Opioids for Pain
Date: April 9, 2018
Issue #:
1544Summary:
Use of nonopioid drugs for pain was reviewed in a
previous issue. For many types of moderate to severe acute pain, acetaminophen and/or an NSAID may be as effective as an opioid. Immediate-release formulations of full opioid agonists should generally be used for acute pain that is severe enough to require treatment with an opioid. Use of extended-release or long-acting opioid formulations initially and treatment durations>1 week have been associated with an increased risk of unintended long-term use. (Source: The Medical Letter)
Source: The Medical Letter - March 21, 2018 Category: Drugs & Pharmacology Authors: admin Tags: Abstral Acetaminophen Actiq Alertec amitiza Antidepressants Apadaz Arymo Aspirin Belbuca benzhydrocodone Buprenex Buprenorphine Butorphanol Butrans Cancer pain capsaicin Codeine Codeine Contin ConZip Dialudid Dolo Source Type: research
Efficacy and feasibility of opioids for burn analgesia: An evidence-based qualitative review of randomized controlled trials
Publication date: Available online 21 November 2017 Source:Burns Author(s): Chao Yang, Xiao-min Xu, Guang-zhao He Opioids are commonly used for burn analgesia, but no comprehensive reviews have been published on such use. We aimed to assess the literature regarding the effectiveness and side effects of opioids both in adult and pediatric burn patients. We conducted a systematic search of the PubMed, Embase, Cochrane, and Web of Science databases. Information on study characteristics, results, and interventions was extracted. The review identified nine studies that satisfied the inclusion criteria. Burn sizes of patien...
Source: Burns - December 16, 2017 Category: Dermatology Source Type: research
Regressive quadriparesis following tracheal resection anastomosis: A rare debilitating but avoidable complication
A 24-year-old male, ASA I patient underwent an uneventful tracheal resection and primary end to end anastomosis. A guardian suture (chin to chest) was placed and the trachea extubated following which the patient was monitored in a seated position. Fentanyl citrate 0.5 μgkg−1h−1 was administered for postoperative analgesia. However (17h postoperatively), the patient complained of uneasiness in the neck along with weakness of both lower limbs (power 1/5) which rapidly progressed to involve the upper limbs too (power 2/5). (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - November 2, 2017 Category: Anesthesiology Authors: Akhil Kumar, Ashwin Marwaha, Ameya Pappu, Shikha Sharma, Jayashree Sood Tags: Correspondence Source Type: research
Pharmacokinetics and safety of fentanyl sublingual spray and fentanyl citrate intravenous: a multiple ascending dose study in opioid-na ïve healthy volunteers.
CONCLUSION: Fentanyl sublingual spray (100 mcg, 200 mg, and 400 mcg) administered every 0.5, 1, 2, and 4 h was generally well tolerated in an opioid-naïve population. The results suggest that doses of 200 mcg or lower may be safe for use in an opioid-naïve population.
PMID: 28942715 [PubMed - as supplied by publisher] (Source: Current Medical Research and Opinion)
Source: Current Medical Research and Opinion - September 27, 2017 Category: Research Tags: Curr Med Res Opin Source Type: research
Pharmacokinetics and safety of fentanyl sublingual spray and fentanyl citrate intravenous: a single ascending dose study in opioid-na ïve healthy volunteers.
CONCLUSIONS: Overall, single-dose fentanyl sublingual spray (100-800 mcg) was generally well tolerated, with greater incidences of AEs (eg, nausea, vomiting, hypoxia) at higher doses. Doses up to 200 mcg may be safely administered to healthy opioid-naïve individuals with routine monitoring; doses between 400-800 mcg may be administered in settings with nasal cannula oxygenation.
PMID: 28681626 [PubMed - as supplied by publisher] (Source: Current Medical Research and Opinion)
Source: Current Medical Research and Opinion - July 8, 2017 Category: Research Tags: Curr Med Res Opin Source Type: research
Battlefield Analgesia in Tactical Combat Casualty Care
Publication date: June 2017 Source:Wilderness & Environmental Medicine, Volume 28, Issue 2, Supplement Author(s): Ian S. Wedmore, Frank K. Butler At the start of the Afghanistan conflict, battlefield analgesia for US military casualties was achieved primarily through the use of intramuscular (IM) morphine. This is a suboptimal choice, since IM morphine is slow-acting, leading to delays in effective pain relief and the risk of overdose and death when dosing is repeated in order to hasten the onset of analgesia. Advances in battlefield analgesia, pioneered initially by Tactical Combat Casualty Care (TCCC), and th...
Source: Wilderness and Environmental Medicine - June 8, 2017 Category: Environmental Health Source Type: research
Continuous wound infiltration system for postoperative pain management in gynecologic oncology patients
ConclusionsCombined therapy using CWIS and IV PCA may be a useful strategy for POSP management in gynecologic oncology patients. (Source: Archives of Gynecology and Obstetrics)
Source: Archives of Gynecology and Obstetrics - April 11, 2017 Category: OBGYN Source Type: research
Opioid-type Respiratory Depressant Side Effects of Cebranopadol in Rats Are Limited by Its Nociceptin/Orphanin FQ Peptide Receptor Agonist Activity
Conclusions The therapeutic window between antinociception and respiratory depression in rats is larger for cebranopadol than that for fentanyl because the nociceptin/orphanin FQ peptide receptor agonist action of cebranopadol counteracts side effects resulting from its μ-opioid peptide receptor agonist action. (Source: Anesthesiology)
Source: Anesthesiology - March 14, 2017 Category: Anesthesiology Source Type: research
Effect of Modulated Electrohyperthermia on the Pharmacokinetics of Oral Transmucosal Fentanyl Citrate in Healthy Volunteers.
This study aimed to determine whether changes occur in fentanyl absorption and disposition when administered in conjunction with modulated electrohyperthermia (mEHT) treatment.
METHODS: A randomized, single-dose, crossover, open-label study was used to investigate the effect of mEHT on the pharmacokinetic properties of fentanyl in 12 healthy volunteers. The 12 healthy volunteers were each administered a single dose of oral transmucosal fentanyl citrate (OTFC) or a single dose of OTFC with mEHT. mEHT was performed on the abdomen for 1 hour. Blood samples were collected for 24 hours after dosing. The temperature of t...
Source: Clinical Therapeutics - November 16, 2016 Category: Drugs & Pharmacology Authors: Lee SY, Kim MG Tags: Clin Ther Source Type: research
[Dose-finding for treatment with a transdermal fentanyl patch : Titration with oral transmucosal fentanyl citrate and morphine sulfate].
Abstract
To date, no studies investigating titration with oral transmucosal fentanyl for the dose-finding of transdermal fentanyl treatment have been published. In an open randomized study 60 patients with chronic malignant (n = 39) or nonmalignant pain (n = 21), who required opioid therapy according to step three of the guidelines of the World Health Organization (WHO), were investigated. In two groups of 30 patients each titration with immediate release morphine (IRM) or oral transmucosal fentanyl citrate (OTFC) was undertaken. For measurement purposes the Brief Pain Inventory (BPI) and Minimal Docum...
Source: Schmerz - April 11, 2016 Category: Anesthesiology Authors: Mücke M, Conrad R, Marinova M, Cuhls H, Elsner F, Rolke R, Radbruch L Tags: Schmerz Source Type: research
Actiq Is Not for Sore Throats!
No abstract available (Source: Home Healthcare Nurse)
Source: Home Healthcare Nurse - March 1, 2016 Category: Nursing Tags: Ismp Medication Errors Source Type: research
Morphine and Fentanyl Citrate Induce Retrotransposition of Long Interspersed Element-1
The retroelement long interspersed element-1 (LINE-1 or L1) comprises about 17% of the human genome. A single human cell has 80 to 100 copies of retrotransposition-competent L1, approximately 10% of which are ‘hot’ and actively ‘jump’ around the genome. Recent observations demonstrated that low-molecular weight compounds may induce L1 retrotransposition through unknown mechanisms. Herein, we demonstrated that the painkillers morphine and fentanyl citrate trigger L1 retrotransposition in neuronal cells without inducing DNA damage or up-regulating L1 mRNA expression. This effect was blocked by an anta...
Source: In Vivo - February 24, 2016 Category: Research Authors: OKUDAIRA, N., ISHIZAKA, Y., NISHIO, H., SAKAGAMI, H. Tags: Experimental Studies Source Type: research
A new once-a-day fentanyl citrate patch (Fentos® Tape) could be a new treatment option in patients with end-of-dose failure using a 72-h transdermal fentanyl matrix patch
Conclusions
A once-a-day fentanyl citrate patch provided stable pain control. Its use may be considered as the dominant strategy for patients receiving a 72-h transdermal fentanyl not lasting 72 h. (Source: Supportive Care in Cancer)
Source: Supportive Care in Cancer - January 28, 2016 Category: Cancer & Oncology Source Type: research
The Influence of Low Salivary Flow Rates on the Absorption of a Sublingual Fentanyl Citrate Formulation for Breakthrough Cancer Pain
Salivary gland hypofunction may affect the absorption of drugs through the oral mucosa, which in turn may affect their clinical efficacy (e.g., onset of action). (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - December 16, 2015 Category: Palliative Care Authors: Andrew Davies, Gill Mundin, Joanna Vriens, Kath Webber, Alison Buchanan, Melanie Waghorn Source Type: research
G18 * Breakthrough pain in patients with head and neck cancer: efficacy and safety of buccal fentanyl citrate
(Source: Annals of Oncology)
Source: Annals of Oncology - October 26, 2015 Category: Cancer & Oncology Authors: Rondonotti, D., Platini, F., Giavarra, M., Patrucco, F., Zanotti, V., Negru, M. E., Sponghini, A. P. Tags: Session G. Head and neck cancer Source Type: research
