4,672 results match your criteria Toxicity Opioids

Antinociceptive effect and mechanism of supercritical carbon dioxide extract of Aloysia gratissima leaves in mice.

Biomed J 2021 Dec 2;44(6S1):S63-S72. Epub 2020 Jul 2.

Stricto Sensu Postgraduate Program in Environmental Sciences, Community University of Chapeco Region (Unochapeco), Chapeco, Brazil; Health Sciences Area, Community University of Chapeco Region (Unochapeco), Chapeco, Brazil. Electronic address:

Background: A. gratissima is a shrub used in folk medicine as analgesic and sedative. However, studies on its antinociceptive activity are scarce. Read More

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December 2021

Future Treatment of Neuropathic Pain in Spinal Cord Injury: The Challenges of Nanomedicine, Supplements or Opportunities?

Biomedicines 2022 Jun 10;10(6). Epub 2022 Jun 10.

Dipartimento Di Psicologia, Sapienza Università Di Rome, 00185 Rome, Italy.

Neuropathic pain (NP) is a common chronic condition that severely affects patients with spinal cord injuries (SCI). It impairs the overall quality of life and is considered difficult to treat. Currently, clinical management of NP is often limited to drug therapy, primarily with opioid analgesics that have limited therapeutic efficacy. Read More

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Current research in pathophysiology of opioid-induced respiratory depression, neonatal opioid withdrawal syndrome, and neonatal antidepressant exposure syndrome.

Brian A Baldo

Curr Res Toxicol 2022 6;3:100078. Epub 2022 Jun 6.

Kolling Institute of Medical Research, Royal North Shore Hospital of Sydney and Department of Medicine, University of Sydney, Sydney, NSW, Australia.

Respiratory depression (RD) is the primary cause of death due to opioids. Opioids bind to mu (µ)-opioid receptors (MORs) encoded by the MOR gene widely expressed in the central and peripheral nervous systems including centers that modulate breathing. Respiratory centers are located throughout the brainstem. Read More

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Protective and restorative potency of diosmin natural flavonoid compound against tramadol-induced testicular damage and infertility in male rats.

Nat Prod Res 2022 Jun 22:1-5. Epub 2022 Jun 22.

Department of Biotechnology & Molecular Drug Evaluation, National Organization for Drug Control and Research (NODCAR)/Egyptian Drug Authority (EDA), Cairo, Egypt.

Flavonoids are polyphenolic natural compounds with various biological actions and limited toxicity including diosmin (DM) which is considered a safe flavonoid natural type with anti-inflammatory and antioxidant activities. Tramadol (TM) is a centrally long-acting analgesic class of opioids extensively being used among the population. It was reported that long-term exposure to TM triggers the releases of oxidative stress, inflammatory factors, and nitric oxides resulting in organs damage. Read More

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Parasternal After Cardiac Surgery (PACS): a prospective, randomised, double-blinded, placebo-controlled trial study protocol for evaluating a continuous bilateral parasternal block with lidocaine after open cardiac surgery through sternotomy.

Trials 2022 Jun 20;23(1):516. Epub 2022 Jun 20.

Institution for Clinical Sciences, Karolinska Institutet at Danderyds Hospital, Stockholm, Sweden.

Background: Multimodal analgesia that provides optimal pain treatment with minimal side effects is important for optimal recovery after open cardiac surgery. Regional anaesthesia can be used to block noxious nerve signals. Because sternotomy causes considerable pain that lasts several days, a continuous nerve block is advantageous. Read More

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Identification of a novel opioid, -piperidinyl etonitazene (etonitazepipne), in patients with suspected opioid overdose.

Clin Toxicol (Phila) 2022 Jun 16:1-3. Epub 2022 Jun 16.

American College of Medical Toxicology, Phoenix, AZ, USA.

Background: Novel opioids in the illicit drug supply, such as the "nitazene" group of synthetic opioids, present an ongoing public health problem due to high potency and respiratory depressant effects. We describe three patients in whom -piperidinyl etonitazene, a compound not previously reported in human exposure, was detected after suspected opioid overdose. Other substances that these patients tested for included fentanyl, cocaine, levamisole, phenacetin, benzoylecgonine, -fluorofentanyl, presumptive heroin (tested as 6-monoacetylmorphine (6-MAM), morphine, and codeine), and tramadol. Read More

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Establishment to measure oxycodone in plasma with liquid chromatography-tandem mass spectrometry.

Neuropsychopharmacol Rep 2022 Jun 11. Epub 2022 Jun 11.

Laboratory of Pharmaceutics, Department of Biomedical Pharmaceutics, Gifu Pharmaceutical University, Gifu, Japan.

Oxycodone (OXY) is classified as a "strong opioid" in the World Health Organization system of cancer pain treatment. However, OXY also causes severe adverse reactions, such as respiratory depression. Thus, in order to adjust the dosage of OXY for well-managed pain relief with less toxicity, we tried establishing and validating a system for measuring plasma concentrations of OXY using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Read More

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Zhx2 is a candidate gene underlying oxymorphone metabolite brain concentration associated with state-dependent oxycodone reward.

J Pharmacol Exp Ther 2022 Jun 10. Epub 2022 Jun 10.

Pharmacology, Boston University School of Medicine, United States

Understanding the pharmacogenomics of opioid metabolism and behavior is vital to therapeutic success, as mutations can dramatically alter therapeutic efficacy and addiction liability. We found robust, sex-dependent BALB/c substrain differences in oxycodone behaviors and whole brain concentration of oxycodone metabolites. BALB/cJ females showed robust state-dependent oxycodone reward learning as measured via conditioned place preference when compared to the closely related BALB/cByJ substrain. Read More

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A Survey of Knowledge and Barriers of Healthcare Professionals toward Opioid Analgesics in Cancer Pain Management.

Int J Clin Pract 2022 12;2022:1136430. Epub 2022 Apr 12.

Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid, Jordan.

Purpose: Pain is among the most frequent and troubling symptoms in cancer patients. Despite the availability of updated treatment guidelines and effective pharmacological therapies, undertreatment of cancer pain remains a global problem. Opioids are the mainstay analgesics to treat moderate-to-severe cancer pain. Read More

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Predicting factors for electrocardiographic findings in patients with tramadol-induced seizure.

J Opioid Manag 2022 May-Jun;18(3):265-271

Faculty of Medicine, Department of Neurosurgery, Tabriz University of Medical Sciences, Tabriz, Iran. ORCID: https://orcid.org/0000-0002-3602-4966.

Background: Seizure and electrocardiographic (ECG) abnormalities are of the most common complications of tramadol toxicity.

Objective: This study aimed to show the prevalence and predictive value of various factors for ECG findings in patients with tramadol-induced seizures.

Method: In a descriptive cross-sectional study, 146 patients with tramadol-induced seizures referred to Poursina Hospital, Guilan, Iran, between June and November 2018 were enrolled. Read More

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Micro- and nanocarriers for pain alleviation.

Adv Drug Deliv Rev 2022 May 30;187:114359. Epub 2022 May 30.

Université Paris-Saclay, CNRS, Institut Galien Paris-Saclay, 92296 Châtenay-Malabry, France. Electronic address:

Acute or chronic pain is a major source of impairment in quality of life and affects a substantial part of the population. To date, pain is alleviated by a limited range of treatments with significant toxicity, increased risk of misuse and inconsistent efficacy, owing, in part, to lack of specificity and/or unfavorable pharmacokinetic properties. Thanks to the unique properties of nanoscaled drug carriers, nanomedicine may enhance drug biodistribution and targeting, thus contributing to improved bioavailability and lower off-target toxicity. Read More

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Continuous thoracic paravertebral analgesia after minimally invasive atrial septal defect closure surgery in pediatric population: Effectiveness and safety analysis.

Rev Esp Anestesiol Reanim (Engl Ed) 2022 05 25;69(5):259-265. Epub 2022 May 25.

Servicio de Anestesiología y Reanimación, Sección de Anestesiología Pediátrica, Hospital General Universitario Gregorio Marañón. Madrid, Spain.

Introduction: Lateral thoracotomy is replacing traditional median sternotomy for atrial septal defect (ASD) closure in children in order to improve cosmetic outcomes. Continuous paravertebral block has been described as an effective and safe analgesic technique in children. The aim of this study is to assess pain management by continuous perfusion of local anesthetic through a thoracic paravertebral catheter (PVC) in a pediatric population after thoracotomy closure of ASD, and its effectiveness in a fast-track program. Read More

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Opioid epidemic and the urge to discover new treatment options.

Drug Discov Today 2022 May 28. Epub 2022 May 28.

College of Pharmacy, Nova Southeastern University, Fort Lauderdale, FL 33328, USA.

The primary tools to alleviate the opioid epidemic in the USA include strict Federal and State laws on opioid prescriptions, tracking opioid medications, accountability of the opioid manufacturers and physicians, as well as boosting public awareness. Although abuse-deterrent opioids have in part lowered the incidence of opioid abuse, many post-marketing studies are still pending and some products have been recalled or terminated. Moreover, some studies show that the current deterrent opioid products might potentially force the abusers to seek more-powerful and deadly illicit drugs that can lead to toxicity and hepatitis C infections. Read More

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Acute, Sublethal, and Developmental Toxicity of Kratom ( Korth.) Leaf Preparations on as an Invertebrate Model for Human Exposure.

Int J Environ Res Public Health 2022 05 22;19(10). Epub 2022 May 22.

Department of Pharmaceutical Sciences, College of Pharmacy, Midwestern University, Glendale, AZ 85308, USA.

Kratom ( Korth.) is a tree native to Southeast Asia with stimulant and opioid-like effects which has seen increased use in Europe and North America in recent years. Its safety and pharmacological effects remain under investigation, especially in regard to developmental and generational toxicity. Read More

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A comprehensive evaluation of the potential binding poses of fentanyl and its analogs at the µ-opioid receptor.

Comput Struct Biotechnol J 2022 14;20:2309-2321. Epub 2022 May 14.

Computational Chemistry and Molecular Biophysics Section, Molecular Targets and Medications Discovery Branch, National Institute on Drug Abuse - Intramural Research Program, National Institutes of Health, Baltimore, MD 21224, USA.

Fentanyl and its analogs are selective agonists of the µ-opioid receptor (MOR). Among novel synthetic opioids (NSOs), they dominate the recreational drug market and are the main culprits for the opioid crisis, which has been exacerbated by the COVID-19 pandemic. By taking advantage of the crystal structures of the MOR, several groups have investigated the binding mechanism of fentanyl, but have not reached a consensus, in terms of both the binding orientation and the fentanyl conformation. Read More

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In vitro-in silico-based prediction of inter-individual and inter-ethnic variations in the dose-dependent cardiotoxicity of R- and S-methadone in humans.

Arch Toxicol 2022 Aug 23;96(8):2361-2380. Epub 2022 May 23.

Van Hall Larenstein University of Applied Sciences, 8901 BV, Leeuwarden, The Netherlands.

New approach methodologies predicting human cardiotoxicity are of interest to support or even replace in vivo-based drug safety testing. The present study presents an in vitro-in silico approach to predict the effect of inter-individual and inter-ethnic kinetic variations in the cardiotoxicity of R- and S-methadone in the Caucasian and the Chinese population. In vitro cardiotoxicity data, and metabolic data obtained from two approaches, using either individual human liver microsomes or recombinant cytochrome P450 enzymes (rCYPs), were integrated with physiologically based kinetic (PBK) models and Monte Carlo simulations to predict inter-individual and inter-ethnic variations in methadone-induced cardiotoxicity. Read More

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Efficacy and Selectivity of Monovalent and Bivalent Vaccination Strategies to Protect against Exposure to Carfentanil, Fentanyl, and Their Mixtures in Rats.

ACS Pharmacol Transl Sci 2022 May 20;5(5):331-343. Epub 2022 Apr 20.

Department of Pharmacology, University of Minnesota Medical School, Minneapolis, Minnesota 55455, United States.

Drug-related fatal overdoses have significantly increased in the past decade due to the widespread availability of illicit fentanyl and other potent synthetic opioids such as carfentanil. Deliberate or accidental consumption or exposure to carfentanil, fentanyl, and their mixture induces respiratory depression and bradycardia that can be difficult to reverse with the opioid receptor antagonist naloxone. Vaccines offer a promising strategy to reduce the incidence of fatalities associated with fentanyl-related substances, as well as treatment for opioid use disorder (OUD). Read More

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Identifying behaviours for survival and wellness among people who use methamphetamine with opioids in British Columbia: a qualitative study.

Harm Reduct J 2022 May 19;19(1):46. Epub 2022 May 19.

BC Centre for Disease Control, 655 W 12th Ave, Vancouver, BC, V5Z 4R4, Canada.

Background: British Columbia (BC) has been in a state of public health emergency since 2016, due to the unprecedented numbers of fatal and non-fatal drug toxicity (i.e. overdose) events. Read More

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Acetaminophen: Is Too Much of a Good Thing Too Much?

Compend Contin Educ Dent 2022 May;43(5):268-273; quiz 274

Associate Principal, Vizient Pharmacy Advisory Solutions, Irving, Texas; Clinical Professor, School of Pharmacy, University of Montana, Missoula, Montana; Clinical Assistant Professor, School of Dentistry, Oregon Health and Sciences University, Portland, Oregon; Adjunct Professor, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia; Fellow, American Society of Health-System Pharmacists; Fellow, American College of Healthcare Executives.

Acetaminophen is a popular, universally used, over-the-counter pain medication contained in more than 600 different products and available in a plethora of dosage forms. Acetaminophen is an important adjunct to manage postoperative dental pain in combination with a nonsteroidal anti-inflammatory drug such as ibuprofen. For the treatment of more severe pain, acetaminophen is often formulated with non-opioid and opioid agents. Read More

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Designer benzodiazepines' activity on opioid receptors: a docking study.

Curr Pharm Des 2022 May 10. Epub 2022 May 10.

Drug Misuse & Novel Psychoactive Substances Research Unit, School of Life & Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, United Kingdom.

Background: Previous studies have reported that benzodiazepines (BZDs) seem to enhance euphoric and reinforcing properties of opioids in opioid users so that a direct effect on opioid receptors has been postulated together with possible synergistic induction of severe side-effects due to their co-use. This is particularly worrisome given the appearance on the market of designer benzodiazepines (DBZDs), whose activity/toxicity profiles are scarcely known.

Objectives: This study aimed to evaluate, through computational studies, the binding affinity (or lack thereof) of 101 DBZDs identified online on the kappa, mu, and delta opioid receptors (K, M, DOR); and to assess whether their mechanism of action could include activity on t of the latter Methods. Read More

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Ifosfamide-induced Encephalopathy With Rapid Response to Thiamine: A Pediatric Case.

J Pediatr Hematol Oncol 2022 May 2. Epub 2022 May 2.

Department of Pediatric Oncology, Hacettepe University Faculty of Medicine.

Ifosfamide is an important chemotherapeutic agent used in the therapeutic protocols of many malignant tumors. Central nervous system toxicity of ifosfamide manifests with encephalopathy in 10% to 30% of patients treated with ifosfamide. Thiamine and methylene blue have been reported beneficial in the treatment and prevention of ifosfamide-induced encephalopathy (IIE). Read More

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Possible Delay in Symptomatology of a Methadone Overdose in a Patient Ingesting an Energy Drink and Dextroamphetamine/Amphetamine.

J Pharm Pract 2022 May 6:8971900221100812. Epub 2022 May 6.

Department of Emergency Medicine, 2345Medical University of South Carolina, Charleston, SC, USA.

Methadone is a mu-opioid agonist with a delayed time to peak concentration that requires an extended period of monitoring following an overdose. Available data suggests that the combination of psychostimulants with methadone may augment antinociception and tolerance to opioids. A 26-year-old male (83. Read More

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Optimization of 4-arylthiophene-3-carboxylic acid derivatives as inhibitors of ANO1: Lead optimization studies toward their analgesic efficacy for inflammatory pain.

Eur J Med Chem 2022 Jul 26;237:114413. Epub 2022 Apr 26.

State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, 100191, China. Electronic address:

Current pain management is largely limited to opioids and non-steroidal anti-inflammatory drugs. Developing new analgesic drugs remains important to address the unmet medical needs of chronic pain patients. Calcium-activated chloride channel anoctamin-1 (ANO1) is a potential analgesic target. Read More

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A case report on cannabinoid hyperemesis syndrome in palliative care: how good intentions can go wrong.

Oncol Res Treat 2022 May 3. Epub 2022 May 3.

Introduction: Synthetic cannabinoids are commonly used to manage pain, nausea, and vomiting in oncology and palliative care. Despite the current acceptance of cannabinoids as a treatment option for nausea and vomiting, there is a lack of data regarding the side effects of its prolonged use leading to possible toxicity due to accumulation, and as a result, exacerbation of nausea and vomiting rather than alleviation. Case report presentation: The patient, a 70-year-old female who was residing in the palliative care unit with the diagnosis of small-cell lung cancer. Read More

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Methadone-related death in detention.

J Forensic Leg Med 2022 May 26;88:102356. Epub 2022 Apr 26.

PO Box 498, Northwich, Cheshire, CW9 9BE, UK.

Oral methadone may be prescribed to detainees with the aim of minimising the risk of fatal opioid poisoning on release. To study the circumstances under which methadone-related deaths can occur in detention, we audited reports of 17 [14 male, 3 female; median (range) age 34 (22-52) years] such deaths, July 2010-December 2011. The median (range) methadone dose was 40 (10-110) mg/d (N = 16). Read More

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Acute Opioid Withdrawal Following Intramuscular Administration of Naloxone 1.6 mg: A Prospective Out-Of-Hospital Series.

Ann Emerg Med 2022 Apr 28. Epub 2022 Apr 28.

Clinical Toxicology Research Group, University of Newcastle, Newcastle, Australia.

Study Objective: Large doses of intramuscular (IM) naloxone are commonly used in out-of-hospital settings to reverse opioid toxicity; however, they are used less commonly in hospitals because of concerns about opioid withdrawal, particularly agitation. We aimed to determine the frequency of severe agitation following a single 1.6 mg IM naloxone dose. Read More

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Pharmacological evaluation and forensic case series of N-pyrrolidino etonitazene (etonitazepyne), a newly emerging 2-benzylbenzimidazole 'nitazene' synthetic opioid.

Arch Toxicol 2022 Jun 28;96(6):1845-1863. Epub 2022 Apr 28.

Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium.

Novel synthetic opioids continue to emerge on recreational drug markets worldwide. In response to legislative bans on fentanyl analogues, non-fentanyl structural templates, such as 2-benzylbenzimidazoles ('nitazenes'), are being exploited to create new μ-opioid receptor (MOR) agonists. Here, we pharmacologically characterize an emerging cyclic analogue of etonitazene, called N-pyrrolidino etonitazene (etonitazepyne), using in vitro and in vivo methods. Read More

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Association of co-prescribing of opioid and benzodiazepine substitutes with incident falls and fractures among older adults: a cohort study.

BMJ Open 2021 12 30;11(12):e052057. Epub 2021 Dec 30.

Sealy Center on Aging, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA.

Objective: Examine the association between the co-prescribing of opioids, benzodiazepines, gabapentinoids (pregabalin and gabapentin) and selective serotonin reuptake inhibitors/serotonin and norepinephrine reuptake inhibitors (SSRI/SNRIs) in different combinations and the risk of falls and fractures.

Design: Retrospective cohort study from 2015 to 2018.

Setting: Medicare enrolment and claims data. Read More

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December 2021

Mechanisms of opioid-induced respiratory depression.

Arch Toxicol 2022 Aug 26;96(8):2247-2260. Epub 2022 Apr 26.

University of Sydney, Sydney, NSW, Australia.

Opioid-induced respiratory depression (OIRD), the primary cause of opioid-induced death, is the neural depression of respiratory drive which, together with a decreased level of consciousness and obstructive sleep apnea, cause ventilatory insufficiency. Variability of responses to opioids and individual differences in physiological and neurological states (e.g. Read More

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Pre-clinical safety and toxicology profile of a candidate vaccine to treat oxycodone use disorder.

Vaccine 2022 May 22;40(23):3244-3252. Epub 2022 Apr 22.

Department of Pharmacology, University of Minnesota Medical School, 321 Church Street, SE (Room 6-120 Jackson Hall), Minneapolis, MN 55455, United States; Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine, Center for Medication Development for Substance Use Disorders, 325 Ninth Avenue, Box 359911, Seattle, WA 98104, United States.

Opioid use disorders (OUD) and overdose represent a public health threat, resulting in thousands of deaths annually worldwide. Vaccines offer a promising treatment for OUD and potentially the prevention of fatal overdoses. The Oxy(Gly)-sKLH Conjugate Vaccine, Adsorbed (Oxy(Gly)-sKLH) has shown promising pre-clinical efficacy at reducing the behavioral and pharmacological effects of oxycodone. Read More

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