Search results for "opioid"
showing 10 items of 320 documents
Oxycodone extended release capsules for the treatment of chronic pain
2017
As a consequence of greater prescription opioid utilization, there has been the parallel increase in misuse, abuse, and overdose, which are serious risks. Associated new formulations may be safer. Areas covered: The introduction of abuse-deterrent opioid formulations and continuous programs to improve opioid prescribing practices may limit the opioid abuse and its consequences. Oxycodone extended release capsules are an extended-release (ER), microsphere-in-capsule abuse-deterrent-formulation designed to retain its extended-release properties following tampering or misuse (e.g., chewing, crushing). Studies have reported that this preparation is efficacious in patients with low back pain, le…
Combined epidural morphine and bupivacaine in the treatment of lumbosacral radicular neuropathic pain: a noncontrolled prospective study
2016
Simone Vigneri,1,2 Gianfranco Sindaco,2 Marco La Grua,2 Matteo Zanella,2 Laura Ravaioli,2 Valentina Paci,2 Gilberto Pari2 1Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, 2Advanced Algology Research and Pain Medicine Unit, Santa Maria Maddalena Hospital, Occhiobello, RO, Italy Objective: The aim of this study was to investigate the therapeutic effectiveness of epidural morphine and bupivacaine in patients with chronic lumbosacral radicular neuropathic pain after the cessation of treatment.Methods: Twenty-two patients with chronic lumbosacral pain with neuropathic features were enrolled. An indwelling catheter was placed into the epidural sp…
A concise review of opioid-induced esophageal dysfunction: is this a new clinical entity?
2017
Opioids have become the most widely prescribed analgesics in Western countries. Opioid-induced bowel dysfunction is a widely known adverse effect, with constipation the most common manifestation. Most of the opioid-related effects occur in the stomach, small intestine, and colon and have been widely studied. However, the effects related to esophageal motility are less known. Recently published retrospective studies have suggested that long-term use of opioids can cause esophageal motility dysfunction, reflecting symptoms similar to motility disorders, such as achalasia and functional esophagogastric junction outflow obstruction. The most common manometric findings, as reported in the litera…
Opioid-induced Lower Esophageal Sphincter Dysfunction
2015
The adverse gastrointestinal effects of opioids have been extensively described in medical literature.1 Their effect takes place mainly on the enteric nervous system, through receptors in the myenteric and submucosal plexuses. There are 3 recognized main opium receptors (μ, δ, and κ) that are expressed in the central and enteric nervous systems, which mediate the gastrointestinal effects.2 The mainly studied adverse gastrointestinal effect of opioids is constipation, due to the greater understanding of opium receptor physiology in the colon.3 However their effect on esophageal motility has seldom been studied. Our study’s objective was to assess esophageal motility, using high-resolution ma…
Akutschmerztherapie in Pädiatrie und Geriatrie – Akutschmerztherapie im Alter –ein ganzheitlicher Ansatz
2011
Post-operative pain management of elderly patients requires special attention. In addition to the organic functional impairments, age-related changes in psychological and social factors play an important role. Also life experiences, painful medical history and a range of different complaints of old age influence the expectations to the treatment of pain. Several factors have to be considered, so 1) age-appropriate preoperative assessment of organic, psychological and social factors, 2) a selection of regularly administered non-opioid, or combination of two different effective non-opioids, notably on the contra-indications and dose limits, 3) if necessary careful titration of the strong opio…
Failure of opioids to affect excitation and contraction in isolated ventricular heart muscle
1989
The opioid agonists morphine (selective for mu-receptors) and ethylketocyclazocine (selective for kappa-receptors), at concentrations evoking strong effects in neuronal structures, did not significantly affect the configuration of the intracellularly recorded action potential and the force of contraction in ventricular heart muscle isolated from guinea pigs, rabbits and man. These results suggest that any changes of heart functions in vivo in response to opioid-like drugs are probably not mediated postsynaptically at the myocardial cell membrane but rather presynaptically, influencing the release of noradrenaline and/or acetylcholine from the nerve terminals.
Recomendaciones prácticas para el manejo del paciente con dolor crónico durante la pandemia de COVID-19
2021
Resumen La infeccion por SARS-CoV-2 ha evolucionado hasta convertirse progresivamente en una pandemia y en una emergencia de salud publica de importancia internacional que ha obligado a las organizaciones de salud a nivel mundial, regional y local a adoptar una serie de medidas para hacer frente a la COVID-19 e intentar disminuir su impacto, no solo en el ambito social sino tambien en el ambito sanitario, modificandose las pautas de actuacion en los servicios de salud. Dentro de estas recomendaciones, que incluyen las unidades de tratamiento del dolor, los pacientes con sospecha o infeccion confirmada por SARS-CoV-2 pueden encontrase en situacion de espera para consulta medica o tecnicas in…
Current Pharmacological Treatment of Painful Diabetic Neuropathy: A Narrative Review.
2020
Background and Objectives: Distal symmetrical polyneuropathy (DSPN) is one of the most common chronic complications of diabetes mellitus. Although it is usually characterized by progressive sensory loss, some patients may develop chronic pain. Assessment of DSPN is not difficult, but the biggest challenge is making the correct diagnosis and choosing the right treatment. The treatment of DSPN has three primary objectives: glycemic control, pathogenic mechanisms, and pain management. The aim of this brief narrative review is to summarize the current pharmacological treatment of painful DSPN. It also summarizes knowledge on pathogenesis-oriented therapy, which is generally overlooked in many p…
Health outcomes and costs in patients with osteoarthritis and chronic pain treated with opioids in Spain: the OPIOIDS real-world study.
2020
Objective: The objective of this study was to analyze health outcomes, resource utilization, and costs in osteoarthritis patients with chronic nociceptive pain who began treatment with an opioid in real-world practice in Spain. Methods: We designed a non-interventional, retrospective, longitudinal study with 36 months of follow-up using electronic medical records (EMRs) from primary care centers, of patients aged 18+ years who began a new treatment with an opioid drug in usual practice for chronic pain due to osteoarthritis. Health/non-health resource utilization and costs, treatment adherence, pain change, cognitive functioning, and dependence for basic activities of daily living (BADL) we…
Prolonged-release buprenorphine formulations: Perspectives for clinical practice
2020
International audience; Buprenorphine and methadone are the two main opioid agonist treatments approved for opioid use disorder. Buprenorphine is a partial agonist of the mu opioid receptors, which has been merely available through sublingual form until now. In practice, the use of buprenorphine is smoother than that of methadone, and it induces reduced risks of overdose. However, sublingual buprenorphine also exposes to risks (e.g., withdrawal, misuse) and constraints (e.g., daily intake). Three new galenic formulations of prolonged-release buprenorphine (PRB) are being commercialized and should allow some improvements in patients' comfort and safety. This narrative review aims to describe…