- |||||||||| morphine sulphate / Generic mfg.
Journal: Synthesis of 3-O-Carboxyalkyl Morphine Derivatives and Characterization of Their Acid-Base Properties. (Pubmed Central) - Sep 19, 2021
Hydrolyzing the products affords the appropriate free carboxylic group containing 3- O -carboxyalkyl derivatives. As these molecules contain an acidic and a basic functional group the protonation macro- and microconstants were determined too, using pH-potentiometry and NMR-pH titration, beside fully characterizing their structure using IR, CD, NMR and HR-MS measurements.
- |||||||||| morphine sulphate / Generic mfg.
Preclinical, Journal: Profiling the Effects of Repetitive Morphine Administration on Motor Behavior in Rats. (Pubmed Central) - Sep 19, 2021
This excitatory phase converted to an inhibition of behavior when a higher morphine dose was introduced. We suggest that the excitatory locomotor effects of repetitive high-dose morphine exposure represent a signature of its behavioral and antinociceptive tolerance.
- |||||||||| morphine sulphate / Generic mfg.
Preclinical, Journal: Anterior cingulate cortex is necessary for spontaneous opioid withdrawal and withdrawal-induced hyperalgesia in male mice. (Pubmed Central) - Sep 19, 2021
We found that escalating doses of morphine (20, 40, 60, 80, and 100 mg/kg, i.p. on days 1-5, respectively) injected twice daily into male C57BL/6 mice evoked withdrawal behaviors and an associated withdrawal-induced mechanical hypersensitivity...The ability of the ACC to regulate both withdrawal behaviors and withdrawal-induced mechanical hypersensitivity suggests overlapping mechanisms between two seemingly distinguishable behaviors. This commonality potentially suggests that the ACC is a locus for multiple withdrawal symptoms.
- |||||||||| morphine sulphate / Generic mfg.
Journal: Extracellular Vesicles in Health and Disease. (Pubmed Central) - Sep 18, 2021
Also, a series of articles discussed the promise of stem cell-derived EVs for treating Parkinson's Disease, Sjogren's Syndrome, and Inflammatory Bowel Disease, and advancements in loading EVs to deliver nucleic acid therapies. This editorial discusses the highlights from these articles.
- |||||||||| gabapentin / Generic mfg., celecoxib oral / Generic mfg.
Clinical, Journal: Multimodal Analgesic Strategies for Trauma: A Pragmatic Randomized Clinical Trial. (Pubmed Central) - Sep 17, 2021
Bilateral intercostal nerve cryoablation is associated with decreased postoperative opioid usage and decreased resource utilization in pediatric patients undergoing a minimally invasive Nuss procedure for pectus excavatum. The MAST MMPR was a generalizable and widely available approach that reduced opioid exposure after trauma and achieved adequate acute pain control.
- |||||||||| morphine sulphate / Generic mfg., ropivacaine / Generic mfg.
Enrollment open, Trial completion date, Trial primary completion date: Comparison of Two Analgesic Strategies After Scheduled Caesarean (clinicaltrials.gov) - Sep 16, 2021
P4, N=104, Recruiting,
The MAST MMPR was a generalizable and widely available approach that reduced opioid exposure after trauma and achieved adequate acute pain control. Not yet recruiting --> Recruiting | Trial completion date: Mar 2021 --> Mar 2022 | Trial primary completion date: Mar 2021 --> Mar 2022
- |||||||||| morphine sulphate / Generic mfg.
Enrollment open: Treatment of Pruritus With Intramuscular Promethazine (clinicaltrials.gov) - Sep 16, 2021
P4, N=110, Recruiting,
Not yet recruiting --> Recruiting | Trial completion date: Mar 2021 --> Mar 2022 | Trial primary completion date: Mar 2021 --> Mar 2022 Not yet recruiting --> Recruiting
- |||||||||| morphine sulphate / Generic mfg.
Review, Journal: Percutaneous Electrical Nerve Stimulation for Facial Pain. (Pubmed Central) - Sep 16, 2021
The precise mechanism of action is not known, although a combination of electrical neuromodulation and release of endogenous morphine-like substance in the central nervous system appears as plausible explanation...We believe that PENS therapy for facial pain and headache is currently underutilised. It is safe, economical and should certainly be part of the armamentarium in the treatment of complex facial pain and headache.
- |||||||||| morphine sulphate / Generic mfg.
Review, Journal: Targeted Drug Delivery (Intrathecal and Intracranial) for Treatment of Facial Pain. (Pubmed Central) - Sep 16, 2021
Intraventricular route was first described by A.K. Ommaya; its use remains limited, mostly with morphine, despite a high clinical efficiency, probably because of the invasive nature of the procedure and the need for daily direct injections...The risks of cervical puncture may explain the rarity of its use. However, new devices allowing a simpler lumbar approach and the ongoing opioid crisis are the factors that may facilitate the wider use of this effective technique for the treatment of facial pain.
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg., tramadol hydrochloride / Generic mfg.
Clinical, Journal: The association between initial opioid type and long-term opioid use after hip fracture surgery in elderly opioid-naïve patients. (Pubmed Central) - Sep 16, 2021
The findings suggest that some elderly, opioid-naïve patients appear to be presented with untreated pain conditions when seen in the hospital for a hip fracture surgery. Decisions regarding the opioid type prescribed after hospitalization for hip fracture surgery may be linked to different indication for pain treatment, emphasizing the likelihood of careful and conscientious opioid prescribing behavior.
- |||||||||| morphine sulphate / Generic mfg.
Journal: Kidney Function Modifies the Effect of Intraoperative Opioid Dosage on Postoperative Delirium. (Pubmed Central) - Sep 16, 2021
Decisions regarding the opioid type prescribed after hospitalization for hip fracture surgery may be linked to different indication for pain treatment, emphasizing the likelihood of careful and conscientious opioid prescribing behavior. This study suggests that incremental increases in intraoperative opioids combined with CKD increase odds of POD2 delirium after hip fracture repair, compared with patients without CKD.
- |||||||||| morphine sulphate / Generic mfg., diazepam / Generic mfg., quetiapine / Generic mfg.
Journal: A Multi-Phase Quality Improvement Initiative for the Treatment of Active Delirium in Older Persons. (Pubmed Central) - Sep 16, 2021
Elements of our unique active delirium treatment program may provide some direction to other program developers working on improving the care of older hospitalized delirious patients. However, the supporting evidence presented is limited, and a more rigorous prospective study is needed.
- |||||||||| duloxetine / Generic mfg.
Journal: Diet and companionship modulate pain via a serotonergic mechanism. (Pubmed Central) - Sep 16, 2021
More significantly, improved diet and companionship enhanced the efficacy of a sub-optimal dose of morphine for analgesia in sickle mice. These findings offer the potential to reduce opioid use without pharmacological interventions to develop effective pain management strategies.
- |||||||||| morphine sulphate / Generic mfg.
PHM-07 - 7mm from Hell: Coping with Kidney Stone Pain (Gracia 1 / L3) - Sep 15, 2021 - Abstract #PAINWeek2021PAINWeek_169;
This is not your average campfire conversation, as the presenter promises to withhold no personal details. [He's sorry, but best yet, this storytelling counts for CE credit!] Learning Objectives: Describe appropriate pain assessment techniques including various pain scales Describe the main components of the 2016 CDC chronic pain opioid guidelines including morphine milligram equivalent (MME) factors, medication storage, and naloxone education Recall important patient counseling concepts for patients with nephrolithiasis including anticipated pharmacological needs and side effects, physiological changes, and low oxalate dietary considerations
- |||||||||| morphine sulphate / Generic mfg.
Presumptive Versus Definitive Drug Testing: What Are We Missing () - Sep 15, 2021 - Abstract #PAINWeek2021PAINWeek_65;
P3
The data revealed that OIC symptom burden was similar between low and high dose MEU groups suggesting that OIC remains an important medical issue. Regardless of opioid dose, naloxegol (12.5 mg and 25 mg) provided rapid and sustained improvement of clinically relevant OIC symptoms.
- |||||||||| morphine sulphate / Generic mfg.
Opioid Stewardship Really WoRx: Leveraging the Electronic Health Record to Support Safe and Appropriate Opioid Use () - Sep 15, 2021 - Abstract #PAINWeek2021PAINWeek_55;
Recommendations included targeted education to providers around the importance of utilizing naloxone in appropriate patients and nursing staff to clarify expectations around pain assessment and documentation. Our results further support the need to increase the entire healthcare team’s awareness of risk factors for respiratory depression with opioid use including administration of higher MME per day, co-administration of opioids with other sedating medications, and utilization of long-acting opioids.
- |||||||||| oxycodone/acetaminophen / Generic mfg.
Opioid Prescribing Patterns in an Emergency Department at a Veterans Affairs Hospital () - Sep 15, 2021 - Abstract #PAINWeek2021PAINWeek_54;
Literature review suggests our ED opioid prescribing rates may be lower than other healthcare facilities, although there exists continued opportunities to reduce the rate of long-acting and injectable opioid use within the ED. Further conclusions will be made as data regarding trends continues to be analyzed.
- |||||||||| morphine sulphate / Generic mfg.
Medical Cannabis as Adjunctive Treatment for Chronic Non-cancer Pain (CNCP) to Reduce High Opioid Doses & Optimize Pain Control () - Sep 15, 2021 - Abstract #PAINWeek2021PAINWeek_46;
With this support, we hope cannabis adjunct therapy will improve pain management outcomes and enable clinicians to use lower opioid doses, reducing the risk of opioid-related harm.Although recommendations were included in this clinical tool to best support the diversity of the CNCP population, it is important to recognize that individuals may have very different responses to medical cannabis therapy. Treatment options should be prioritized to best support a patient’s pain management goals.
- |||||||||| morphine sulphate / Generic mfg.
Is There a Role for Transdermal Buprenorphine to Manage Acute Pain in the Clinical Setting? () - Sep 15, 2021 - Abstract #PAINWeek2021PAINWeek_39;
It is particularly helpful for acute pain control in the clinical setting of older patients, who may not be good candidates for other opioid therapies. When using the patch for postoperative pain, it is typically applied shortly before surgery and delivers a consistent dose of analgesic medicine over the course of about seven days, which maps onto many postsurgical pain trajectories.
- |||||||||| morphine sulphate / Generic mfg., tramadol hydrochloride / Generic mfg.
Impact of Limiting Short-Acting Opioids on Chronic Pain Management in Veterans at VA Loma Linda () - Sep 15, 2021 - Abstract #PAINWeek2021PAINWeek_37;
Secondary objectives assessed SA opioid restrictions on reduction of total morphine milligram equivalents (MME) and additional referrals to addiction or other services...Exclusion criteria: cancer/chemotherapy, hospice/palliative care, liquid opioid formulations, tramadol, and combination buprenorphine and naloxone...Quantity restrictions of SA opioids resulted in either increased strengths of current SA opioid prescriptions, addition of LA opioids, or both. In the interests of overcoming study limitations, future research should both consider standardized patient chart documentation for consistency, and examine the impact of LA opioid dose limitations, effects of alternative or adjuvant non-opioid treatment, and SA opioid dose limitations in patients with dementia.
- |||||||||| morphine sulphate / Generic mfg.
Evaluating the Impact of Interprofessional Teams to Decrease Opioid Risk in a Veteran Population () - Sep 15, 2021 - Abstract #PAINWeek2021PAINWeek_32;
Purpose : To evaluate the impact of implementation of an interdisciplinary Stratification Tool for Opioid Risk Mitigation (STORM) review team on the reduction in oral morphine equivalent dose per day versus single provider review...There was a decrease in MEDD in both the single provider review and interdisciplinary teams groups, with the interdisciplinary team group showing a larger non-statistically significant decrease. There was a statistically significant decreased in the interdisciplinary teams group (11 point decrease, p = 0.0325) compared to single provider review (8 point decrease.) Conclusion : This project found a statistically and clinically significant improvement in outcomes based on the decrease in RIOSORD score after implementation of interdisciplinary team review.
- |||||||||| morphine sulphate / Generic mfg.
Enkephalin as a Potential Analgesic and CNS Modulator () - Sep 15, 2021 - Abstract #PAINWeek2021PAINWeek_31;
The development of new therapies as viable alternatives to mu-opioids is urgently needed.Drug overdose deaths in the United States rose nearly 30% in 2020 to more than 93,000, with almost 70,000 involving opioids, according to preliminary data released today by the Centers for Disease Control and Prevention3. These data do not reflect a significantly greater number of non-fatal overdoses.Enkephalins are endogenous peptides reported to have a number of central and peripheral physiological effects.
- |||||||||| morphine sulphate / Generic mfg.
A Digital Platform to Enable Longitudinal Remote Patient Monitoring Confers a Reduction in Medication Utilization () - Sep 15, 2021 - Abstract #PAINWeek2021PAINWeek_2;
The platform has, in this pilot study, demonstrated opioid sparing effects which is suggestive of clinical utility in managing pain. Branch is a promising Software-as-a-Medical-Device (SaMD) with the capability to extend the physical clinic by enabling patient reported outcome measurement, remote patient/therapeutic monitoring (RPM/RTM) as well as offering downstream artificial intelligence to tailor content, resources and ancillary services.
- |||||||||| morphine sulphate / Generic mfg.
Clinical, Journal: Opioid Prescription Usage After Benign Gynecologic Surgery: A Prospective Cohort Study. (Pubmed Central) - Sep 15, 2021
Branch is a promising Software-as-a-Medical-Device (SaMD) with the capability to extend the physical clinic by enabling patient reported outcome measurement, remote patient/therapeutic monitoring (RPM/RTM) as well as offering downstream artificial intelligence to tailor content, resources and ancillary services. In this cohort, gynecologic surgeons prescribed nearly three times more opioid tablets and MME than was used by patients despite patients reporting similar levels of pain after minor and major surgeries.
- |||||||||| morphine sulphate / Generic mfg.
Journal: Changes in Quantity of Opioids Dispensed Following Florida's Restriction Law for Acute Pain Prescriptions. (Pubmed Central) - Sep 15, 2021
Among a group of privately-insured plan enrollees in Florida, and as a result of the law, there were significant decreases in the number of units dispensed, and total MMEs of opioid prescriptions. The immediate reduction in new opioid utilization following policy implementation suggests effective policy; however, impacts on chronic pain patients were not assessed.
- |||||||||| zaleplon / Generic mfg.
Clinical, Journal: The Risk of Overdose With Concomitant Use of Z-Drugs and Prescription Opioids: A Population-Based Cohort Study. (Pubmed Central) - Sep 15, 2021
The Z-drugs (zolpidem, zopiclone, zaleplon) are widely used to treat insomnia in patients receiving prescription opioids, and the risk of overdose resulting from this coprescription has not been explored...Patients with concomitant exposure to Z-drugs were matched 1:1 to patients with exposure to prescription opioids alone based on opioid prescribed, morphine equivalents, number of days' supply, and hospitalization within the past 30 days...Among patients receiving prescription opioids, after controlling for all confounding factors, concomitant treatment with Z-drugs was associated with a substantial relative increase in the risk of overdose. The potential implications are significant given the large number of opioid-treated patients receiving Z-drugs.
- |||||||||| morphine sulphate / Generic mfg.
Journal: Prediction of Prolonged Opioid Use After Surgery in Adolescents: Insights From Machine Learning. (Pubmed Central) - Sep 15, 2021
Machine-learning models to predict POUS risk among adolescents show modest to strong results for different surgeries and reveal variables associated with higher risk. These results may inform health care system-specific identification of patients at higher risk for POUS and drive development of preventative measures.
- |||||||||| morphine sulphate / Generic mfg.
Clinical, Journal: Predictive Performance of Oximetry to Detect Sleep Apnea in Patients Taking Opioids. (Pubmed Central) - Sep 15, 2021
Overnight home oximetry has a high predictive performance in predicting moderate-to-severe and severe sleep apnea in patients on opioids for chronic pain. It is a useful additional tool for health care providers for the screening of sleep apnea in this high-risk group.
- |||||||||| morphine sulphate / Generic mfg.
Preclinical, Journal: Effect of Electro-Acupuncture at ST36 and SP6 on the cAMP -CREB Pathway and mRNA Expression Profile in the Brainstem of Morphine Tolerant Mice. (Pubmed Central) - Sep 14, 2021
Similarly, western blot revealed the phosphorylation levels of PKA, ERK, and CREB were up-regulated in morphine tolerant mice, whereas the EA group showed a significantly reduced expression level instead. This study observed an attenuating effect of the EA at ST36 and SP6 on morphine tolerance in mice, and suggested several potential biological targets by RNA-seq, which include the cAMP-PKA/ERK-CREB signaling pathway, strongly supporting a useful treatment for combatting the opioid epidemic, and opioid-tolerant patients.
|
