[Opioids in chronic osteoarthritis pain : A systematic review and meta-analysis of efficacy, tolerability and safety in randomized placebo-controlled studies of at least 4 weeks duration.]
CONCLUSION: Opioids were superior to placebo in terms of efficacy and inferior in terms of tolerability. The effect sizes of average reduction in pain intensity and physical disability were small. Opioids and placebo did not differ in terms of safety. The conclusion on the safety of opioids compared to placebo is limited by the low number of SAE and deaths. Short-term opioid therapy may be considered in selected chronic OA pain patients. No current evidence-based guideline recommends opioids as first-line treatment option for chronic OA pain. To provide superior evidence for future treatment guidelines, RCTs must directly ...
Source: Schmerz - November 8, 2014 Category: Anesthesiology Authors: Schaefert R, Welsch P, Klose P, Sommer C, Petzke F, Häuser W Tags: Schmerz Source Type: research
Concomitant Pseudomonas Discitis from Shared Needles in Intravenous Opioid Abusers
AbstractSpinal discitis is a relatively rare infection of the vertebral disks that only occurs in 2% to 4% of all bony infections.1 Intravenous drug users are a specific group of patients who are at increased risk for this type of infection because bacterial organism is introduced to the bloodstream from needle usage. In this case series, we present 2 cases of concomitant Pseudomonas aeruginosa discitis after chronic intravenous administration of Opana (oxymorphone hydrochloride) with shared needles. Both patients underwent computed tomography–guided aspiration and were treated with long-term intravenous antibiotics, whi...
Source: Infectious Diseases in Clinical Practice - October 31, 2014 Category: Infectious Diseases Tags: Case Reports Source Type: research
Pathophysiology and principles of management of the many faces of the acute vaso‐occlusive crisis in patients with sickle cell disease
This article is protected by copyright. All rights reserved. (Source: European Journal of Haematology)
Source: European Journal of Haematology - October 1, 2014 Category: Hematology Authors: Samir K. Ballas Tags: Review Article Source Type: research
Tapentadol Abuse Potential: A Postmarketing Evaluation Using a Sample of Individuals Evaluated for Substance Abuse Treatment
ConclusionsTapentadol abuse was seen infrequently in this study and, on a prescription basis, was less likely to be abused than most of the examined Schedule II analgesics. (Source: Pain Medicine)
Source: Pain Medicine - September 22, 2014 Category: Anesthesiology Authors: Stephen F. Butler, Emily C. McNaughton, Ryan A. Black Tags: Original Source Type: research
Oral or transdermal opioids for osteoarthritis of the knee or hip.
CONCLUSIONS: The small mean benefit of non-tramadol opioids are contrasted by significant increases in the risk of adverse events. For the pain outcome in particular, observed effects were of questionable clinical relevance since the 95% CI did not include the minimal clinically important difference of 0.37 SMDs, which corresponds to 0.9 cm on a 10-cm VAS.
PMID: 25229835 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - September 17, 2014 Category: Journals (General) Authors: da Costa BR, Nüesch E, Kasteler R, Husni E, Welch V, Rutjes AW, Jüni P Tags: Cochrane Database Syst Rev Source Type: research
Assessing Abuse Potential of New Analgesic Medications Following Market Release: An Evaluation of Internet Discussion of Tapentadol Abuse
ConclusionsRecreational abusers posting on web forums appear to be less interested in abusing tapentadol when compared with other, selected prescription analgesics based on the amount of discussion (i.e., fewer posts and authors mentioning tapentadol). Endorsement of the product for abuse was also low. (Source: Pain Medicine)
Source: Pain Medicine - September 1, 2014 Category: Anesthesiology Authors: Emily C. McNaughton, Ryan A. Black, Sarah E. Weber, Stephen F. Butler Tags: Original Article Source Type: research
Pharmacodynamic effects of oral oxymorphone: abuse liability, analgesic profile and direct physiologic effects in humans
Abstract
Oxymorphone is a semisynthetic μ‐opioid agonist, marketed as a prescription analgesic purported to be twice as potent as oxycodone for pain relief. Oral formulations of oxymorphone were reintroduced in the United States in 2006 and reports of abuse ensued; however, there are limited data available on its pharmacodynamic effects. The current study aimed to examine the direct physiologic effects, relative abuse liability, analgesic profile and overall pharmacodynamic potency of oxymorphone in comparison with identical doses of oxycodone. Healthy, non‐dependent opioid abusers (n = 9) were enrolled in this wi...
Source: Addiction Biology - July 1, 2014 Category: Addiction Authors: Shanna Babalonis, Michelle R. Lofwall, Paul A. Nuzzo, Sharon L. Walsh Tags: Original Article Source Type: research
New Opioids [REVIEW ARTICLES]
Despite the skilled use of opioid analgesics, which is crucial to the relief of cancer pain, there is a lack of evidence to support many aspects of current clinical practice. Therefore, there is a significant need for more effective treatment options. New opioids have been marketed in the past years, including hydrocodone and oxymorphone. Moreover, mixed opioids with combined mechanisms of action have been developed; one such agent, tapentadol, is a centrally acting oral analgesic that possesses a combined mechanism of action: μ-opioid receptor activation with norepinephrine reuptake inhibition. Drug development strateg...
Source: Journal of Clinical Oncology - May 27, 2014 Category: Cancer & Oncology Authors: Mercadante, Porzio, Gebbia Tags: Pain Control, Supportive Care, Palliative Care REVIEW ARTICLES Source Type: research
Sulfation of opioid drugs by human cytosolic sulfotransferases: Metabolic labeling study and enzymatic analysis.
Abstract
The current study was designed to examine the sulfation of eight opioid drugs, morphine, hydromorphone, oxymorphone, butorphanol, nalbuphine, levorphanol, nalorphine, and naltrexone, in HepG2 human hepatoma cells and human organ samples (lung, liver, kidney, and small intestine) and to identify the human SULT(s) responsible for their sulfation. Analysis of the spent media of HepG2 cells, metabolically labeled with [(35)S]sulfate in the presence of each of the eight opioid drugs, showed the generation and release of corresponding [(35)S]sulfated derivatives. Five of the eight opioid drugs, hydromor...
Source: European Journal of Pharmaceutical Sciences - May 12, 2014 Category: Drugs & Pharmacology Authors: Kurogi K, Chepak A, Hanrahan MT, Liu MY, Sakakibara Y, Suiko M, Liu MC Tags: Eur J Pharm Sci Source Type: research
Comparison of the cardiorespiratory effects of a combination of ketamine and propofol, propofol alone, or a combination of ketamine and diazepam before and after induction of anesthesia in dogs sedated with acepromazine and oxymorphone.
Conclusions and Clinical Relevance-In dogs, K-P treatment maintained mean arterial blood pressure better than propofol alone and increased heart rate, cardiac output, or oxygen delivery, as did the K-D treatment. Supplemental 100% oxygen should be provided during IoA with all 3 treatments.
PMID: 24564308 [PubMed - in process] (Source: American Journal of Veterinary Research)
Source: American Journal of Veterinary Research - March 1, 2014 Category: Veterinary Research Authors: Henao-Guerrero N, Riccó CH Tags: Am J Vet Res Source Type: research
Successful treatment of intravenously abused oral Opana ER‐induced thrombotic microangiopathy without plasma exchange
We report a similar case series of 15 patients with 18 episodes of thrombotic microangiopathy associated with recent intravenous abuse of oral Opana ER. In our series, we demonstrate that therapeutic plasma exchange is unnecessary; supportive care and treatment of underlying infections and renal dysfunction (without use of plasma exchange) resulted in clinical improvement in all patients. Thus, it appears that plasma exchange with associated costs and risks can be safely omitted in patients with thrombotic microangiopathy resulting from IV abuse of oral Opana ER. (Source: American Journal of Hematology)
Source: American Journal of Hematology - March 1, 2014 Category: Hematology Authors: Peter John Miller, Andrew Matthew Farland, Mary Ann Knovich, Katharine Marie Batt, John Owen Tags: Research Article Source Type: research
Observations of Urinary Oxycodone and Metabolite Distributions in Pain Patients.
Abstract
Oxycodone is an opioid analgesic metabolized to oxymorphone and noroxycodone by cytochrome P450 (CYP) 2D6 and 3A4/5, respectively. This was a retrospective study to evaluate sex, age, urinary pH and concurrent medication use on oxycodone, oxymorphone and noroxycodone distributions. Urine specimens obtained from patients on chronic opioid therapy were analyzed by LC-MS-MS. There were 108,923 specimens from a subject's first or single visit, who were at least 18 years of age, and had documented physician-reported oxycodone use. The majority of specimens had detectable oxycodone urine concentrations ...
Source: Pain Physician - February 11, 2014 Category: Anesthesiology Authors: Elder NM, Atayee RS, Best BM, Ma JD Tags: J Anal Toxicol Source Type: research
Resurgence of intravenous Opana as a cause of secondary thrombotic thrombocytopenic purpura
(Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - February 10, 2014 Category: Emergency Medicine Authors: Meghan Rane, Aakash Aggarwal, Emerald Banas, Amit Sharma Source Type: research
Pharmacokinetics of oxycodone hydrochloride and three of its metabolites after intravenous administration in Chinese patients with pain.
CONCLUSION: Our pharmacokinetics of oxycodone injection in Chinese patients with pain strongly support continued development of oxycodone as an effective analgesic drug in China.
PMID: 24905321 [PubMed - as supplied by publisher] (Source: Pharmacological Reports)
Source: Pharmacological Reports - February 1, 2014 Category: Drugs & Pharmacology Authors: Hao GT, Zhou HY, Gao HZ, Qu HY, Liang YG, Li YY, Dong RH, Zhang LJ, Wang XF, Liu ZY Tags: Pharmacol Rep Source Type: research
