- |||||||||| Retrospective data, Journal: Ultrasound-Guided PECS II + Serratus Plane Fascial Blocks Are Associated with Reduced Opioid Consumption and Lengths of Stay for Minimally Invasive Cardiac Surgery: An Observational Retrospective Study. (Pubmed Central) - Jun 25, 2022
Group 1 (41 patients) received ultrasound-guided PECS II + serratus plane blocks with Ropivacaine 0.25% 10 mL + 20 mL + 30 mL...The primary outcomes were: the pain perceived: Critical-Care Pain Observation Tool (CPOT) score; the opioids consumption: mg morphine or tramadol, or µg sufentanyl administered; and mg paracetamol, toradol, tramadol or morphine administered as a rescue...Group 1 vs. Group 2 consumed less opioids (Sufentanyl p < 0.0001; Morphine p < 0.0001), had a lower pain perceived (p = 0.002 at 6 h, p = 0.0088 at 12 h, p < 0.0001 at 24 h), need for rescue analgesia (p = 0.0005), episodes of nausea and vomiting (p = 0.0237) and intubation time and ICU stay (p = 0.0147 time of IOT, p < 0.0001 stay in ICU). Ultrasound-guided PECS II + serratus plane blocks demonstrated better than intravenous opioids analgesia in patients undergoing minimally invasive cardiac surgery.
- |||||||||| morphine sulphate / Generic mfg.
Reimbursement, Journal: Conversion Total Knee Arthroplasty After Tibial Plateau Fixation Is Associated With Lower Reimbursement, Greater Complication Rates, and Similar Opioid Use. (Pubmed Central) - Jun 25, 2022
Opioid use over the episode of care, evaluated by morphine milligram equivalents (MME), and 30-day reimbursed cost were compared between groups using an unequal variance t-test. Complication rates at 30 days, 90 days, and one year postoperatively, and revision rates at one and two years postoperatively were compared using the odd's ratio (OR) with 95% confidence intervals (95%CI)...Conclusion Patients with a history of tibial plateau fracture who then underwent conversion TKA have a lower reimbursed cost of TKA but a higher postoperative risk for dehiscence, mechanical complications, and surgical site infections. There is no significant difference in postoperative opioid use between the two groups.
- |||||||||| morphine sulphate / Generic mfg.
Journal: Simultaneous determination of some opioid drugs using Cu-hemin MOF@MWCNTs as an electrochemical sensor. (Pubmed Central) - Jun 24, 2022
Due to its toxicological and pharmacological activity, the misuse and overuse of morphine (MO), codeine (CO), and heroine have attracted attention in the medical and forensic toxicology fields...Moreover, the applicability in real samples was confirmed by the simultaneous determination of MO and CO in human urine and MO injection. This work reveals a trustable sensor based on MOF and MWCNTs to simultaneously determine opioid drugs in clinical application.
- |||||||||| Carafate (sucralfate) / AbbVie
Is Opioid Use in the Management of Stage III Non-Small Cell Lung Cancer Patients Necessary? (Exhibit Hall - Hall B) - Jun 24, 2022 - Abstract #IASLCWCLC2022IASLC_WCLC_1808;
Most patients with unresectable stage III NSCLC undergoing chemoradiation were able to manage their pain without the use of opioids by relying on adjuncts such as NSAIDs, PPIs, and steroids. Future studies should examine pain management regimens in a randomized control trial to better assess the efficacy of non-opioid pain medications.Observed pain regimens in Stage III NSCLC patients undergoing definitive chemoradiation.
- |||||||||| morphine sulphate / Generic mfg., methadone / Generic mfg.
Journal: Current research in pathophysiology of opioid-induced respiratory depression, neonatal opioid withdrawal syndrome, and neonatal antidepressant exposure syndrome. (Pubmed Central) - Jun 24, 2022
Morphine showed a differential influence on preBötC and KF neurons - low doses attenuated RD following deletion of MORs from preBötC neurons and an increase in apneas after high doses whereas deletion of MORs from KF neurons but not the preBötC attenuated RD at both high and low doses...Methadone, administered to alleviate symptoms of neonatal opioid withdrawal syndrome (NOWES), desensitized rats to OIRD...Enzyme CYP2D6 involved in opioid detoxification is polymorphic. Individuals of different CYP2D6 genotype may show increased, decreased, or no enzyme activity, contributing to the variability of patient responses to different opioids and OIRD.
- |||||||||| morphine sulphate / Generic mfg.
Journal: Morphine, pain and religions (Pubmed Central) - Jun 24, 2022
Respecting spirituality has the potential to strengthen the therapeutic alliance and promote appropriate care. This article provides food for thought through clinical vignettes frequently encountered in clinical practice.
- |||||||||| morphine sulphate / Generic mfg.
Preclinical, Journal: Sex Differences in the Amygdaloid Projections to the Ventrolateral Periaqueductal Gray and Their Activation During Inflammatory Pain in the Rat. (Pubmed Central) - Jun 24, 2022
In addition to pain, this descending circuit (or pathway) can be engaged by endogenous opioids (i.e., endorphins) or exogenous opioids (i.e., morphine), and we have previously reported sex differences in the activation of this circuit during pain and analgesia...In contrast, inflammatory pain resulted in a greater activation of the CeA-vlPAG pathway in females. As females experience a greater number of chronic pain syndromes, the CeA-vlPAG pathway may play a facilitatory (and not inhibitory) role in pain modulation.
- |||||||||| morphine sulphate / Generic mfg.
Journal: Trends in Opioid Prescribing by General Dentists and Dental Specialists in the U.S., 2012-2019. (Pubmed Central) - Jun 23, 2022
A greater magnitude of decline occurred post 2016 following the implementation of strategies aimed to further regulate opioid prescribing. Understanding the factors that influence prescribing trends can aid in development of tailored resources to encourage and support a conservative approach by dentists, to prescribing opioids.
- |||||||||| morphine sulphate / Generic mfg.
Trial completion, Enrollment change, Trial completion date, Trial primary completion date, Surgery: Pharmacokinetics of Morphine and Oxycodone in Frail Elderly Undergoing Cardiac Surgery (clinicaltrials.gov) - Jun 23, 2022
P=N/A, N=34, Completed,
This dose was not associated with development of respiratory depression and can therefore be administered safely to patients who are discharged to the ward postoperatively in a resource constraint environment. Recruiting --> Completed | N=20 --> 34 | Trial completion date: Apr 2022 --> Nov 2021 | Trial primary completion date: Apr 2022 --> Nov 2021
- |||||||||| What lies beneath: a case of squamous cell carcinoma masquerading as rhinophyma () - Jun 23, 2022 - Abstract #BAD2022BAD_486;
He had a background of rheumatoid arthritis, controlled with methotrexate, ischaemic heart disease; atrial fibrillation...Treatment options include isotretinoin, tetracyclines, surgical excision; laser therapy...Subtle tissue differences noted during rhinophymaplasty should also prompt clinicians to investigate further. Rhinophyma is often encountered in cosmetic dermatology,; clinicians must continue to have a high index of suspicion for malignancy in patients presenting with atypical findings, as this is not a diagnosis to be missed.
- |||||||||| Humira (adalimumab) / Eisai, AbbVie
Painand hidradenitis suppurativa: do our patients feel heard? () - Jun 23, 2022 - Abstract #BAD2022BAD_409;
A questionnaire survey was sent to 85 patients currently on adalimumab therapy or due to start...Forms of analgesia taken for HS included co-codamol, naproxen, ibuprofen, morphine; lidocaine patches...This study highlights the need for further exploration into pain; the psychosocial impact of HS. Following on from our findings, we now routinely document pain scores in clinics; liaise with GPs to offer pain relief.
- |||||||||| morphine sulphate / Generic mfg.
Journal: Changes in Prescribing by Provider Type Following a State Prescription Opioid Restriction Law. (Pubmed Central) - Jun 22, 2022
Following on from our findings, we now routinely document pain scores in clinics; liaise with GPs to offer pain relief. Pre-policy opioid prescribing varied by provider type with a differential impact on mean MMEs, mean days' supply, and mean number of units dispensed per prescription following implementation.
- |||||||||| morphine sulphate / Generic mfg., phenobarbital / Generic mfg.
Clinical, Journal: The use of buprenorphine + naloxone sublingual tablet in the treatment of neonatal opioid withdrawal syndrome: Two case reports. (Pubmed Central) - Jun 22, 2022
Since oral alternatives are not available in many clinics, as in our unit, parenteral morphine is still the drug of the first choice...Due to the lack of oral treatment alternatives, first, we tried phenobarbital up to 40 mg/kg orally...There were no adverse effects and babies were discharged fully recovered. Sublingual Buprenorphine 2 mg + Naloxone 0.5 mg (4:1) tablet could be used efficiently and without side effects to treat neonatal opioid withdrawal syndrome.
- |||||||||| morphine sulphate / Generic mfg.
Journal: Effect of opioid-free anesthesia on postoperative analgesia after laparoscopic gynecologic surgery. (Pubmed Central) - Jun 22, 2022
Use of oliceridine in postoperative care among patients at high risk provides a favorable health economic benefit compared to the use of morphine. Compared to opioid-inclusive anesthesia during laparoscopic gynecologic surgery, OFA was associated with significant improvement in postoperative analgesia, reduced PONV incidenceprevalence and severity, and faster first passage of flatus.
- |||||||||| morphine sulphate / Generic mfg., diazepam / Generic mfg.
Reimbursement, Journal, Medicare: Dosing profiles of concurrent opioid and benzodiazepine use associated with overdose risk among US Medicare beneficiaries: Group-based multi-trajectory models. (Pubmed Central) - Jun 22, 2022
Compared to opioid-inclusive anesthesia during laparoscopic gynecologic surgery, OFA was associated with significant improvement in postoperative analgesia, reduced PONV incidenceprevalence and severity, and faster first passage of flatus. Patterns of concurrent opioid and benzodiazepine use most associated with overdose risk among fee-for-service US Medicare beneficiaries initiating opioid prescriptions include very high-dose opioid use (MME > 150), high-dose benzodiazepine use (DME > 40) or medium-dose opioid with low-dose benzodiazepine use.
- |||||||||| morphine sulphate / Generic mfg., oxycodone/acetaminophen / Generic mfg., paracetamol / Generic mfg.
Journal: The Effect of an Automated Order on Postpartum Opioid Use After Uncomplicated Vaginal Deliveries. (Pubmed Central) - Jun 22, 2022
As secondary outcomes, the impact on average total morphine milligram equivalents (MMEs) and discharge opioid prescriptions was investigated...No significant difference was found with discharge opioid prescriptions between the two groups. Order sets within EMR systems appear to have a significant influence on physician prescribing behaviors and removing these automated orders for opioids should be considered.
- |||||||||| ketoconazole / Generic mfg., morphine sulphate / Generic mfg.
Journal: The respiratory depressant effects of mitragynine are limited by its conversion to 7-OH mitragynine. (Pubmed Central) - Jun 22, 2022
The limiting rate of conversion of mitragynine into its active metabolite results in a built-in ceiling effect of the mitragynine-induced respiratory depression. These data suggest that such 'metabolic saturation' at high doses may underlie the improved safety profile of mitragynine as an opioid analgesic.
- |||||||||| morphine sulphate / Generic mfg.
Journal: Assessment of a Naloxone Coprescribing Alert for Patients at Risk of Opioid Overdose: A Quality Improvement Project. (Pubmed Central) - Jun 22, 2022
The current study found that women with physical, inflammatory, and psychiatric disability were prescribed more opioids and at higher dosages during pregnancy than their counterparts without disability, after adjusting for chronic pain status. A targeted decision support alert for patients at risk for opioid overdose significantly increased the rate of naloxone coprescribing and was relatively easy to build.
- |||||||||| morphine sulphate / Generic mfg.
Retrospective data, Journal: Comparing Opioid Usage in Non-Intensive Care Unit Trauma Patients After Implementing Multimodal Analgesia Order Sets. (Pubmed Central) - Jun 22, 2022
Implementation of a multimodal order set was not associated with significant reduction in the amount of opioids used in non-intensive care unit trauma patients. However, pain scores were unchanged despite an increased number of procedures performed suggesting that multimodal analgesia sets may be a useful tool to aid in decreasing opioid utilization after traumatic injuries.
- |||||||||| morphine sulphate / Generic mfg.
Preclinical, Journal: HIV-1 Tat reduces apical dendritic spine density throughout the trisynaptic pathway in the hippocampus of male transgenic mice. (Pubmed Central) - Jun 22, 2022
We exposed inducible male HIV-1 Tat transgenic mice to escalating doses of morphine (10-40 mg/kg, b.i.d.) and examined synaptodendritic structure in Golgi-impregnated hippocampal neurons. HIV-Tat, but not morphine, systematically reduced the density of apical, but not basilar, dendrites of CA1 and CA3 pyramidal neurons, and granule neuronal apical dendrites, suggesting the coordinated loss of specific synaptic interconnections throughout the hippocampal trisynaptic pathway.
- |||||||||| morphine sulphate / Generic mfg.
Journal: Effects of the mu-opioid receptor agonist morphine on facial mimicry and emotion recognition. (Pubmed Central) - Jun 22, 2022
These findings suggest that MOR activity is involved in automatic facial responses to fearful stimuli, but not in their identification. Overall, the current results, together with the previously reported small effects of opioid compounds, suggest a relatively marginal role of the MOR system in emotion simulation and perception.
- |||||||||| morphine sulphate / Generic mfg.
Journal: BDNF-AAV has protective effects on morphine-induced conditioned place preference through BDNF, TrkB, and CREB concentration changes in the VTA and NAc. (Pubmed Central) - Jun 22, 2022
Western blot assays were used to determine the changes caused by BDNF, for example, changes in total BDNF, tropomyosin-related kinase receptor B (TrkB), and cAMP response element binding protein (CREB) in the ventral tegmental area (VTA) and nucleus accumbens (NAc). The results showed that the BDNF-adeno-associated viral vector (BDNF-AAV) injected in the VTA, attenuated morphine-induced CPP with synergistic changes in BDNF/TrkB/CREB concentrations in the VTA and NAc in the CPP acquisition and recurrence phases; however, the attenuation was lower in the extinction phase, with different changes in molecules downstream of the BDNF.
- |||||||||| morphine sulphate / Generic mfg., tramadol hydrochloride / Generic mfg.
Journal: Impact of Hydrocodone Rescheduling on Dental Prescribing of Opioids. (Pubmed Central) - Jun 22, 2022
Monthly dentist-based opioid prescribing rate (opioid prescription [Rx]/1,000 dentists) and monthly average opioid dosages per prescription (mean morphine milligram equivalent per day [MME/d]) were measured in the 24 mo before and after hydrocodone rescheduling in October 2014 (index or interruption)...Hydrocodone was the most commonly prescribed opioid pre- and postindex (74.9% and 63.8%, respectively), followed by codeine (13.8% and 21.6%), oxycodone (8.1% and 9.5%), and tramadol (2.9% and 4.8%)...The study findings can be used by policy makers to make informed decisions in developing future risk mitigation strategies aimed to regulate opioid prescribing behaviors. Furthermore, dentist-specific resources and guidelines are needed subsequent to these policies in order to meet the dental population needs.
- |||||||||| morphine sulphate / Generic mfg., methadone / Generic mfg.
Clinical, Journal: Morphine versus methadone for neonatal opioid withdrawal syndrome: a randomized controlled pilot study. (Pubmed Central) - Jun 22, 2022
P4
Infants treated with morphine versus methadone had no significant differences in LOS or LOT in this pilot study. Infants treated with methadone received up to 3 times the opioid based on morphine equivalents as infants treated with morphine and had more transfers to the NICU for over sedation.
- |||||||||| Nucynta (tapentadol) / Collegium Pharma, Grunenthal
Biomarker, Observational data, Journal, Real-world evidence: Oxycodone/naloxone versus tapentadol in real-world chronic non-cancer pain management: an observational and pharmacogenetic study. (Pubmed Central) - Jun 22, 2022
Pain intensity and relief, quality of life, morphine equivalent daily doses (MEDD), concomitant analgesic drugs, adverse events (AEs), hospital frequentation and genetic variants of OPRM1 (rs1799971, A118G) and COMT (rs4680, G472A) genes, were analysed...Here, OXN achieved the greatest pain relief under a 28% higher MEDD, 8-13% higher use of pregabalin and duloxetine, and 23% more prescription change due to pain, compared to TAP...CNCP real-world patients achieved higher pain relief than other traditional opioids with a better tolerability for TAP. Further research is necessary to clarify the potential influence of COMT and sex on OXN side-effects.
- |||||||||| Prialt (ziconotide) / Jazz
Review, Journal: The Role of Intrathecal Pumps in Nonmalignant Pain. (Pubmed Central) - Jun 22, 2022
There has been increasing use of intrathecal drug administration in the management of patients with nonmalignant pain in recent years given the advances in technology and research on the topic. However, due to its invasive nature, intrathecal pumps remain the last option among patients with chronic pain.
- |||||||||| morphine sulphate / Generic mfg., amphetamine / Generic mfg.
Review, Journal: Contribution of Illicit Drug Use to Pharmaceutical Load in the Environment: A Focus on Sub-Saharan Africa. (Pubmed Central) - Jun 22, 2022
The information on the occurrences of illicit drugs and their metabolic products in the sub-Saharan Africa environment and their contribution to pharmaceutical load is missing. In this case, it is important to research further the presence, levels, distribution, and environmental risks of exposure to human beings and the entire ecosystem.
- |||||||||| fentanyl citrate / Generic mfg.
Preclinical, Journal: S-Nitroso-L-Cysteine Stereoselectively Blunts the Deleterious Effects of Fentanyl on Breathing While Augmenting Antinociception in Freely-Moving Rats. (Pubmed Central) - Jun 22, 2022
Taken together, these findings add to existing knowledge that S-nitroso-L-cysteine stereoselectively modulates the detrimental effects of opioids on breathing, and opens the door for mechanistic studies designed to establish whether the pharmacological actions of S-nitroso-L-cysteine involve signaling processes that include 1) the activation of plasma membrane ion channels and receptors, 2) selective intracellular entry of S-nitroso-L-cysteine, and/or 3) S-nitrosylation events. Whether alterations in the bioavailability and bioactivity of endogenous S-nitroso-L-cysteine is a key factor in determining the potency/efficacy of fentanyl on breathing is an intriguing question.
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