogs was developed and assessed. This method confirms human exposures to fentanyl, sufentanil, carfentanil, alfentanil, lofentanil, α-methyl fentanyl, and 3-methyl fentanyl in blood with minimal sample volume and reduced shipping and storage costs. Seven fentanyl analogs were detected and quantitated from DBS made from venous blood. The calibration curve in matrix was linear in the concentration range of 1...
2017: Analytical Methods: Advancing Methods and Applications
https://www.readbyqxmd.com/read/29178007/correction-to-pharmacokinetics-of-fentanyl-and-its-derivatives-in-children-a-comprehensive-review
#10
Victoria C Ziesenitz, Janelle D Vaughns, Gilbert Koch, Gerd Mikus, Johannes N van den Anker
Fentanyl and its derivatives sufentanil, alfentanil, and remifentanil are potent opioids. A comprehensive review of the use of fentanyl and its derivatives in the pediatric population was performed using the National Library of Medicine PubMed. Studies were included if they contained original pharmacokinetic parameters or models using established routes of administration in patients younger than 18 years of age. Of 372 retrieved articles, 44 eligible pharmacokinetic studies contained data of 821 patients younger than 18 years of age, including more than 46 preterm infants, 64 full-term neonates, 115 infants/toddlers, 188 children, and 28 adolescents...
March 2018: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/29132231/the-use-of-desflurane-for-neurosurgical-procedures-in-rhesus-macaque-macaca-mulatta
#11
Henri Gmj Bertrand, Charlotte Sandersen, Paul A Flecknell
Volatile agents are widely used to anaesthetise laboratory non-human primates as they allow a rapid induction and recovery as well as an easy adjustment of the anaesthesia plan. Desflurane is currently the volatile agent with the lowest solubility in blood, and hence enables the most rapid onset of anaesthesia and most rapid recovery. This study aimed to investigate the suitability of desflurane for maintenance of general anaesthesia in rhesus macaques undergoing elective experimental neurosurgery. Fourteen primates (five males and nine females) were sedated with ketamine (10 mg kg-1 ) and anaesthesia was induced with propofol (usually 8 mg kg-1 IV)...
January 1, 2017: Laboratory Animals
https://www.readbyqxmd.com/read/29111148/effects-of-opioid-and-nonopioid-analgesics-on-canine-wheal-formation-and-cultured-human-mast-cell-degranulation
#12
Eric Schmidt-Rondon, Zhenping Wang, Shelle A Malkmus, Anna Di Nardo, Keith Hildebrand, Linda Page, Tony L Yaksh
Mast cell (MC) degranulation has been implicated in the side effect profile of a variety of clinically useful agents. Thus, after intrathecal delivery, formation of space-occupying, meningeally-derived masses may be related to local MC degranulation. We systematically characterized degranulating effects of opioid and nonopioid analgesics on cutaneous flares in the dog and in primary human MC (hMC) cultures. METHODS: Dogs were anesthetized with IV propofol and received intradermal (ID) injections (50μL)...
January 1, 2018: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/29020995/sedation-with-propofol-during-ercp-is-the-combination-with-esketamine-more-effective-and-safer-than-with-alfentanil-study-protocol-for-a-randomized-controlled-trial
#13
Susanne Eberl, Lena Koers, Jeanin E van Hooft, Edwin de Jong, Thomas Schneider, Markus W Hollmann, Benedikt Preckel
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a gastrointestinal procedure that requires a relatively motionless patient during the intervention. Deep sedation by intravenous propofol combined with an opioid has recently become the preferred sedation technique. However, when high doses of propofol are used, side effects, namely respiratory depression, may occur. Esketamine has hypnotic, analgesic, and sympathomimetic effects. Our assumption is that a combination of propofol with esketamine reduces the dosage of individual drugs, thereby minimizing sedation side effects while keeping the same satisfaction level of patients and endoscopists...
October 11, 2017: Trials
https://www.readbyqxmd.com/read/28980330/the-fentanyl-family-a-distinguished-medical-history-tainted-by-abuse
#14
R B Raffa, J V Pergolizzi, J A LeQuang, R Taylor, S Colucci, M H Annabi
WHAT IS KNOWN AND OBJECTIVE: Beginning in the 1950s, a family of potent opioids was synthesized and developed (fentanyl and analogues). They continue to serve as valuable analgesic agents. But the recent spike and notoriety of their abuse has raised alarm, even calls for tighter control. We review the trajectory of these compounds. COMMENT: To rectify shortcomings of the then available opioid analgesics, an analogue family of compounds was synthesized having a piperidine ring (presumptive principal active moiety in morphine and meperidine)...
February 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28948899/comparison-of-emergence-times-and-quality-between-isoflurane-and-sevoflurane-in-rhesus-macaque-macaca-mulatta-undergoing-neurosurgical-procedure
#15
Henri G M J Bertrand, Svenja Springer, Wesley Burnside, Charlotte Sandersen, Paul A Flecknell
Volatile agents for anaesthesia are widely used for anaesthetizing laboratory primates, and isoflurane is one of the most frequently used agents. Sevoflurane has been shown to offer a more rapid recovery than isoflurane in a number of species, but no comparisons have been made in non-human primates. This study compared the recovery characteristics of isoflurane and sevoflurane in rhesus macaques undergoing experimental neurosurgery. Twelve primates (7 males and 5 females) were randomly allocated to the treatment groups...
October 2017: Laboratory Animals
https://www.readbyqxmd.com/read/28928100/effects-of-alfentanil-or-fentanyl-added-to-propofol-for-sedation-in-colonoscopy-on-cognitive-functions-randomized-controlled-trial
#16
Güler Doğanay, Perihan Ekmekçi, Baturay Kansu Kazbek, Hakan Yılmaz, Gülbanu Erkan, Filiz Tüzüner
BACKGROUND/AIMS: To assess the effect of propofol supplemented with alfentanil or fentanyl on cognitive functions for sedation during elective colonoscopy. MATERIALS AND METHODS: Patients (n=150, 18-65 years old, American Society of Anesthesiologists risk group I-III) scheduled undergo elective colonoscopy were included. They were randomized into three groups using the closed envelope methodpropofol-alfentanil (Group A), propofol-fentanyl (Group F), and propofol only (Group P)...
September 19, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28834382/application-of-a-screening-method-for-fentanyl-and-its-analogues-using-uhplc-qtof-ms-with-data-independent-acquisition-dia-in-ms-e-mode-and-retrospective-analysis-of-authentic-forensic-blood-samples
#17
Carolina Noble, Petur Weihe Dalsgaard, Sys Stybe Johansen, Kristian Linnet
The steady appearance of new fentanyl analogues and the associated overdose deaths require the development of sensitive screening approaches to detect these compounds in biological samples and seizures. We developed a targeted screening method to detect 50 4-anilidopiperidine-related fentanyl analogues in whole blood using ultra-high performance liquid chromatography quadrupole time-of-flight mass spectrometry in data-independent acquisition mode. Sample preparation was performed using protein precipitation on a fully automated robotic setup...
April 2018: Drug Testing and Analysis
https://www.readbyqxmd.com/read/28750840/electroacupuncture-reduced-sedative-and-analgesic-requirements-for-diagnostic-eus-a-prospective-randomized-double-blinded-sham-controlled-study
#18
Anthony Yuen Bun Teoh, Charing Ching Ning Chong, Wing Wa Leung, Simon Kin Cheong Chan, Yee Kit Tse, Enders Kwok Wai Ng, Paul Bo San Lai, Justin Che Yuen Wu, James Yun Wong Lau
BACKGROUND AND AIMS: The role of electroacupuncture (EA) in reducing sedative and analgesic requirements during EUS is uncertain. The aim of this study was to investigate the efficacy of EA in reducing procedure-related pain and discomfort during EUS. METHODS: This was a double-blinded randomized controlled study conducted between March 2014 and July 2016. Consecutive patients who were scheduled for diagnostic EUS were recruited and randomized to receive EA or sham-electroacupuncture (SA)...
February 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28688027/pharmacokinetics-of-fentanyl-and-its-derivatives-in-children-a-comprehensive-review
#19
REVIEW
Victoria C Ziesenitz, Janelle D Vaughns, Gilbert Koch, Gerd Mikus, Johannes N van den Anker
Fentanyl and its derivatives sufentanil, alfentanil, and remifentanil are potent opioids. A comprehensive review of the use of fentanyl and its derivatives in the pediatric population was performed using the National Library of Medicine PubMed. Studies were included if they contained original pharmacokinetic parameters or models using established routes of administration in patients younger than 18 years of age. Of 372 retrieved articles, 44 eligible pharmacokinetic studies contained data of 821 patients younger than 18 years of age, including more than 46 preterm infants, 64 full-term neonates, 115 infants/toddlers, 188 children, and 28 adolescents...
February 2018: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28504483/comparison-of-a-new-intranasal-naloxone-formulation-to-intramuscular-naloxone-results-from-hypothesis-generating-small-clinical-studies
#20
B T Gufford, G R Ainslie, J R White, M E Layton, J M Padowski, G M Pollack, M F Paine
Easy-to-use naloxone formulations are needed to help address the opioid overdose epidemic. The pharmacokinetics of i.v., i.m., and a new i.n. naloxone formulation (2 mg) were compared in six healthy volunteers. Relative to i.m. naloxone, geometric mean (90% confidence interval [CI]) absolute bioavailability of i.n. naloxone was modestly lower (55%; 90% CI, 43-70% vs. 41%; 90% CI, 27-62%), whereas average (±SE) mean absorption time was substantially shorter (74 ± 8.8 vs. 6.7 ± 4.9 min). The opioid-attenuating effects of i...
September 2017: Clinical and Translational Science
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