- |||||||||| fentanyl citrate / Generic mfg.
Review, Journal: The use of heat to deliver fentanyl via pulmonary drug delivery. (Pubmed Central) - Oct 28, 2021
Furthermore, forced degradation of fentanyl has been studied which showed that longer heating time and higher temperatures will result in the formation of degradation products. The evidence indicates that heat can be used to deliver drugs to the lungs where fast onset reaction can be obtained giving fast and non-invasive pain relief.
- |||||||||| morphine sulphate / Generic mfg.
Trial completion, Trial completion date, Trial primary completion date, Surgery: Metabolomic Profiling of Erector Spinae Plane Block* for Breast Cancer Surgery (clinicaltrials.gov) - Oct 28, 2021
P=N/A, N=91, Completed,
Current evidence indicates that lidocaine does not improve rehabilitation after laparoscopic colectomies. Not yet recruiting --> Completed | Trial completion date: Jan 2022 --> Oct 2021 | Trial primary completion date: Aug 2021 --> May 2021
- |||||||||| morphine sulphate / Generic mfg.
Preclinical, Journal: Antinociceptive and neurochemical effects of a single dose of IB-MECA in chronic pain rat models. (Pubmed Central) - Oct 28, 2021
Rats were treated with a single dose of IB-MECA (0.5 μmol/kg i.p.), a vehicle (dimethyl sulfoxide-DMSO), or positive control (morphine, 5 mg/kg i.p.)...There was an increase in IL-1β levels promoted by CIP. NP model promoted increase in the brainstem BDNF levels, which was reversed by IB-MECA.
- |||||||||| morphine sulphate / Generic mfg.
Journal: ß2-Arrestin germline knockout does not attenuate opioid respiratory depression. (Pubmed Central) - Oct 28, 2021
One such approach has been the design of so-called 'biased agonists' that signal through some, but not all pathways downstream of the µ-opioid receptor (MOR), the target of morphine and other opioid analgesics...To verify this important result that motivated the 'biased agonist' approach, we re-examined breathing in ß2-arrestin deficient mice and instead find no connection between ß2-arrestin and opioid respiratory depression. This result suggests that any attenuated effect of 'biased agonists' on breathing is through an as-yet defined mechanism.
- |||||||||| morphine sulphate / Generic mfg.
Retrospective data, Journal: Mepivacaine vs Bupivacaine Spinal Anesthesia in Total Hip Arthroplasty at an Ambulatory Surgery Center. (Pubmed Central) - Oct 28, 2021
Dose reduction was rare, while a majority of patients required further dose escalation prior to discharge. Mepivacaine spinal anesthesia for anterior-approach THA safely facilitated more rapid SDD from the ASC through decreased times to controlled void and ambulation with only minor increase in pain when compared to bupivacaine.
- |||||||||| vancomycin / Generic mfg., morphine sulphate / Generic mfg., rocuronium / Generic mfg.
Review, Journal, Adverse drug reaction: MRGPRX2 and Adverse Drug Reactions. (Pubmed Central) - Oct 28, 2021
A comparison with plasma drug levels suggests that MRGPRX2 mediates many of these mild-to-moderate events. For some of these drugs, then, MRGPRX2 activation may be considered a regular and predictable feature after administration of high doses.
- |||||||||| morphine sulphate / Generic mfg.
Clinical, Journal: Effects of Prescription Opioid Use on Traumatic Brain Injury Risk in Older Adults. (Pubmed Central) - Oct 28, 2021
We found no significant difference in adjusted TBI risk between high-dose and standard-dose opioid use, nor did we find a significant difference in adjusted TBI risk between acute and chronic opioid use. This analysis can inform prescribing of opioids to community-dwelling older adults for pain management.
- |||||||||| fentanyl citrate / Generic mfg.
Journal: Fentanyl causes naloxone-resistant vocal cord closure: A platform for testing opioid overdose treatments. (Pubmed Central) - Oct 28, 2021
While pre-treatment with naloxone prevented fentanyl-induced VCC, naloxone was unable to reverse the effect, suggesting a non-opioid receptor-mediated mechanism. These findings demonstrate the necessity of VCC inclusion in animal models of synthetic opioid overdose and the urgent need for more effective treatments for fentanyl-related overdoses.
- |||||||||| Lucemyra (lofexidine) / US WorldMeds, Stada
Enrollment open: Assessing a Clinically-meaningful Opioid Withdrawal Phenotype (clinicaltrials.gov) - Oct 27, 2021
P2, N=60, Recruiting,
These findings demonstrate the necessity of VCC inclusion in animal models of synthetic opioid overdose and the urgent need for more effective treatments for fentanyl-related overdoses. Not yet recruiting --> Recruiting
- |||||||||| ceftriaxone / Generic mfg., gabapentin / Generic mfg.
[VIRTUAL] SICKLE DISEASE: BONE INFARCTION OR OSTEOMIELITIS? () - Oct 27, 2021 - Abstract #HEMO2021HEMO_1535;
Not yet recruiting --> Recruiting Objective To identify clinical and laboratory characteristics of osteomyelitis (OM) in 3 patients with sickle cell disease (FD).Method Retrospective review of medical records. Case 1 A 12-year-old boy, HbSS, in chronic transfusion since he was 8 years old, due to stroke. He went to the emergency room (ER) complaining of severe pain in the upper (ms) and lower (mi) limbs for 1 day, denying trauma, fever or other complaints, which improved with the use of tramadol. Hb 10.6g/dL; GB 2600/mm3 (6475N; 3667L); PCR 97.32 mg/L. On the 2nd day of hospitalization (DI) he started to experience paresthesia in the left mandible (E), with signs of inflammation and pain in the last molar E. Ulectomy: discharge of purulent secretion. On the 3rd DI, ceftriaxone (CTX) and clindamycin were introduced and molar drainage. Magnetic resonance (MR) OM signals. Afebrile for 9 days. No agents have been isolated. High Hb 11.5; GB 12300 (7417 N; 2645 L) PCR 6.85, with ciprofloxacin (CPX) and clindamycin, VO, for 49 days. Case 2 Girl, 9 years old, HbSC. He sought the ER complaining of severe pain in the lumbar region radiating to the mmii for 2 hours, he denied fever, trauma or other complaints. OM in femur E at age 3 years with need for surgical treatment. Hb 10.6; GB 1540 (8624N; 5852L) and PCR 95.99. On the 2nd DI she had a fever peak, and treatment for STA was started with CTX. Complaint of pain in the right humerus (D), shoulder E, hip and femur bilaterally, with restricted mobility. The OM hypothesis was made, and oxacillin (OX) was introduced. MRI: OM of the head of the E femur and fracture of the L4 vertebra. Maintained fever peaks for 5 days. On the 6thDI, he presented pain relief. She remained hospitalized for 22 days, receiving CTX and OX. No agents were isolated in cultures. High Hb 11.3; GB 6910(2419N; 4077L) PCR 4.29, with CPX, VO, for 76 days. Case 3 A 17-year-old girl, HbSS, using HU (since 2011; dose 22.5 mg/kg/day). He looked for an ER complaining of intense pain in the miE, sternum and thoracic spine for 3 h. Hb 7,8; GB 14118 (8471N; 3106L) and PCR 324.32. On the 2ndDI, he evolved with pain in the hip and thigh joint and difficult to control analgesia with morphine, associated with multiple therapy with baclofen, gabapentin and dipyrone. On the 4th DI, he evolved with STA, introduced CTX and azithromycin. Hb 7.3 (post transfusion); GB 14659 (1M; 1M; 1B; 67N; 25L). Due to the persistence of fever, on the 6th DI she was escalated to cefepime. Hb 7.8;GB 9393(1M; 1M;3B; 6951N; 1691L). He persisted with fever and severe pain in hip and thigh D, with limited walking, on the 10th DI, hypothesized hypothesis of OM and osteonecrosis of hip and thigh D, confirmed by MRI and started with vancomycin. Discharged on the 21st DI with CPX, VO, for 133 days and after completing cefepime and vancomycin. No agents were isolated in cultures. Hb 9.3; GB 2520(1273N; 1081L) PCR 10.85. After 19 weeks, he needed a new hospitalization due to a vaso-occlusive crisis. MRI: signs of bone infarction.Conclusion Patients with FD are at increased risk for osteomyelitis. Differential diagnosis between bone infarction related to vaso-occlusive crisis is a challenge, as the initial clinical presentation is similar. Osteomyelitis should be suspected in patients with FD who present a vaso-occlusive crisis in only one site, with prolonged fever and an increase in inflammatory evidence. Early antibiotic therapy directed at the most frequent agents can prevent complications and allow for a better prognosis.
- |||||||||| dexamethasone / Generic mfg.
[VIRTUAL] POEMS SYNDROME: OSTEOSCLEROTIC MYELOMA () - Oct 27, 2021 - Abstract #HEMO2021HEMO_1320;
In August 2020, it was associated with Cyclophosphamide 50 mg/day. The patient had a significant improvement in mobility, clubbing and neuropathic pain, interrupting the use of a wheelchair and morphine. He was referred for autologous bone marrow transplantation, performed in July 2021. Discussion and Conclusion The patient's initial clinical condition was marked by the acronym of POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, M protein and skin changes), which allowed the correct diagnosis and a starting point for initiating treatment. Currently, there is no defined therapeutic line, however, some studies suggest that the association between corticosteroids and chemotherapeutics in the long term increases survival and decreases the neuropathic symptoms of patients, as observed in the report above. Distinguishing POEMS Syndrome from its differential diagnoses is important for the choice of treatment, supportive care, and toxicities in relation to the drugs involved. An incorrect diagnosis can lead to worsening of the condition and increased morbidity.
- |||||||||| morphine sulphate / Generic mfg.
[VIRTUAL] MASTER MANIPULATION OF DRUGS IN ONCOLOGY: LITERATURE REVIEW AND RESEARCH FOR THE PREPARATION OF OFF-LABEL FORMULATIONS FOR MORPHINE () - Oct 27, 2021 - Abstract #HEMO2021HEMO_1133;
Discussion Morphine is an essential medication within the Palliative Care (PC) approach. of a strong opioid analgesic, and which is mainly indicated for the treatment of moderate to severe pain. In the context of cancer, the goals of pain control include a greater sense of comfort and an improved ability to perform everyday functions. A comprehensive approach is needed as pain is often due to multiple factors and requires more than one intervention.Conclusion Patients use these formulas prepared from ampoules or tablets and our experience with research, preparation and administration of these extemporaneous formulations , proves similar Results to other national and international hospitals.
- |||||||||| morphine sulphate / Generic mfg.
Journal: Preoperative opioid use is associated with increased length of stay after pancreaticoduodenectomy. (Pubmed Central) - Oct 27, 2021
Following PD, preoperative opioid users had worse pain scores, received more opioids at discharge, refilled prescriptions more frequently, and were more likely to have prolonged LOS. As most opioid utilization research has been focused on low complexity surgery, additional work aimed at optimizing opioid use in complex oncologic operations is warranted.
- |||||||||| ketamine / Generic mfg., gabapentin / Generic mfg.
Clinical, Journal: Perioperative multimodal analgesia reduces opioid use following skin grafting in non-intubated burn patients. (Pubmed Central) - Oct 27, 2021
Patients who received either gabapentin or a combination of acetaminophen, gabapentin and ketamine had a smaller increase in their opioid use than patients who did not receive the medications (-25 ME, 95% CI [-46, -4]; p=0.018 and -47 ME [-81, -11]; p=0.010 respectively). These results support using a combination of acetaminophen, gabapentin and ketamine for perioperative analgesia in burn patients undergoing autologous skin grafting.
- |||||||||| chlorpheniramine / Generic mfg., morphine sulphate / Generic mfg., cimetidine / Generic mfg.
Preclinical, Journal: Anti-nociceptive and antioxidant activity of Betaine on Formalin- and Writhing tests induced pain in mice. (Pubmed Central) - Oct 27, 2021
For co-injections mice received betaine (30 mg/kg) + naloxone (2 mg/kg) or atropine (1 mg/kg), chlorpheniramine (20 mg/kg), flumazenil (5 mg/kg), cimetidine (12.5 mg/kg) and cyproheptadine (4 mg/kg)...No adverse locomotion and sedation effect were observed in betaine-treated mice. These findings suggest that betaine has anti-nociceptive and antioxidant activity in mice, and its anti-nociceptive role interacts with opioidergic and GABA receptors.
- |||||||||| morphine sulphate / Generic mfg.
Clinical, Journal: Opioid Prescription Consumption Patterns After Total Joint Arthroplasty in Chronic Opioid Users Versus Opioid Naive Patients. (Pubmed Central) - Oct 27, 2021
Chronic opioid users (n = 49; 15.7%) filled an average of 13,006.64 morphine equivalent doses per patient in the 12-month postoperative period, while opioid-naive users (n = 263; 84.3%) filled an average of 854.48 morphine equivalent doses per patient (P < 0.01)...Chronic users obtained prescriptions from myriad sources, only a minority of which originated from our orthopaedic department. In the current opioid epidemic, vigilance regarding opioid prescribing is critical.
- |||||||||| morphine sulphate / Generic mfg.
Journal: Five-year Trends in Opioid Prescribing Following Orthopaedic Trauma. (Pubmed Central) - Oct 27, 2021
Over 5 years, providers have successfully reduced the amount of opioid medication prescribed to surgically managed orthopaedic trauma patients through self-directed measures. The effects of opioid prescribing legislation should be viewed from this baseline.
- |||||||||| morphine sulphate / Generic mfg.
Journal: Erector spinae plane block for rescue analgesia following caesarean delivery. (Pubmed Central) - Oct 27, 2021
Erector spinae plane block can be used as an effective and safe alternative to thoracic epidural analgesia and shows superior analgesic profile to serratus anterior plane block for patients with lung cancer undergoing posterolateral thoracotomy. With intrathecal morphine combined with multimodal analgesia, approximately 5–10% of patients experience severe breakthrough pain after caesarean delivery that is difficult to manage [1]...No abstract available
- |||||||||| morphine sulphate / Generic mfg.
Review, Journal: Opportunities and challenges for nonaddictive interventions in chronic pain. (Pubmed Central) - Oct 27, 2021
In this brief review, we aim to provide a bench-to-bedside overview of promising biomarkers, therapeutic targets, and challenges related to treating patients with chronic pain. We hope this review will inspire new opportunities and insights into the development of novel, nonaddictive treatments for chronic pain that will be available to patients in the near future.
- |||||||||| morphine sulphate / Generic mfg.
Review, Journal: Synthesis of Morphinans through Anodic Aryl-Aryl Coupling. (Pubmed Central) - Oct 27, 2021
The morphinans are an important class of structurally fascinating and physiologically important natural products as exemplified by the famous opium alkaloids of the morphine family...This review highlights electrosynthetic approaches towards natural and semisynthetic morphinan alkaloids. The historical progress in applying anodic aryl-aryl couplings to the construction of the morphinan framework is described in chronological order while particular benefits and challenges concerning the electrochemical transformations are grouped together, including the influence of substitution patterns, protecting groups, and reaction conditions.
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