A Recipe for Disaster: Gabapentin and Opioid Use in an Older Adult
Chronic pain is common among older adults, as is the use of medications to treat these symptoms. Aging physiology, in combination with a higher likelihood of medication use and declining renal function, makes older adults more susceptible to adverse drug effects. As such, monitoring for side effects and changes in renal function is important to avoid drug toxicity, especially during acute illness when medication errors and acute changes in renal function are more likely to occur among older adults.
Publication date: Available online 21 November 2019Source: Journal of Acupuncture and Meridian StudiesAuthor(s): Maria P. Volpato, Izabela C.A. Breda, Ravena C. de Carvalho, Caroline de Castro Moura, Laís L. Ferreira, Marcelo L. Silva, Josie R.T. Silva
The hypothalamus–pituitary–adrenal (HPA) axis acts to release cortisol into the blood stream, as cortisol calls the body into action to combat stress. When high amounts of cortisol interact with the hypothalamus, the HPA axis will slow down its activity. The amygdala detects stress, while the prefrontal cortex regulates our reactions to stress. Source: Bezdek K and Telzer E (2017) Have No Fear, the Brain is Here! How Your Brain Responds to Stress. Front. Young Minds. 5:71. doi: 10.3389/frym.2017.00071 _______ [Editor’s note: Continued from yesterday’s Exploring the human brain and how it responds to...
Conclusion: The current study demonstrated no analgesic effects of postoperative chlorzoxazone administration compared with placebo on acute or chronic postoperative pain 12 months following TKR and THR.
Discussion: Most clinicians agreed that OIH is a complication of opioid therapy, but were divided regarding the prevalence of OIH, etiological factors, and optimal management.
Discussion: The study provides important new findings regarding the associations between social factors and physical and psychological functioning of individuals with chronic pain, supporting biopsychosocial models.
Discussion: Our findings support the notion of a positive association between inflammatory biomarkers and nonspecific LBP, specifically for CRP, TNFs, and IL-6. Although further high quality longitudinal studies are needed to confirm these findings and evaluate the magnitude of these associations, our findings suggest a role of inflammation in the pathogenesis of nonspecific LBP.
Discussion: The 2-factor model of the 3*I “family members” subscale identified in the current study reflects previous findings and extends the psychometric validity of the 3*I to a US multiethnic sample of individuals with CLBP.
CONCLUSION: In veterans with chronic pain, PTSD symptomology has a large effect for many negative health-related outcomes. This review supports the need for clinicians to screen and understand the effects of PTSD symptoms on patients with pain. Clinicians should recognize that veterans with PTSD and pain likely have elevated pain catastrophizing beliefs and decreased self-efficacy that should be targeted for intervention. PMID: 32248229 [PubMed - as supplied by publisher]
Regenerative pain medicine, which seeks to harness the body’s own reparative capacity, is rapidly emerging as a field within pain medicine and orthopedics. It is increasingly appreciated that common analgesic mechanisms for these treatments depend on neuroimmune modulation. In this Review, we discuss recent progress in mechanistic understanding of nociceptive sensitization in chronic pain with a focus on neuroimmune modulation. We also examine the spectrum of regenerative outcomes, including preclinical and clinical outcomes. We further distinguish the analgesic mechanisms of regenerative therapies from those of cell...
Conclusion. This study shows that financial worries were significantly associated with chronic spinal pain. Financial worries may be important to be taken into consideration by clinicians managing patients with spinal pain. More future research is needed to explore the association between financial worries and spinal pain. Level of Evidence: 3