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therapeutic uses of morphine

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https://www.readbyqxmd.com/read/29442362/a-descriptive-systematic-review-of-salivary-tdm-in-neonates-and-infants
#1
Laura Hutchinson, Marlene Sinclair, Bernadette Reid, Kathryn Burnett, Bridgeen Callan
INTRODUCTION: Saliva, as a matrix, offers many benefits over blood in therapeutic drug monitoring (TDM), in particular for infantile TDM. However, the accuracy of salivary TDM in infants remains an area of debate. This review explored the accuracy, applicability and advantages of using saliva TDM in infants and neonates. METHODS: Databases were searched up to and including September 2016. Studies were included based on PICO as follows: P: Infants and neonates being treated with any medication, I: Salivary Therapeutic Drug Monitoring vs C: Traditional methods and O: accuracy, advantages/disadvantages and applicability to practice...
February 14, 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29396996/intranasal-ketamine-and-its-potential-role-in-cancer-related-pain
#2
Vinita Singh, Theresa W Gillespie, R Donald Harvey
Cancer-related pain continues to be a significant therapeutic challenge, made more difficult by contemporary opioid use and diversion concerns. Conventional treatment utilizing a tiered approach of non-steroidal anti-inflammatory drugs (NSAIDs), opioids, and adjuvant agents is limited; and alternatives are needed for patients with rapidly progressing pain and those who develop hyperalgesia and tolerance to opioids. Ketamine, an N-methyl-D-aspartate (NMDA) selective antagonist, has historically been used for anesthesia in adult and pediatric populations, but has also been investigated for depression, bipolar disorder, and general and post-operative pain management...
February 3, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29369967/lateralized-kappa-opioid-receptor-signaling-from-the-amygdala-central-nucleus-promotes-stress-induced-functional-pain
#3
Kelsey M Nation, Milena DeFelice, Pablo I Hernandez, David W Dodick, Volker Neugebauer, Edita Navratilova, Frank Porreca
The diffuse noxious inhibitory controls (DNIC) response is often decreased, or lost, in stress-related functional pain syndromes. As the dynorphin/kappa opioid receptor (KOR) pathway is activated by stress, we determined its role in DNIC using a model of stress-induced functional pain. Male, Sprague Dawley rats were primed for 7 days with systemic morphine resulting in opioid-induced hyperalgesia. Fourteen days after priming, when hyperalgesia was resolved, rats were exposed to environmental stress and DNIC was evaluated by measuring hindpaw response threshold to noxious pressure (test stimulus) following capsaicin injection in the forepaw (conditioning stimulus)...
January 23, 2018: Pain
https://www.readbyqxmd.com/read/29363579/repeated-morphine-produces-sensitization-to-reward-and-tolerance-to-anti-allodynia-in-male-and-female-rats-with-chemotherapy-induced-neuropathy
#4
Luke P Legakis, S Stevens Negus
Paclitaxel is a cancer chemotherapy drug with adverse effects that include chemotherapy-induced neuropathic pain (CINP) as well as depression of behavior and mood. In the clinical setting, opioids are often used concurrently with or following chemotherapy to treat pain related to the cancer or CINP, but repeated opioid exposure can also increase risk of opioid abuse. In this study, male and female Sprague Dawley rats were used to test the hypothesis that repeated 3.2 mg/kg morphine would induce tolerance to its antinociceptve effects in a mechanical sensitivity assay and increased expression of its abuse-related rewarding effects in an assay of intracranial self-stimulation (ICSS)...
January 23, 2018: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/29346142/neonatal-abstinence-syndrome-an-update
#5
Lauren A Sanlorenzo, Ann R Stark, Stephen W Patrick
PURPOSE OF REVIEW: The current review provides an update focused on the evolving epidemiology of neonatal abstinence syndrome (NAS), factors influencing disease expression, advances in clinical assessment of withdrawal, novel approaches to NAS treatment, and the emerging role of quality improvement in assessment and management of NAS. RECENT FINDINGS: The rise in the incidence of NAS disproportionately occurred in rural and suburban areas. Polysubstance exposure and genetic polymorphisms have been shown to modify NAS expression and severity...
January 17, 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29344928/morphine-mediated-brain-region-specific-astrocytosis-involves-the-er-stress-autophagy-axis
#6
Susmita Sil, Palsamy Periyasamy, Ming-Lei Guo, Shannon Callen, Shilpa Buch
A recent study from our lab has revealed a link between morphine-mediated autophagy and synaptic impairment. The current study was aimed at investigating whether morphine-mediated activation of astrocytes involved the ER stress/autophagy axis. Our in vitro findings demonstrated upregulation of GFAP indicating astrocyte activation with a concomitant increase in the production of proinflammatory cytokines in morphine-exposed human astrocytes. Using both pharmacological and gene-silencing approaches, it was demonstrated that morphine-mediated defective autophagy involved upstream activation of ER stress with subsequent downstream astrocyte activation via the μ-opioid receptor (MOR)...
January 17, 2018: Molecular Neurobiology
https://www.readbyqxmd.com/read/29330156/application-of-receptor-theory-to-the-design-and-use-of-fixed-proportion-mu-opioid-agonist-and-antagonist-mixtures-in-rhesus-monkeys
#7
Jeremy C Cornelissen, Samuel Obeng, Kenner C Rice, Yan Zhang, S Stevens Negus, Matthew Banks
Receptor theory predicts that fixed-proportion mixtures of a competitive, reversible agonist (e.g. fentanyl) and antagonist (e.g. naltrexone) at a common receptor (e.g. mu opioid receptors; MOR) will result in antagonist proportion-dependent decreases in apparent efficacy of the mixtures and downward shifts in mixture dose-effect functions. The present study tested this hypothesis by evaluating behavioral effects of fixed-proportion fentanyl/naltrexone mixtures in a warm-water tail-withdrawal procedure in rhesus monkeys (n=4)...
January 12, 2018: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/29322265/the-role-of-sphingolipids-in-psychoactive-drug-use-and-addiction
#8
REVIEW
Liubov S Kalinichenko, Erich Gulbins, Johannes Kornhuber, Christian P Müller
Psychoactive drug use is a common behavior in many societies worldwide, frequently associated with drug instrumentalization. Regular use may develop into drug addiction, which is a severe psychiatric disorder with multiple pathological effects to virtually all organ systems. Treatment strategies for addiction are often insufficient with no broadly working pharmaco-treatment available. Recently, lipids, and particularly sphingolipids, have been considered as new mediators in the pathogenic pathways and as possible therapeutic targets for the treatment of addictive states...
January 10, 2018: Journal of Neural Transmission
https://www.readbyqxmd.com/read/29304922/the-appropriate-use-of-opioids-in-the-treatment-of-refractory-restless-legs-syndrome
#9
Michael H Silber, Philip M Becker, Mark J Buchfuhrer, Christopher J Earley, William G Ondo, Arthur S Walters, John W Winkelman
Restless legs syndrome (RLS) is a distinct disorder, differing from chronic pain in many ways. Refractory RLS is characterized by unresponsiveness to dopamine agonists or alpha-2-delta ligands due to inadequate efficacy, augmentation, or adverse effects. This may result in severely impaired quality of life, profound insomnia, and suicidal depression. Opioid therapy is a mainstay in the management of these patients. This article summarizes the basic science and clinical evidence in support of their use, including the positive result of a large controlled multicenter study of 306 subjects, and outlines an approach to their use in clinical practice...
January 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29299214/intervention-of-the-gamma-aminobutyric-acid-type-b-receptors-of-the-amygdala-central-nucleus-on-the-sensitivity-of-the-morphine-induced-conditionally-preferred-location-in-wistar-female-rats
#10
Firoozeh Alavian, Saeedeh Ghiasvand, Hedayat Sahraei, Maryam Rafiei-Rad
Background: The amygdala is one of the nerve centers involved in drug reward. It is suggested that the central nucleus of the amygdala (CeA) is involved in morphine dependency. The CeA gamma-aminobutyric acid-ergic (GABAergic) system is a mediator of morphine rewarding effects. In this research, the effects of stimulation or inhibition of CeA GABA type B (GABAB) receptors on sensitization acquisition to morphine-induced reward was evaluated in Wistar female rats using conditioned place preferential (CPP) method...
April 2017: Addiction & Health
https://www.readbyqxmd.com/read/29274831/preoperative-cesarean-section-intravenous-acetaminophen-treatment-for-postoperative-pain-control-a-randomized-double-blinded-placebo-control-trial
#11
Craig V Towers, Sarah Shelton, Jaclyn van Nes, Emily Gregory, Emily Liske, Arion Smalley, Edward Mobley, Barbara Faircloth, Kim B Fortner
BACKGROUND: The United States currently has an opioid use disorder epidemic and research evaluating ways to minimize the use of opioids post-surgery are needed. One of these options is intravenous (IV) acetaminophen. If the use of preoperative IV acetaminophen was found to be effective for cesarean delivery, this would be beneficial for both the mother and breastfeeding neonate. OBJECTIVE: The primary study objective was to see if maternal opioid use was significantly less in the postoperative period for the study group that received 1 gram of IV acetaminophen preoperatively compared with a control group that received placebo...
December 21, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29274661/perioperative-celecoxib-and-postoperative-opioid-use-in-hand-surgery-a-prospective-cohort-study
#12
Jeffrey G Stepan, Daniel A London, Daniel A Osei, Martin I Boyer, Agnes Z Dardas, Ryan P Calfee
PURPOSE: Prescription opioid abuse is an epidemic in the United States; multimodal analgesia has been suggested as a potential solution to decrease postoperative opioid use. The primary aim of this study was to determine the effect of perioperative celecoxib on opioid intake. Secondary goals were to determine whether perioperative administration of celecoxib decreased postoperative patient-reported pain and whether patient demographic characteristics could predict postoperative pain and opioid intake...
December 21, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29237389/venlafaxine-attenuates-the-development-of-morphine-tolerance-and-dependence-role-of-l-arginine-nitric-oxide-cgmp-pathway
#13
Mohammad Taghi Mansouri, Bahareh Naghizadeh, Behnam Ghorbanzadeh, Soheila Alboghobeish, Gholamreza Houshmand, Neda Amirgholami
BACKGROUND: Severe pain reduce quality of life in patients with various diseases, often because chronic morphine therapy results in reduced analgesic effectiveness, or tolerance, leading to escalating doses and distressing adverse effects. Nitric oxide (NO) play a role in morphine tolerance and dependence. OBJECTIVE: Venlafaxine, an antidepressant, is known to modulate nitric oxide (NO) pathway in nervous tissues. In the present study the effect of systemic venlafaxine (VLF) on the development of morphine tolerance and dependence, acute morphine-induced antinociception, and the probable involvement of the L-arginine/NO/cGMP pathway in these effects were investigated in mice...
December 13, 2017: Endocrine, Metabolic & Immune Disorders Drug Targets
https://www.readbyqxmd.com/read/29223722/the-effectiveness-of-intravenous-parecoxib-on-the-incidence-of-ipsilateral-shoulder-pain-after-thoracotomy-a-randomized-double-blind-placebo-controlled-trial
#14
Tanyong Pipanmekaporn, Yodying Punjasawadwong, Somrat Charuluxananan, Worawut Lapisatepun, Pavena Bunburaphong, Settapong Boonsri, Apichat Tantraworasin, Nutchanart Bunchungmongkol
OBJECTIVES: To determine the incidence of ipsilateral shoulder pain (ISP) with the therapeutic use of parecoxib compared with a placebo after thoracotomy. DESIGN: A prospective, randomized, double-blind, placebo-controlled trial. SETTING: A tertiary-care university hospital. PARTICIPANTS: Adult patients undergoing an elective thoracotomy between June 2011 and February 2015. INTERVENTIONS: Patients were allocated randomly into the parecoxib group (n = 80) and the control group (n = 80)...
June 1, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29223632/comparative-morbidity-of-cubital-tunnel-surgeries-a-prospective-cohort-study
#15
Robert Staples, Daniel A London, Agnes Z Dardas, Charles A Goldfarb, Ryan P Calfee
PURPOSE: Randomized controlled trials have not identified a superior surgical approach to cubital tunnel syndrome surgery. This study evaluates the early morbidity of open in situ decompression and transposition. METHODS: This prospective cohort study enrolled 125 adult patients indicated for cubital tunnel surgery at a tertiary institution. Exclusion criteria included preoperative use of narcotics and concurrent elbow procedures. In situ decompressions (n = 47) and ulnar nerve transpositions (n = 78) were performed...
December 6, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29189168/targeting-cytokines-for-morphine-tolerance-a-narrative-review
#16
Dai-Qiang Liu, Ya-Qun Zhou, Feng Gao
BACKGROUND: Despite its various side effects, morphine has been widely used in clinics for decades due to its powerful analgesic effect. Morphine tolerance is one of the major side effects which hinders its long-term usage for pain therapy. Currently, the thorough cellular and molecular mechanisms underlying morphine tolerance remain largely uncertain. METHODS: We searched the PubMed database with Medical subject headings (MeSH) including 'morphine tolerance', 'cytokines', 'interleukin 1', 'interleukin 1 beta', 'interleukin 6', 'tumor necrosis factor alpha', 'interleukin 10', 'chemokines'...
November 28, 2017: Current Neuropharmacology
https://www.readbyqxmd.com/read/29187328/survey-of-the-prescription-of-step-2-analgesics-in-persons-aged-75-years-and-older-in-general-practitioners
#17
Adrien Brocard, Sofia Da Silva, Maurice Giroud, Alain Putot, Patrick Manckoundia
Although step-2 analgesics (S2A) are recommended when step-1 analgesics (S1A) are ineffective or in cases of moderate to severe pain, their efficacy varies. This study evaluated the place attributed by general practitioners (GPs) to S2A in the treatment of nociceptive pain in elderly persons (EP). Descriptive, transversal and declarative study conducted among GPs in Burgundy. In total, 115 GPs took part in the survey. Among these, 60.8% had at least one consultation/day for pain. After paracetamol, which was systematically preferred, 56...
December 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/29175519/a-new-tridecapeptide-with-an-octaarginine-vector-has-analgesic-therapeutic-potential-and-prevents-morphine-induced-tolerance
#18
Vladimir A Kashkin, Elena V Shekunova, Michail I Titov, Ivan I Eliseev, Maxim A Gureev, Yuri B Porozov, Marina N Makarova, Valery G Makarov
A growing body of evidence suggests that peptides may possess analgesic effects without tolerance development. The synthetic tetrapeptide Tyr-d-Arg-Phe-Gly-NH2 was modified with the inclusion of a (d-Arg)8 vector to prevent the action of endopeptidase and to increase the duration of the analgesic action of the tetrapeptide when administered orally. The aim of this study was to estimate the analgesic efficacy of the tetrapeptide with (d-Arg)8 (tridecapeptide, TDP) in experimental models of acute and chronic pain...
January 2018: Peptides
https://www.readbyqxmd.com/read/29170340/43-management-of-acute-low-back-pain-in-the-ed-a-systematic-review
#19
Jane Ashbrook, Nikos Rodgdakis, Peter Goodwin, Gill Yeowell, Michael Callaghan
STUDY OBJECTIVE: There is no consensus on the management of low back pain in the ED and evidence suggests that these patients are likely to receive unwarranted imaging and inappropriate opioid prescription.The purpose of this study is to review the available literature pertaining to the clinical management of acute low back pain in the ED. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) guidelines were observed during this review...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29158691/project-for-the-introduction-of-prehospital-analgesia-with-fentanyl-and-morphine-administered-by-specially-trained-paramedics-in-a-rural-service-area-in-germany
#20
Maximilian Scharonow, Timo Alberding, Wolfgang Oltmanns, Christian Weilbach
Background: In patients with serious illness or trauma, reduction of severe pain is a key therapeutic goal of emergency medical service (EMS) teams. In Germany, only physicians are allowed to use opioid analgesics. In the rural EMS area studied, the mean arrival time for paramedics is 8 minutes, 23 seconds, and for the rescue physician between 10 minutes, 30 seconds and 16 minutes, 59 seconds, depending on EMS site. In cases of parallel callouts, rescue-physician arrival times may be considerably longer...
2017: Journal of Pain Research
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