- |||||||||| naltrexone / Generic mfg.
Journal: Naltrexone at low doses (LDN) and its relevance to cancer therapy. (Pubmed Central) - Apr 27, 2022
Naltrexone was designed to inhibit opioid receptors without activating them and hence used to block the stimulatory effects of morphine and heroin...Considering the increase in number of anecdotal reports of activity, there will likely be a bigger drive towards using LDN in the oncological setting. These reports support clinical trials of LDN in cancer, especially when given in combination with certain chemotherapy.
- |||||||||| morphine sulphate / Generic mfg.
Journal: Opioids Dispensed in the U.S. by Prescribing Specialty, 2012-2017. (Pubmed Central) - Apr 27, 2022
These reports support clinical trials of LDN in cancer, especially when given in combination with certain chemotherapy. During a period in which prescribing interventions were expanded, opioid prescribing declined overall, although not uniformly by specialty.
- |||||||||| morphine sulphate / Generic mfg.
Retrospective data, Journal: Opioid Requirements After Intercostal Cryoanalgesia in Thoracic Surgery. (Pubmed Central) - Apr 27, 2022
Pulmonary function, 90-d opioid prescriptions, and adverse events were no different between groups. It may serve as a useful adjunct for opioid-sparing pain management in thoracic surgery.
- |||||||||| morphine sulphate / Generic mfg., paracetamol / Generic mfg.
Observational data, Retrospective data, Journal: Perioperative Multimodal Pain Management Approach in Older Adults With Polytrauma. (Pubmed Central) - Apr 27, 2022
N=30 --> 0 | Not yet recruiting --> Withdrawn The use of multimodal pain management with IV APAP as first-line therapy was associated with reduced opioid use in the perioperative setting for older adults with polytrauma.
- |||||||||| morphine sulphate / Generic mfg.
Journal: Phoenixin-14 Ameliorates Cellular Senescence Against Morphine in M17 Neuronal Cells. (Pubmed Central) - Apr 27, 2022
Knockdown of YAP abolished the beneficial effects of phoenixin-14 on cellular senescence against morphine induction. Taken together, these aggregate data demonstrate that phoenixin-14 prevented cellular senescence against morphine induction in M17 neuronal cells via regulating YAP expression.
- |||||||||| morphine sulphate / Generic mfg., hydromorphone hydrochloride / Generic mfg.
Journal: Association of Patient Controlled Analgesia and Total Inpatient Opioid Use After Pancreatectomy. (Pubmed Central) - Apr 27, 2022
Standardizing initial IV-PCA settings was associated with a reduced first-24-h opioid exposure, proportional and absolute total IV-PCA use, and total inpatient OMEs. Because of the contribution of an IV-PCA to the total inpatient opioid exposure, purposeful reduction or omission of an IV-PCA is critical to perioperative opioid reduction strategies.
- |||||||||| PPL-138 / Phoenix PharmaLabs
Preclinical, Journal: PPL-138 (BU10038): A bifunctional NOP/mu partial agonist that reduces cocaine self-administration in rats. (Pubmed Central) - Apr 27, 2022
Consistently, treatment with morphine (1, 3, and 10 mg/kg) dose-dependently reduced IntA cocaine self-administration measures...However, suppression of cocaine self-administration was retained when subsequent PPL-138 treatments were administered 48 h apart. These findings demonstrate that the approach of combining partial NOP/mu-opioid activation successfully reduces cocaine use, but properties of PPL-138 seem to depend on the timing of drug administration.
- |||||||||| morphine sulphate / Generic mfg.
Journal: Early Postoperative Opioid Requirement is Associated With Later Pain Control Needs After Supratentorial Craniotomies. (Pubmed Central) - Apr 27, 2022
Postcraniotomy patients are at higher risk for requiring opioid pain medications if they have a history of preoperative opioid use, are of younger age, or undergo a longer surgery. Moreover, early requirement of intravenous opioid medications in the postoperative period should alert treating physicians that a patient's pain may require additional or alternative methods of pain control than routinely administered, to avoid over-reliance on opioid medications.
- |||||||||| morphine sulphate / Generic mfg., ropivacaine / Generic mfg.
Trial completion date, Trial primary completion date: Comparison of Two Analgesic Strategies After Scheduled Caesarean (clinicaltrials.gov) - Apr 27, 2022
P4, N=104, Recruiting,
Moreover, early requirement of intravenous opioid medications in the postoperative period should alert treating physicians that a patient's pain may require additional or alternative methods of pain control than routinely administered, to avoid over-reliance on opioid medications. Trial completion date: Mar 2022 --> Sep 2022 | Trial primary completion date: Mar 2022 --> Sep 2022
- |||||||||| morphine sulphate / Generic mfg.
Clinical, Journal: Does Transient Opioid Use Increase Risk of Short-Term Respiratory Exacerbation among Older Adults with Chronic Obstructive Pulmonary Disease? (Pubmed Central) - Apr 26, 2022
Transient exposure to opioids was associated with a 76% increase in the odds of an acute COPD exacerbation (OR: 1.76, 95%CI: 1.67-1.84), and each 25 mg increase in morphine milligram equivalent dose was associated with a 18% increase in the odds of exacerbation (OR: 1.18, 95% CI: 1.15-1.21)...Transient exposure to opioids was associated with an increased short-term risk of respiratory exacerbation among older adults with COPD. Treatment decisions for breathlessness among individuals with COPD need to account for the benefit-risk profile of opioids.Supplemental data for this article is available online at https://doi.org/10.1080/15412555.2021.2013460 .
- |||||||||| morphine sulphate / Generic mfg.
Retrospective data, Journal: Does Maternal Incarceration Impact Infants with Neonatal Abstinence Syndrome? (Pubmed Central) - Apr 26, 2022
Infants with NAS born to incarcerated women in Connecticut had longer LOS, lower rates of being fed breast milk, and different prenatal substance exposures than infants with NAS born to non-incarcerated women. Supporting the maternal-infant dyad until infant discharge may mitigate the potential negative impact of maternal incarceration on the care of infants with NAS.
- |||||||||| morphine sulphate / Generic mfg., galantamine hydrobromide / Generic mfg.
Review, Journal: Natural isoquinoline alkaloids: Pharmacological features and multi-target potential for complex diseases. (Pubmed Central) - Apr 26, 2022
This review offers an exhaustive compilation of the pharmacological relevance and multi-target potential of natural isoquinolines, emphasizing their features and promising activity in complex diseases such as Alzheimer, Parkinson, and Cancer. Selected examples were discussed in depth to illustrate the most relevant structural motifs and their possible relationship with the multimodal activity offering a comprehensive baseline in the search and optimization of isoquinoline scaffolds with polypharmacological potential for complex diseases.
- |||||||||| morphine sulphate / Generic mfg.
Journal: Vedvarende bruk av opioider og samtidig bruk av andre vanedannende legemidler. (Pubmed Central) - Apr 26, 2022
Selected examples were discussed in depth to illustrate the most relevant structural motifs and their possible relationship with the multimodal activity offering a comprehensive baseline in the search and optimization of isoquinoline scaffolds with polypharmacological potential for complex diseases. Prolonged prescribing of opioids on white prescription and concurrent prescribing of other addictive drugs may indicate undesirable use with no clear indication.
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg., dexmedetomidine / Generic mfg.
Review, Journal: Pharmacologic Analgesia and Sedation in Neonates. (Pubmed Central) - Apr 26, 2022
Continuous low-dose morphine or dexmedetomidine may be considered for preterm or term neonates exhibiting signs of stress during mechanical ventilation and therapeutic hypothermia, respectively. Further research is required regarding the pharmacokinetics, pharmacodynamics, safety, and efficacy of pharmacologic agents used to mitigate mild, moderate, and chronic pain and stress in neonates.
- |||||||||| morphine sulphate / Generic mfg.
Journal: Computational Investigation of the Bisphenolic Drug Metabolism by Cytochrome P450: What Factors Favor Intramolecular Phenol Coupling. (Pubmed Central) - Apr 26, 2022
This work performs density functional theory computations to reveal the P450-mediated metabolic pathway leading from R-reticuline to the morphine precursor salutaridine by exploring possible intramolecular phenol coupling mechanisms involving diradical coupling, radical addition, and electron transfer...Especially, the high rebound barrier of the phenoxy radical derived from the weak electron-donating ability of the phenoxy radical is revealed as an intrinsic nature. Therefore, the revealed intramolecular phenol coupling mechanism can be potentially extended to several other bisphenolic drugs to infer groups of unexpected metabolites in organisms.
- |||||||||| morphine sulphate / Generic mfg.
Retrospective data, Journal: Association of opioid exposure before surgery with opioid consumption after surgery. (Pubmed Central) - Apr 26, 2022
For most patients with preoperative opioid exposure, existing guidelines may meet their postoperative needs. However, guidelines may need tailoring for patients with chronic use, and providers should anticipate a higher likelihood of postoperative refills for all opioid-exposed patients.
- |||||||||| morphine sulphate / Generic mfg., diazepam / Generic mfg., paracetamol / Generic mfg.
Journal: Highlighting the hidden dangers of a 'weak' opioid: Deaths following use of dihydrocodeine in England (2001-2020). (Pubmed Central) - Apr 26, 2022
There is an urgent need to understand increasing polypharmacy in overdose deaths. Additionally, suicides involving DHC is a potential cause for concern and a review of OTC opioid-paracetamol preparations is necessary to determine whether the benefits of these medications continue to outweigh the risks of intentional overdose.
- |||||||||| methamphetamine / Generic mfg.
Review, Journal: Goofballing of Opioid and Methamphetamine: The Science Behind the Deadly Cocktail. (Pubmed Central) - Apr 26, 2022
This present review discusses the human and animal behavioral, neuroanatomical, and neurochemical changes underlying both morphine and methamphetamine dependence separately, as well as its combination. This narrative review also delineates the recent advances in the pharmacotherapy of mono- and poly drug-use of opioids and methamphetamine at clinical and preclinical stages.
- |||||||||| Dynastat (parecoxib) / Pfizer
Journal: Parecoxib Reduced Postsurgical Pain and Facilitated Movement More Than Patient Controlled Analgesia. (Pubmed Central) - Apr 26, 2022
This is the first trial of which the authors are aware, that supports intravenous parecoxib as significantly enhancing patient mobility, in addition to having pain control efficacy, when compared with PCA. This study could be used as a reference when instituting interventions to improve the adaptation process and clinical prognoses after lumbar spinal fusion surgery.
- |||||||||| dexmedetomidine / Generic mfg.
Trial completion date, Trial primary completion date, Surgery: Dexmedetomidine Supplemented Analgesia and Incidence of Postoperative Delirium (clinicaltrials.gov) - Apr 26, 2022
P=N/A, N=1500, Recruiting,
This study could be used as a reference when instituting interventions to improve the adaptation process and clinical prognoses after lumbar spinal fusion surgery. Trial completion date: Dec 2024 --> May 2022 | Trial primary completion date: Dec 2021 --> Apr 2022
- |||||||||| morphine sulphate / Generic mfg.
POST-PROCEDURAL PAIN ASSESSMENT AFTER IMPLEMENTATION OF SAME-DAY DISCHARGE IN PATIENTS UNDERGOING PERORAL ENDOSCOPIC MYOTOMY (POEM) (Poster Hall - San Diego Convention Center) - Apr 25, 2022 - Abstract #DDW2022DDW_6475;
The pain medication requirement was maximum between 0-3 hours post procedure with a significant reduction in its usage after discharge (median morphine equivalent 30 vs. 0; P=0.0006)...Furthermore, the pain significantly decreases after a few hours of the procedure requiring minimal opioid medications subsequently. Further larger studies are needed to identify the clinical and procedural factors predicting postprocedural pain and the need for admission.
- |||||||||| morphine sulphate / Generic mfg.
OPIOID REDUCTION FOLLOWING MINIMALLY INVASIVE LIVER SURGERY: AIMING BEYOND INCISION SIZE (9 - San Diego Convention Center) - Apr 25, 2022 - Abstract #DDW2022DDW_5353;
Methods : Using a prospectively maintained single-institutional database of all patients undergoing minimally invasive liver surgery, clinical characteristics, non-opioid adjunct utilization, and inpatient oral morphine equivalents (OME, intraoperative, inpatient, and discharge prescriptions) were compared between patients treated before (1/2017-7/2018) and after (8/2018-11/2021) implementation of a departmental opioid education and prescribing guideline initiative...Conclusion s: Intentional efforts to curb opioid overpresciption through implementation of an education initiative and prescribing guidelines successfully reduced both intraoperative and discharge OME in minimally invasive liver surgery, without increasing pain scores. Mindful stewardship of opioid use is applicable even with minimally invasive surgery.
- |||||||||| ropivacaine / Generic mfg.
TUNNEL INSTILLATION OF ROPIVACAINE FOR PERIOPERATIVE POEM ANALGESIA (Poster Hall - San Diego Convention Center) - Apr 25, 2022 - Abstract #DDW2022DDW_4829;
Patients were divided into two groups based on the instillation of 0.5% topical ropivacaine (30 ml) with epinephrine (1:200,000) after myotomy and prior to closure of mucosotomy for a total contact time of 5 minutes (with the intention to reduce total narcotic usage)...Patients’ pain medication requirements were standardized according to morphine equivalents...In our study, it reduced the perioperative narcotic requirements. Randomized trials are needed to validate these findings.
- |||||||||| morphine sulphate / Generic mfg., tramadol hydrochloride / Generic mfg.
TYPE OF OPIOID DICTATES RISK FOR SPASTIC DISORDER OF THE ESOPHAGEAL BODY (Poster Hall - San Diego Convention Center) - Apr 25, 2022 - Abstract #DDW2022DDW_3296;
2) Greater than 1 in 4 patients with dysphagia and on opioids had a diagnosis of either distal esophageal spasm or hypercontractile esophagus. 3) Type of opioid dictates risk of spastic disorder with highest odds associated with morphine followed by oxycodone and then hydrocodone.
- |||||||||| Botox (onabotulinumtoxin A) / GSK, AbbVie, Healis Therap
OPIOID EXPOSURE IS ASSOCIATED WITH HIGHER LONG TERM ESOPHAGEAL SYMPTOM BURDEN: A PROSPECTIVE COHORT STUDY (Poster Hall - San Diego Convention Center) - Apr 25, 2022 - Abstract #DDW2022DDW_1778;
Demographics, opioid exposure (within 24 hours and 3 months, converted to morphine milliequivalents/MME), opioid type, interventions performed, and diagnosis based on HRM findings were collected from chart review...Endoscopy with esophageal dilation, botox injection, acid suppressive medication, and neuromodulators were the most commonly used interventions...Conclusion : This is the first study to show that chronic opioid exposure in patients with spastic motility disorders lead to persistent symptom burden long term. While non-opioid users with spastic disorders have improvement over time post intervention, opioid users continue to be symptomatic despite therapy.
- |||||||||| morphine sulphate / Generic mfg.
INCIDENCE AND IMPACT OF OPIOID USE ON OUTCOMES AFTER PER-ORAL ENDOSCOPIC MYOTOMY. (Poster Hall - San Diego Convention Center) - Apr 25, 2022 - Abstract #DDW2022DDW_1765;
Opioid use prior to baseline HRM was evaluated from clinic records or phone calls when required and dose was standardized by morphine equivalent dosing (MED)...Compared to non-opioid users, heartburn was more common in the opioid group, but clinical response and the diagnosis of GERD was similar between the groups. These findings suggest that POEM may be considered for motility disorders among opioid users even when narcotics may not be discontinued.
- |||||||||| morphine sulphate / Generic mfg.
THE ASSOCIATION BETWEEN OPIOID USE AND OPIOID TYPE AND THE CLINICAL COURSE AND OUTCOMES OF ACUTE PANCREATITIS (Poster Hall - San Diego Convention Center) - Apr 25, 2022 - Abstract #DDW2022DDW_1152;
The incidence of 30-day mortality did not differ significantly between the study groups, 3.9%, 2.9% and 4.4% in the non-opioid, non-morphine-opioid and morphine groups respectively, P=0.366.In multivariate analysis the composite endpoint consisting of 30-day mortality,invasive ventilation, emergent abdominal surgery and need for vasopressors wassignificantly more likely to occur in the morphine group than in the non-opioid group,adjusted OR=1.69 (95% CI, 1.1-2.598, P=0.01) Conclusion : Mortality among acute pancreatitis patients did not differ significantly between patients receiving morphine, non-morphine opioids and non-opioid analgesics. However, morphine treatment was associated with higher rates of some serious adverse events, such as invasive ventilation, emergent abdominal surgery and need for vasopressors.
- |||||||||| morphine sulphate / Generic mfg.
Challenges of acute and chronic pain management in sickle cell disease: Outcomes of an English national audit (Exchange 11) - Apr 25, 2022 - Abstract #BSH2022BSH_37;
The most common analgesic prescribed in adults and children was morphine...The questionnaire results will inform the workplans of four working groups within the NSPG (acute pain, chronic pain, education, research). To develop national policies for acute and chronic pain management, it will be necessary to generate evidence through a more detailed audit of outcomes in scenarios of best practice.
- |||||||||| morphine sulphate / Generic mfg.
Retrospective data, Review, Journal: Postoperative Analgesic Effectiveness of Peripheral Nerve Blocks in Cesarean Delivery: A Systematic Review and Network Meta-Analysis. (Pubmed Central) - Apr 24, 2022
The purpose of this systematic review and network meta-analysis was to determine the analgesic effectiveness of peripheral nerve blocks (PNBs), including each anatomical approach, with or without intrathecal morphine (ITMP) in cesarean delivery (CD)...Using the six described analgesic strategies for postoperative pain management after CD is considered reasonable. Lateral TAP block, WI, and WC below the fascia may be useful alternatives in patients with a history of sensitivity or severe adverse effects to opioids or when the CD is conducted under general anesthesia.
- |||||||||| modafinil / Generic mfg.
Preclinical, Journal: Analgesic and anti-inflammatory effects of modafinil in a mouse model of neuropathic pain: A role for nitrergic and serotonergic pathways. (Pubmed Central) - Apr 23, 2022
Mice also received pretreatments of the nonselective nitric oxide (NO) synthase (NOS) inhibitor L-NAME, the selective neuronal NOS inhibitor 7-nitroindazole, the selective inducible NOS inhibitor aminoguanidine, and the selective serotonin reuptake inhibitor citalopram before modafinil (100 mg/kg)...Histopathology illustrated marked axonal degeneration and shrinkage in the cuffed sciatic nerve, which were improved in the modafinil-treated group. Modafinil exerts analgesic and neuroprotective effects in cuff-induced neuropathic mice via possible involvement of the nitrergic/inflammatory and serotonergic systems.
- |||||||||| morphine sulphate / Generic mfg.
Journal: Opioid-induced pronociceptive signaling in the gastrointestinal tract is mediated by delta-opioid receptor signaling. (Pubmed Central) - Apr 23, 2022
Chronic in vivo administration of morphine by intraperitoneal injection in male C57BL/6 mice evoked tolerance and evidence of OIH in an assay of colonic afferent nerve mechanosensitivity; this was inhibited by the δ-opioid receptor (DOPr) antagonist naltrindole when intraperitoneally injected in previous morphine administration...Furthermore, the role of DOPr was dependent on OPr internalization and activation of a protein kinase C (PKC) signaling pathway. Thus, targeting DOPr or key components of the downstream signaling pathway could mitigate adverse side effects by opioids.
- |||||||||| bepecin (BPC-157) / Pliva
Preclinical, Journal: The anti-nociceptive effect of BPC-157 on the incisional pain model in rats. (Pubmed Central) - Apr 23, 2022
A 1-cm longitudinal incision was made through the skin, fascia, and muscle of the plantar aspect of the hind paw in isoflurane-anesthetised rats...It was also effective during phase 1 but not during phase 2, as determined by the formalin test. BPC-157 might have a short antinociceptive effect, even though it has anti-inflammatory and wound healing effects.
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