4,170 results match your criteria Toxicity Opioids


Potential Cytochrome P450 Drug-Drug Interaction Among Adult and Adolescent Patients Undergoing Tonsillectomy.

OTO Open 2020 Apr-Jun;4(2):2473974X20932503. Epub 2020 Jun 18.

University of Rochester, Rochester, New York, USA.

Objective: To assess the frequency of potential drug-drug interactions affecting cytochrome P450 (CYP)-mediated metabolism of opioids among adult and adolescent patients who underwent adenotonsillectomy.

Study Design: Retrospective chart review.

Setting: Tertiary care university hospital. Read More

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http://dx.doi.org/10.1177/2473974X20932503DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7303781PMC

Combining a candidate vaccine for opioid use disorders with extended-release naltrexone increases protection against oxycodone-induced behavioral effects and toxicity.

J Pharmacol Exp Ther 2020 Jun 25. Epub 2020 Jun 25.

Pharmacology, University of Minnesota Medical School, United States

Opioid use disorders (OUD) and opioid-related fatal overdoses are a significant public health concern in the United States and worldwide. To offer more effective medical interventions to treat or prevent OUD, anti-opioid vaccines are in development that reduce the distribution of the targeted opioids to brain and subsequently reduce the associated behavioral and toxic effects. Of critical importance is that anti-opioid vaccines should not interfere with medications to treat OUD. Read More

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http://dx.doi.org/10.1124/jpet.120.000014DOI Listing

Vitamin D and Its Potential Interplay With Pain Signaling Pathways.

Front Immunol 2020 28;11:820. Epub 2020 May 28.

College of Medicine, QU Health, Qatar University, Doha, Qatar.

About 50 million of the U.S. adult population suffer from chronic pain. Read More

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http://dx.doi.org/10.3389/fimmu.2020.00820DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7270292PMC

Characteristics and circumstances of death related to the self-administration of ketamine.

Addiction 2020 Jun 13. Epub 2020 Jun 13.

National Drug & Alcohol Research Centre, University of New South Wales, NSW, Australia.

Background And Aims: Ketamine is used for anaesthesia, sedation and the treatment of mood disorders, but also widely used for non-medical purposes. This study aimed to: 1. determine the characteristics and circumstances of all recorded cases of self-administered ketamine-related death in Australia, 2000-2019 and 2. Read More

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http://dx.doi.org/10.1111/add.15154DOI Listing

[Opioids in patients with renal impairment].

Ther Umsch 2020 ;77(1):10-13

Abteilung Klinische Pharmakologie und Toxikologie, Universitätsspital Basel.

Opioids in patients with renal impairment Renal impairment can reduce the elimination of certain opioids and their metabolites. Accumulation and toxicity may occur. Due to their pharmacokinetic properties, fentanyl, alfentanil and buprenorphine can be used safely in patients with renal impairment. Read More

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http://dx.doi.org/10.1024/0040-5930/a001144DOI Listing
January 2020

Managing long-term high-dose prescription opioids in patients with non-cancer pain: The potential role of sublingual buprenorphine.

Aust J Gen Pract 2020 06;49(6):339-343

BSc (Hons), MBChB, PhD, FRANZCP, FAChAM, Director, Turning Point, Eastern Health, Vic; Professor of Addiction Studies, Monash University, Vic.

Background: Opioids are frequently used to manage chronic non-cancer pain despite the lack of evidence of benefit and clear evidence of opioid-related harms. Patients undergoing high-dose opioid therapy are at risk of multiple complications, such as opioid toxicity, including fatal overdose and opioid dependence.

Objective: This article provides an overview of the pharmacology of buprenorphine and reviews current evidence for the use of high-dose sublingual buprenorphine-naloxone in the pharmacological management of patients at high risk of complications from chronic opioid use. Read More

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http://dx.doi.org/10.31128/AJGP-07-19-4994DOI Listing

Polymer-mediated delivery of vaccines to treat opioid use disorders and to reduce opioid-induced toxicity.

Vaccine 2020 Jun 19;38(30):4704-4712. Epub 2020 May 19.

Hennepin Healthcare Research Institute, Minneapolis, MN, United States; University of Minnesota Medical School, Department of Pharmacology, Minneapolis, MN, United States; University of Minnesota, Center for Immunology, Minneapolis, MN, United States. Electronic address:

Vaccines offer a potential strategy to treat opioid use disorders (OUD) and to reduce the incidence of opioid-related overdoses. Vaccines induce opioid-specific polyclonal antibodies that selectively and effectively bind the target opioid and prevent its distribution across the blood-brain barrier. Because antibody-mediated reduction of drug distribution to the brain reduces drug-induced behavior and toxicity, vaccine efficacy depends on the quantity and quality of the antibody response. Read More

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http://dx.doi.org/10.1016/j.vaccine.2020.05.027DOI Listing

Managing breakthrough pain for advanced malignancy in elderly patients: A real challenge.

J Opioid Manag 2020 May/Jun;16(3):219-222

Additional Professor, Department of Onco-Anaesthesia and Palliative medicine, Dr B.R.A.I.R.C.H, All India Institute of Medical Sciences, New Delhi, India.

Pain management in advanced cancer patients using opioids like morphine is challenging due to presence of predisposing factors like renal insufficiency, hepatic insufficiency, hypoproteinemia, hypoalbuminemia, and anemia that can easily precipitate inadvertent toxic effects. We report a case morphine toxicity in an elderly patient of lung cancer with concomitant presence of chronic obstructive pulmonary disease (COPD) and recent onset renal impairment. Opioid analgesic overdose is a lethal but at the same time, a preventable and treatable condition. Read More

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http://dx.doi.org/10.5055/jom.2020.0571DOI Listing

An open-label, randomized, single-dose, two-period, two-treatment crossover bioavailability study comparing 5 mg/0.5 mL of intramuscular naloxone hydrochloride to 2 mg/0.4 mL intramuscular naloxone hydrochloride autoinjector in healthy subjects.

J Opioid Manag 2020 May/Jun;16(3):209-214

Adamis Pharmaceuticals Corp., San Diego, California.

Naloxone is an opioid antagonist used for the acute treatment of opioid overdoses. There has been a dramatic increase of deaths due to synthetic opioids such as fentanyl, some requiring multiple doses of naloxone for reversal of opioid tox-icity. Fentanyl appears to differ from other opiates as having a very rapid onset and transport in and out of the central nervous system (CNS). Read More

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http://dx.doi.org/10.5055/jom.2020.0569DOI Listing

Opium-Related Lead Toxicity: An Integrative Review and Case Series.

J Emerg Med 2020 May 13. Epub 2020 May 13.

Urmia University of Medical Sciences, Urmia, Iran.

Background: Restrictive regulations and the increased price of opioids have resulted in the addition of impurities to illicit opioids by drug dealers. Among the adulterants, lead salts are optimal agents to make packages heavier. Consequently, lead toxicity has emerged in the opioid-user population. Read More

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http://dx.doi.org/10.1016/j.jemermed.2020.04.020DOI Listing
May 2020
1.175 Impact Factor

Differential effects of alprazolam against methylphenidate-induced neurobehavioral alterations.

Physiol Behav 2020 Aug 12;222:112935. Epub 2020 May 12.

Institute of Forensic Sciences and Criminology, Panjab University, Chandigarh-160014, India. Electronic address:

Background: In the previous decade, abuse of several types of prescription drugs, particularly anxiolytics, opioid analgesics, and stimulants has increased significantly worldwide. Methylphenidate (MPH) and Alprazolam (ALZ) are extensively used drugs for the treatment of attention deficit hyperactivity disorder (ADHD) and anxiety disorders, respectively. However, these drugs have a high risk of being misused or abused alone, and their combination in some peculiar cases has shown their deleterious effects. Read More

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http://dx.doi.org/10.1016/j.physbeh.2020.112935DOI Listing
August 2020
2.976 Impact Factor

In vivo assessment of the drug interaction between sorafenib and paracetamol in rats.

Cancer Chemother Pharmacol 2020 Jun 11;85(6):1039-1048. Epub 2020 May 11.

Department of Clinical Pharmacy and Biopharmacy, Poznań University of Medical Sciences, 14 Św. Marii Magdaleny Str., 61-861, Poznań, Poland.

Purpose: Sorafenib is a multi-targeted tyrosine kinase inhibitor (TKI) used for the treatment of advanced renal cell carcinoma, hepatocellular carcinoma and radioactive iodine resistant thyroid carcinoma. Neoplastic diseases are the cause of pain, which may occur regardless of the stage of the disease. Paracetamol is a non-opioid analgesic used alone or in combination with opioids for the treatment of cancer pain. Read More

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http://dx.doi.org/10.1007/s00280-020-04075-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7305075PMC

The Implausibility of Neonatal Opioid Toxicity from Breastfeeding.

Clin Pharmacol Ther 2020 May 7. Epub 2020 May 7.

Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

The belief that newborns can develop opioid toxicity from breastfeeding is widely held but supported by very little data. Based largely on a single, highly publicized case report (the "Toronto case"), major health agencies worldwide now caution against codeine use by nursing mothers. As a result, "stronger" opioids with greater abuse liability are increasingly prescribed in its place, potentially to the detriment of maternal health. Read More

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http://dx.doi.org/10.1002/cpt.1882DOI Listing

Pregabalin poisoning and rising recreational use: a retrospective observational series.

Br J Clin Pharmacol 2020 May 6. Epub 2020 May 6.

Clinical Toxicology Research Group, University of Newcastle, Newcastle, New South Wales, Australia.

Aims: With rising use worldwide, pregabalin is increasingly implicated in poisoning deaths. We aimed to investigate the clinical effects and complications of pregabalin poisoning.

Methods: This is a retrospective review of patients presenting with pregabalin poisoning to two tertiary toxicology units from 1 July 2014 to 30 June 2019. Read More

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http://dx.doi.org/10.1111/bcp.14348DOI Listing

Review on the occurrence and biological effects of illicit drugs in aquatic ecosystems.

Environ Sci Pollut Res Int 2020 May 2. Epub 2020 May 2.

Department of Ecotoxicology, Santa Cecília University, Santos, São Paulo, Brazil.

Illicit drugs (IDs) and their metabolites are recognized as contaminants of emerging concern. After consumption, illicit drugs are partially metabolized and excreted unchanged in urine and feces or as active metabolites reaching wastewater treatment plants (WWTPs). Furthermore, most WWTPs are insufficient in the treatment of effluents containing IDs, which may be released into aquatic ecosystems. Read More

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http://dx.doi.org/10.1007/s11356-020-08375-2DOI Listing

Ecotoxicity screening evaluation of selected pharmaceuticals and their transformation products towards various organisms.

Environ Sci Pollut Res Int 2020 May 1. Epub 2020 May 1.

Department of Environmental Analysis, Faculty of Chemistry, University of Gdańsk, ul. Wita Stwosza 63, 80-308, Gdańsk, Poland.

The intensive development of medical science has led to an increase in the availability and use of pharmaceutical products. However, nowadays, most of scientific attention has been paid to the native forms of pharmaceuticals, while the transformation products (TPs) of these substances, understood herein as metabolites, degradation products, and selected enantiomers, remain largely unexplored in terms of their characterization, presence, fate and effects within the natural environment. Therefore, the main aim of this study was to evaluate the toxicity of seven native compounds belonging to different therapeutic groups (non-steroidal anti-inflammatory drugs, opioid analgesics, beta-blockers, antibacterial and anti-epileptic drugs), along with the toxicity of their 13 most important TPs. Read More

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http://dx.doi.org/10.1007/s11356-020-08881-3DOI Listing

In vitro and in vivo pharmacological characterization of the synthetic opioid MT-45.

Neuropharmacology 2020 Jul 25;171:108110. Epub 2020 Apr 25.

Department of Morphology, Surgery and Experimental Medicine, Section of Legal Medicine and LTTA Centre, University of Ferrara, Italy; Collaborative Center of the National Early Warning System, Department for Anti-Drug Policies, Presidency of the Council of Ministers, Italy. Electronic address:

MT-45 is a synthetic opioid that was developed in the 1970s as an analgesic compound. However, in recent years MT-45 has been associated with multiple deaths in Europe and has been included in the class of novel psychoactive substances known as novel synthetic opioids (NSOs). Little is known about the pharmaco-toxicological effects of MT-45. Read More

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http://dx.doi.org/10.1016/j.neuropharm.2020.108110DOI Listing

Opioid overdose reversals using naloxone in New York City by people who use opioids: Implications for public health and overdose harm reduction approaches from a qualitative study.

Int J Drug Policy 2020 Apr 15;79:102751. Epub 2020 Apr 15.

Division on Substance Use Disorders, Columbia University Medical Center and New York State Psychiatric Institute, 1051 Riverside Drive, Unit 20, New York, NY 10032, United States.

Background: Adverse reactions to naloxone, such as withdrawal symptoms and aggression, are widely recognised in the literature by pharmaceutical manufacturers and clinical practitioners as standard reactions of individuals who are physically dependent upon opioid drugs following the reversal of potentially fatal opioid overdose. This paper seeks to provide a differentiated view on reactions to naloxone that may have important implications for public health and harm reduction approaches.

Methods: Analyses from a qualitative investigation embedded within a 5-year Randomised Controlled Trial (RCT) examined the risks and benefits of Overdose Education and Naloxone Distribution (OEND) training models (brief or extended training) in various populations of people who use opioids in New York City. Read More

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http://dx.doi.org/10.1016/j.drugpo.2020.102751DOI Listing

Postoperative administration of ketorolac averts morphine-induced angiogenesis and metastasis in triple-negative breast cancer.

Life Sci 2020 Jun 31;251:117604. Epub 2020 Mar 31.

Department of Anesthesiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 510120 Guangzhou, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China. Electronic address:

Aims: Opioids (i.e. morphine) were found to induce triple negative breast cancer (TNBC) metastasis while nonsteroidal anti-inflammatory drugs (i. Read More

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http://dx.doi.org/10.1016/j.lfs.2020.117604DOI Listing

Etizolam: A rapid review on pharmacology, non-medical use and harms.

Drug Alcohol Rev 2020 May 3;39(4):330-336. Epub 2020 Apr 3.

School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.

Issues: Etizolam is a thienodiazepine derivative, with high affinity for the benzodiazepine site of GABA receptors. It is often referred to as a new (or novel) psychoactive substance, a 'designer' benzodiazepine or a 'street benzodiazepine'. Increasing reports of non-medical use, identification of etizolam as an ingredient in counterfeit medications and the common identification of etizolam in drug-related deaths, highlight the need for a greater understanding of etizolam. Read More

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http://dx.doi.org/10.1111/dar.13052DOI Listing

Impact of Pharmacological Treatments for Opioid Use Disorder on Mortality.

CNS Drugs 2020 Jun;34(6):629-642

School of Population and Global Health, The University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA, 6009, Australia.

The use of pharmacological treatments for opioid use disorders, including methadone, buprenorphine and naltrexone has been associated with a reduction in mortality compared with illicit opioid use. However, these treatments can also contribute significantly to the risk of death. The opioid agonists methadone and buprenorphine achieve clinical efficacy in patients with an opioid use disorder through suppressing craving and diminishing the effectiveness of illicit opioid doses, while the antagonist naltrexone blocks the action of opioids. Read More

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http://dx.doi.org/10.1007/s40263-020-00719-3DOI Listing

Analgesic Efficacy and Adverse Effects of Meperidine in Managing Postoperative or Labor Pain: A Narrative Review of Randomized Controlled Trials.

Pain Physician 2020 03;23(2):175-201

Laboratory and Clinical Research Institute for Pain, Dept of Anesthesiology, The University of Hong Kong.

Background: Meperidine, a synthetic opioid, has a rapid onset and short duration of action. Mounting evidence has challenged meperidine's analgesic benefits, and concerns have been raised about its safety profile. Despite recommendations to restrict the prescription of meperidine, the drug remains frequently used. Read More

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Decontamination of Toxic Industrial Chemicals and Fentanyl by Application of the RSDL® Kit.

J Spec Oper Med 2020 ;20(1):55-59

Purpose: This study investigated the decontamination effectiveness of selected toxic industrial chemicals using RSDL® (Reactive Skin Decontamination Lotion Kit; Emergent BioSolutions Inc.; https://www.rsdl. Read More

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The neuroprotective effect of NeuroAid on morphine-induced amnesia with respect to the expression of TFAM, PGC-1α, ΔfosB and CART genes in the hippocampus of male Wistar rats.

Gene 2020 Jun 19;742:144601. Epub 2020 Mar 19.

Institute for Cognitive Science Studies (ICSS), Tehran, Iran; Department of Pharmacology School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Department of Neuroendocrinology, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

Morphine is a natural alkaloid which derived from the opium poppy Papaver somniferum. Many studies have reported the effect of morphine on learning, memory and gene expression. CART (cocaine-amphetamine regulated transcript)is an important neuropeptide which has a critical role in physiological processes including drug dependence and antioxidant activity. Read More

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http://dx.doi.org/10.1016/j.gene.2020.144601DOI Listing
June 2020
2.138 Impact Factor

Cardiac Arrhythmia Secondary to Loperamide Abuse and Toxicity.

Cureus 2020 Feb 10;12(2):e6936. Epub 2020 Feb 10.

Internal Medicine, Texas A&M Health Science Center, Bryan, USA.

Loperamide is a synthetic, over-the-counter, antidiarrheal medication that is widely available and used for the treatment of diarrhea. It is a peripherally acting opioid agonist acting mostly on the μ-opioid receptors in the gut. It was thought to be a very safe medication up until very recently, as the bioavailability of the drug is very low. Read More

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http://dx.doi.org/10.7759/cureus.6936DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7067360PMC
February 2020

Assessment of structure-activity relationships and biased agonism at the Mu opioid receptor of novel synthetic opioids using a novel, stable bio-assay platform.

Biochem Pharmacol 2020 Jul 14;177:113910. Epub 2020 Mar 14.

Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium. Electronic address:

Fentanyl and morphine are agonists of the Mu opioid receptor (MOR), which is a member of the GPCR family. Their analgesic effects are associated with unwanted side effects. On a signaling level downstream from MOR, it has been hypothesized that analgesia may be mediated through the G protein pathway, whereas the undesirable effects of opioids have been linked to the β-arrestin (βarr) pathway. Read More

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http://dx.doi.org/10.1016/j.bcp.2020.113910DOI Listing

Testicular toxicity following chronic codeine administration is via oxidative DNA damage and up-regulation of NO/TNF-α and caspase 3 activities.

PLoS One 2020 13;15(3):e0224052. Epub 2020 Mar 13.

Department of Physiology, College of Medicine, Ladoke Akintola University of Technology, Ogbomoso, Oyo, Nigeria.

Background: Codeine, a 3-methylmorphine, and other related opioids have been implicated in androgen suppression, although the associated mechanisms remain unclear.

Aim: Therefore, the objective of the current study was to elucidate the in vivo molecular mechanisms underlying codeine-induced androgen suppression.

Methods: This study made use of twenty-one healthy male rabbits, distributed into three groups randomly, control and codeine-treated groups. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0224052PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7069647PMC

Unintentional Drug-related Deaths in Cambridgeshire: A Retrospective Observational Study.

Cureus 2020 Jan 23;12(1):e6750. Epub 2020 Jan 23.

Public Health Directorate, Cambridgeshire County Council, Cambridge, GBR.

Background:  Drug-related deaths are a growing public health problem in the United Kingdom, overtaking road fatalities and homicides in terms of annual deaths. In this study, we investigated the causes and circumstances of unintentional drug-related deaths occurring in the county of Cambridgeshire, with the objective of identifying the prevalence of physical, mental, and social health problems within this cohort.

Methods:  We collected data on the demographics and mental and physical health of, and drugs contributing to, 30 consecutive unintentional drug-related deaths recorded by the Cambridgeshire and Peterborough County Council Coroners in 2017. Read More

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http://dx.doi.org/10.7759/cureus.6750DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7039352PMC
January 2020

Cannabinoids as an Alternative Option for Conventional Analgesics in Cancer Pain Management: A Pharmacogenomics Perspective.

Indian J Palliat Care 2020 Jan-Mar;26(1):129-133. Epub 2020 Jan 28.

Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India.

The global cancer burden is significantly increasing at an alarming rate affecting patients, relatives, communities, and health-care system. Cancer patients require adequate pain relief and palliative care throughout the life course, especially in terminal illness. Although opioid treatment is successful in majority of patients, around 40% do not achieve enough analgesia or are prone to serious side effects and toxicity. Read More

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http://dx.doi.org/10.4103/IJPC.IJPC_155_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7017683PMC
January 2020

The Utility of Stereotactic Ablative Radiation Therapy for Palliation of Metastatic Pancreatic Adenocarcinoma.

Pract Radiat Oncol 2020 Feb 29. Epub 2020 Feb 29.

Department of Radiation Oncology, Stanford Cancer Institute, Stanford, California. Electronic address:

Purpose: Our purpose was to report the outcome of stereotactic ablative radiation therapy (SABR) to the primary tumor for patients with metastatic pancreatic cancer.

Methods And Materials: We examined the records of patients with metastatic pancreatic cancer treated with SABR to the primary tumor between 2002 and 2018. Toxicities were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events Version 4. Read More

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http://dx.doi.org/10.1016/j.prro.2020.02.010DOI Listing
February 2020

Isotonitazene Quantitation and Metabolite Discovery in Authentic Forensic Casework.

J Anal Toxicol 2020 Feb 24. Epub 2020 Feb 24.

Center for Forensic Science Research and Education at the Fredric Rieders Family Foundation, 2300 Stratford Ave, Willow Grove, PA, 19090.

The synthetic opioid landscape continues to change as non-fentanyl related substances appear in forensic toxicology casework. Among the newest synthetic opioids to emerge is isotonitazene, an analogue of a benzimidazole class of analgesic compounds. Isotonitazene is an active and potent synthetic opioid, but the extent to which this compound is causing toxicity among drug users was previously unknown. Read More

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http://dx.doi.org/10.1093/jat/bkaa016DOI Listing
February 2020

[Stocktaking of local anesthetics 2020].

Anaesthesist 2020 May;69(5):301-313

Klinik für Anästhesie und Intensivtherapie, Philipps Universität Marburg, Marburg, Deutschland.

For decades local anesthetics have proven to be safe and effective drugs in the clinical practice, crucially promoting the enormous achievements in regional anesthesia. Meanwhile, it is a well-known fact that local anesthetics are much more than just "simple" sodium channel blockers. They also interact with numerous other ion channels and subcellular structures, enhancing nerve blockade and resulting in systemic "alternative" effects, which can sometimes even be clinically used. Read More

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http://dx.doi.org/10.1007/s00101-020-00740-7DOI Listing

Risk of opioid misuse in people with cancer and pain and related clinical considerations: a qualitative study of the perspectives of Australian general practitioners.

BMJ Open 2020 02 17;10(2):e034363. Epub 2020 Feb 17.

Medicine - Primary Care and Population Health, Stanford University, Stanford, California, USA.

Objective: To explore the perspectives of general practitioners (GPs) concerning the risk of opioid misuse in people with cancer and pain and related clinical considerations.

Design: A qualitative approach using semistructured telephone interviews. Analysis used an integrative approach. Read More

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http://dx.doi.org/10.1136/bmjopen-2019-034363DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044941PMC
February 2020

Carfentanil toxicity in the African green monkey: Therapeutic efficacy of naloxone.

Toxicol Lett 2020 Jun 15;325:34-42. Epub 2020 Feb 15.

United States Army Medical Research Institute of Chemical Defense, 8350 Ricketts Point Rd, Aberdeen Proving Ground, MD, 21010, United States. Electronic address:

Carfentanil is an ultra-potent opioid with an analgesic potency 10,000 times that of morphine but has received little scientific investigation. Three experiments were conducted to evaluate the toxicity of carfentanil and the efficacy of naloxone in adult male African green monkeys. The first experiment determined the ED (found to be 0. Read More

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http://dx.doi.org/10.1016/j.toxlet.2020.02.008DOI Listing

Dihydrocodeine for detoxification and maintenance treatment in individuals with opiate use disorders.

Cochrane Database Syst Rev 2020 02 18;2:CD012254. Epub 2020 Feb 18.

South African Medical Research Council, Alcohol, Tobacco and Other Drug Research Unit, Francie Van Zijl Drive, Tygerberg, Western Cape, South Africa, 7505.

Background: Medical treatment and detoxification from opiate disorders includes oral administration of opioid agonists. Dihydrocodeine (DHC) substitution treatment is typically low threshold and therefore has the capacity to reach wider groups of opiate users. Decisions to prescribe DHC to patients with less severe opiate disorders centre on its perceived safety, reduced toxicity, shorter half-life and more rapid onset of action, and potential retention of patients. Read More

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http://dx.doi.org/10.1002/14651858.CD012254.pub2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7027221PMC
February 2020

Role of β-Caryophyllene in the Antinociceptive and Anti-Inflammatory Effects of Cav. Essential Oil.

Molecules 2020 Feb 5;25(3). Epub 2020 Feb 5.

Departamento de Farmacia, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad Universitaria 04510, Mexico.

Cav. (Asteraceae) is an ancient medicinal plant commonly used to alleviate pain. Nevertheless, scientific studies validating this property are lacking in the literature. Read More

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http://dx.doi.org/10.3390/molecules25030675DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7037113PMC
February 2020
2.416 Impact Factor

Effect of fentanyl and its three novel analogues on biochemical, oxidative, histological, and neuroadaptive markers after sub-acute exposure in mice.

Life Sci 2020 Apr 4;246:117400. Epub 2020 Feb 4.

Division of Pharmacology and Toxicology, Defence Research and Development Establishment, Jhansi Road, Gwalior 474 002, M.P., India. Electronic address:

Aims: Comparative sub-acute toxicity, including tolerance and dependence potential of fentanyl and its three novel and potent analogues was determined in mice.

Main Methods: Comparative sub-acute (21 d, intraperitoneal; 1/10 LD) toxicity of fentanyl and its three novel analogues viz., N-(1-(2-phenoxyethyl)-4-piperidinyl) propionanilide (2), N-isopropyl-3-(4-(N-phenylpropionamido)piperidin-1-yl)propanamide (5), and N-t-butyl-3-(4-(N-phenylpropionamido)piperidin-1-yl)propanamide (6) was determined in mice. Read More

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http://dx.doi.org/10.1016/j.lfs.2020.117400DOI Listing
April 2020
2.702 Impact Factor

Toxicokinetic Studies and Analytical Toxicology of the New Synthetic Opioids Cyclopentanoyl-Fentanyl and Tetrahydrofuranoyl-Fentanyl.

J Anal Toxicol 2020 Apr;44(5):449-460

Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University, 66421 Homburg, Germany.

The growing number of new synthetic opioids (NSO) on the new psychoactive substances (NPS) market bears new challenges in toxicology. As their toxicodynamics and particularly their toxicokinetics are usually unknown, impact on human health is not yet fully understood. Detection of the 2 NSO cyclopentanoyl-fentanyl (CP-F) and tetrahydrofuranoyl-fentanyl (THF-F) was first reported in 2016. Read More

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http://dx.doi.org/10.1093/jat/bkaa010DOI Listing

Kratom-Pharmacology, Clinical Implications, and Outlook: A Comprehensive Review.

Pain Ther 2020 Jun 28;9(1):55-69. Epub 2020 Jan 28.

Department of Anesthesiology, Louisiana State University School of Medicine, 1501 Kings Hwy, Shreveport, LA, 71103, USA.

Kratom, or Mitragyna, is a tropical plant indigenous to Southeast Asia, with unique pharmacological properties. It is commonly consumed by preparing the leaves into decoction or tea, or by grinding them into a powder. Recent evidence has revealed that kratom has physiological effects similar to opioids, including pain relief and euphoria, as well as stimulant properties, which together raise potential concern for dependence and addiction. Read More

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http://dx.doi.org/10.1007/s40122-020-00151-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7203303PMC

Prevention of oral mucositis with cryotherapy in children undergoing hematopoietic stem cell transplantations-a feasibility study and randomized controlled trial.

Support Care Cancer 2020 Jan 28. Epub 2020 Jan 28.

Department of Women's and Children's Health, Pediatric Oncology, Uppsala University, Uppsala, Sweden.

Purpose: To evaluate the feasibility of oral cryotherapy (OC) in children and to investigate if OC reduces the incidence of severe oral mucositis (OM), oral pain, and opioid use in children undergoing hematopoietic stem cell transplantation (HSCT).

Methods: Fifty-three children, 4-17 years old, scheduled for HSCT in Sweden were included and randomized to OC or control using a computer-generated list. OC instructions were to cool the mouth with ice for as long as possible during chemotherapy infusions with an intended time of ≥ 30 min. Read More

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http://dx.doi.org/10.1007/s00520-019-05258-2DOI Listing
January 2020

Evaluation of a Long-Acting Opioid Restriction Policy: Does Restriction Reduce the Need for Naloxone Reversal?

Hosp Pharm 2020 Feb 5;55(1):32-36. Epub 2018 Dec 5.

Upstate University Hospital, Syracuse, NY, USA.

After a sentinel event related to long-acting (LA) opioid administration at our institution and subsequent root cause analysis, an inpatient LA opioid restriction policy was implemented to improve patient safety. The objectives of this study were to evaluate the effect of an inpatient LA opioid restriction policy on inpatient therapy utilization and to compare rates of naloxone reversal events among patients administered LA opioids before and after policy implementation. To evaluate the first objective, an electronic medical record report was created to capture all inpatient LA opioid orders prescribed to adults at our institution between March 1, 2014, and July 30, 2017. Read More

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http://dx.doi.org/10.1177/0018578718817471DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6961157PMC
February 2020

Naloxone dosing in the era of ultra-potent opioid overdoses: a systematic review.

CJEM 2020 Mar;22(2):178-186

Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.

Objectives: Evaluate the relationship between naloxone dose (initial and cumulative) and opioid toxicity reversal and adverse events in undifferentiated and presumed fentanyl/ultra-potent opioid overdoses.

Methods: We searched Embase, MEDLINE, Cochrane Central Register of Controlled Trials, DARE, CINAHL, Science Citation Index, reference lists, toxicology websites, and conference proceedings (1972 to 2018). We included interventional, observational, and case studies/series reporting on naloxone dose and opioid toxicity reversal or adverse events in people >12 years old. Read More

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http://dx.doi.org/10.1017/cem.2019.471DOI Listing

Acute Pain Management for Patients Receiving Medication-Assisted Therapy.

Authors:
Peggy Compton

AACN Adv Crit Care 2019 Dec;30(4):335-342

Peggy Compton is Associate Professor, School of Nursing, University of Pennsylvania, 418 Curie Blvd, Room 402, Philadelphia, PA 19104

Evidence-based approaches for the treatment of opioid use disorder include the use of opioid medications (methadone, buprenorphine, or naltrexone), collectively referred to as medication-assisted therapy. Patients receiving medication-assisted therapy may present in the acute care setting with pain, often related to planned surgical procedures to treat health issues that were not addressed before entering treatment. Because these medications act on the same receptors as do analgesic opioids-and, in the cases of methadone and buprenorphine, have analgesic properties - managing acute pain in these patients can be challenging. Read More

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http://dx.doi.org/10.4037/aacnacc2019328DOI Listing
December 2019

'New/Designer Benzodiazepines': an analysis of the literature and psychonauts' trip reports.

Curr Neuropharmacol 2020 Jan 10. Epub 2020 Jan 10.

Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, AL10 9AB, Herts. 0.

Background: NPS belonging to the benzodiazepine (BZD) class, e.g., 'legal/designer BZDs'/'research chemicals', have recently emerged on the drug (mainly online/virtual) market. Read More

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http://dx.doi.org/10.2174/1570159X18666200110121333DOI Listing
January 2020
3.049 Impact Factor

Assessing the human risk and the environmental fate of pharmaceutical Tramadol.

Sci Total Environ 2020 Mar 10;710:135396. Epub 2019 Dec 10.

Department of Chemistry, University of Ioannina, Ioannina, GR-45110, Greece.

Tramadol (TRA) is a widely used human pharmaceutical and a well-established emerging pollutant and its potential genotoxic and cytotoxic effects on humans as well as its fate in aqueous systems demand full investigation. The present study is a multidisciplinary approach and provides important insights on the potential risks of Tramadol on humans accompanied by its photolytic transformation under simulated solar irradiation. The present study revealed that Tramadol can induce genotoxic and cytotoxic effects under the specific experimental conditions, significantly depended on the tested concentration. Read More

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http://dx.doi.org/10.1016/j.scitotenv.2019.135396DOI Listing

Pharmacovigilance in Hospice/Palliative Care: De-Prescribing Combination Controlled Release Oxycodone-Naloxone.

J Palliat Med 2020 May 3;23(5):656-661. Epub 2020 Jan 3.

School of Medicine and Public Health, IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), University of Technology Sydney, Australia.

Pharmacovigilance studies in hospice/palliative care provide extra information to improve medication safety. Combination controlled release oxycodone-naloxone offers an alternative opioid with less risk of opioid-induced constipation. To examine why palliative care clinicians chose to cease oxycodone-naloxone and to explore immediate and short-term benefits and harms of this medication change. Read More

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http://dx.doi.org/10.1089/jpm.2019.0226DOI Listing

Surge in Fentanyl Toxicity Deaths in Jefferson Parish, LA, 2013-2018.

Ochsner J 2019 ;19(4):314-318

Coroner, Jefferson Parish Coroner's Office, Harvey, LA.

The opioid epidemic in the United States has resulted in a significant increase in fentanyl-related overdoses nationwide since 2013. Because of an increased rate of fentanyl-related overdoses seen in Jefferson Parish, LA, the Jefferson Parish Coroner's Office (JPCO) hypothesized that the opioid epidemic, specifically related to fentanyl, had reached this region. To test this hypothesis, JPCO analyzed fentanyl overdose deaths to determine if the deaths had increased during a 6-year period and if the change met the definition of an epidemic. Read More

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http://dx.doi.org/10.31486/toj.19.0039DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6928666PMC
January 2019

Diverse changes in myelin protein expression in rat brain after perinatal methadone exposure.

Acta Neurobiol Exp (Wars) 2019 ;79(4):367-373

Pediatric Research Institute, Department of Pediatrics, University of Louisville School of Medicine, Louisville, USA;

The national incidence of neonatal abstinence syndrome has dramatically increased over the last decade due to an increase in antenatal opioid exposure. Recent human and animal studies suggest that antenatal opioid exposure impacts the developing brain. The purpose of this study is to evaluate the effects of perinatal methadone exposure on myelination in multiple regions in the developing rat brain. Read More

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