3,898 results match your criteria Toxicity Opioids


THE BURDEN OF OPIOID ADVERSE EVENTS AND THE INFLUENCE ON CANCER PATIENTS' SYMPTOMATOLOGY.

J Pain Symptom Manage 2019 Feb 15. Epub 2019 Feb 15.

Department of Oncology, Unit of Cancer Epidemiology, Laboratory of Methodology for Clinical Research, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.

Context: Opioids are frequently used for the treatment of moderate to severe pain and their use may produce a number of unwanted adverse events (AEs).

Objectives: To understand the burden of opioid-induced AEs in cancer patients with pain after the introduction of strong opioids (WHO step III).

Methods: This is a cohort study derived from a randomized controlled trial involving 498 cancer patients with pain who received strong opioids. Read More

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http://dx.doi.org/10.1016/j.jpainsymman.2019.02.009DOI Listing
February 2019

Core Entrustable Professional Activities in Clinical Pharmacology for Entering Residency: Common Problem Drugs and How to Prescribe Them.

J Clin Pharmacol 2019 Feb 15. Epub 2019 Feb 15.

The American College of Clinical Pharmacology, Ashburn, VA, USA.

Although the medical profession strives for safe prescribing, most medications are unique challenges even when prescribed by an experienced provider. In this article we discuss the pitfalls associated with drug interactions between commonly used antibiotics and anticoagulants, the complexities associated with the administration of novel reversible anticoagulants, the often-overlooked severe adverse drug reactions from commonly used classes of medications such as corticosteroids, the nuances of managing an acetaminophen overdose, and uncommon yet serious adverse events associated with the use of contraceptive hormone drugs. Read More

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http://dx.doi.org/10.1002/jcph.1389DOI Listing
February 2019

Evaluation of the fentanyl patch-for-patch program in Ontario, Canada.

Int J Drug Policy 2019 Feb 8;66:82-86. Epub 2019 Feb 8.

Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada; Institute for Clinical Evaluative Sciences, Toronto, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.

Background: Rising use of prescription opioids is a major public health concern associated with increased risk of mortality worldwide. Fentanyl, a synthetic opioid available in patch form, is particularly concerning given its high potency. To curb the misuse and diversion of fentanyl patches, a Patch-for-Patch (P4P) program was implemented in some counties in Ontario between 2012 and 2015. Read More

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http://dx.doi.org/10.1016/j.drugpo.2019.01.025DOI Listing
February 2019
2 Reads

Gabapentin-related Deaths: Patterns of Abuse and Postmortem Levels.

J Forensic Sci 2019 Feb 7. Epub 2019 Feb 7.

Department of Forensic Sciences, Commonwealth of Virginia, 500 North 7th Street, Richmond, VA.

Gabapentin, a GABA analogue, is a nonopioid prescribed for seizure control and neuralgic pain. Its abuse for recreational purposes has been increasing in recent years as the number of prescriptions also increases. In our series, we review 104 cases of decedents who tested positive for gabapentin in postmortem blood samples and an additional 53 nonfatal cases of motor vehicle drivers suspected of driving under the influence. Read More

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http://dx.doi.org/10.1111/1556-4029.14021DOI Listing
February 2019
2 Reads

Epidemiology, clinical features and management of patients presenting to European emergency departments with acute cocaine toxicity: comparison between powder cocaine and crack cocaine cases.

Clin Toxicol (Phila) 2019 Jan 30:1-9. Epub 2019 Jan 30.

a Emergency Department , Hospital Clínic, Barcelona; IDIBAPS , Barcelona , Spain.

Objective: To analyse the epidemiology, clinical picture and emergency department (ED) management of a large series of patients who presented to European EDs after cocaine consumption, comparing data from powder (C group) and crack (C group) consumers.

Methods: Between October 2013 and December 2016, the Euro-DEN Plus Registry recorded 17,371 consecutive acute recreational drug toxicity presentations to 22 EDs in 14 European countries. Epidemiological and demographic data, co-ingestion of alcohol and other drugs, clinical features, ED management and outcome (death) were analysed for cocaine cases, and comparison of clinical picture in C and C patients were performed adjusting for alcohol and other drug co-ingestion. Read More

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http://dx.doi.org/10.1080/15563650.2018.1549735DOI Listing
January 2019
1 Read

"Safety issues of pharmacological acute pain treatment in children".

Clin Pharmacol Ther 2019 Jan 16. Epub 2019 Jan 16.

Division of Clinical Pharmacology and Toxicology, Department of Anesthesiology, Pharmacology, Intensive care and Emergency medicine, Geneva University Hospitals, Switzerland.

Acute nociceptive pain management in children is a major public health concern. Effective and safe pain treatment is essential, but safety data cannot be simply extrapolated from adults to children due to pharmacokinetic and pharmacodynamic specificities. In addition, the frequent absence of child-specific data, the difficulty to assess drug tolerability and the infants' inability to communicate properly and voluntarily report adverse drug reactions, make children more vulnerable to safety issues. Read More

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http://dx.doi.org/10.1002/cpt.1358DOI Listing
January 2019
5 Reads

Opioid overdose detection using smartphones.

Sci Transl Med 2019 Jan;11(474)

Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA 98195, USA.

Early detection and rapid intervention can prevent death from opioid overdose. At high doses, opioids (particularly fentanyl) can cause rapid cessation of breathing (apnea), hypoxemic/hypercarbic respiratory failure, and death, the physiologic sequence by which people commonly succumb from unintentional opioid overdose. We present algorithms that run on smartphones and unobtrusively detect opioid overdose events and their precursors. Read More

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http://dx.doi.org/10.1126/scitranslmed.aau8914DOI Listing
January 2019
1 Read

Predictive Factors of Treatment Outcomes for Hospital Care in Children with Acute Methadone Poisoning.

J Res Pharm Pract 2018 Oct-Dec;7(4):200-204

Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Objective: The trend of methadone toxicity in children and adolescents seems to be increasing in Iran since it is used as a legal measure of the treatment for opioids addiction in methadone maintenance therapy clinics. In the present study, we describe the clinical and demographical characteristics of acute methadone toxicity in a cohort of pediatric poisoned patients in Isfahan, Iran and discussed the predictive factors for their treatment outcomes.

Methods: In this 4-year cross-sectional study which was performed from 2013 to 2016 in a referral university hospital (Isfahan, Iran), medical records of the demographic and admission time clinical characteristics of all in-patients aged <18 years with acute methadone poisoning were abstracted and analyzed. Read More

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http://www.jrpp.net/text.asp?2018/7/4/200/246984
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http://dx.doi.org/10.4103/jrpp.JRPP_16_141DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6298138PMC
January 2019
7 Reads

Incidence of mortality due to rebound toxicity after 'treat and release' practices in prehospital opioid overdose care: a systematic review.

Emerg Med J 2018 Dec 22. Epub 2018 Dec 22.

Dalhousie University, Halifax, Canada.

Introduction: Death due to opioid overdose was declared a public health crisis in Canada in 2015. Traditionally, patients who have overdosed on opioids that are managed by emergency medical services (EMS) are treated with the opioid antagonist naloxone, provided ventilatory support and subsequently transported to hospital. However, certain EMS agencies have permitted patients who have been reversed from opioid overdose to refuse transport, if the patient exhibits capacity to do so. Read More

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http://dx.doi.org/10.1136/emermed-2018-207534DOI Listing
December 2018
3 Reads

Pharmacogenetics and prediction of adverse events in prescription opioid use disorder patients.

Basic Clin Pharmacol Toxicol 2018 Oct 29. Epub 2018 Oct 29.

Neuropharmacology on Pain (NED), Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain.

The threats involved in the long-term opioid treatment of chronic non-cancer pain (CNCP) have increased notably. Strategies to identify at-risk patients are important because there is no clear evidence showing which screening or deprescription programmes are appropriate. Our aim was to evaluate the evidence provided by pharmacogenetics applied to predict an analgesic toxicity profile in prescription opioid use disorder (POUD) patients participating in an opioid deprescription programme. Read More

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http://dx.doi.org/10.1111/bcpt.13155DOI Listing
October 2018
2 Reads

Electroacupuncture Treatment Alleviates the Remifentanil-Induced Hyperalgesia by Regulating the Activities of the Ventral Posterior Lateral Nucleus of the Thalamus Neurons in Rats.

Neural Plast 2018 11;2018:6109723. Epub 2018 Nov 11.

Neuroscience Research Institute and Department of Neurobiology, School of Basic Medical Sciences, Peking University, Beijing 100083, China.

Mechanisms underlying remifentanil- (RF-) induced hyperalgesia, a phenomenon that is generally named as opioid-induced hyperalgesia (OIH), still remain elusive. The ventral posterior lateral nucleus (VPL) of the thalamus, a key relay station for the transmission of nociceptive information to the cerebral cortex, is activated by RF infusion. Electroacupuncture (EA) is an effective method for the treatment of pain. Read More

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http://dx.doi.org/10.1155/2018/6109723DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252233PMC
January 2019
1 Read

[Loperamide abuse - constipation or heart attack?]

Laeknabladid 2018 12;104(12):543-548

Department of Psychiatry, National University Hospital of Iceland.

Loperamide is a μ-opioid receptor agonist with antidiarrhoeal effects. It is considered to have a low abuse potential because of substantial first-pass metabolism and P-glycoprotein-mediated efflux at the level of the blood-brain barrier. Previous case reports have described that high dosage of loperamide can induce an opioid-like effect on the central nervous system. Read More

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http://dx.doi.org/10.17992/lbl.2018.12.207DOI Listing
December 2018
17 Reads

Human deaths from drug overdoses with carfentanyl involvement-new rising problem in forensic medicine: A STROBE-compliant retrospective study.

Medicine (Baltimore) 2018 Nov;97(48):e13449

Department of Pathology, Forensic Medicine and Pharmacology, Institute of Biomedical Sciences of the Faculty of Medicine of Vilnius University.

Carfentanyl, an ultra-potent synthetic opioid, is approved for use only in veterinary medicine as a tranquilizing agent. However, many cases of human poisoning with carfentanyl have recently appeared in the news with limited information given and scientific literature provides only 1 case of documented human exposure to carfentanyl.Fifteen cases of death from drug overdoses with carfentanyl involvement are being presented. Read More

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http://dx.doi.org/10.1097/MD.0000000000013449DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6283219PMC
November 2018
3 Reads

Continuing war on pain: a personalized approach to the therapy with nonsteroidal anti-inflammatory drugs and opioids.

Per Med 2018 Nov 28. Epub 2018 Nov 28.

St Catherine Specialty Hospital, 10000 Zagreb & 49210 Zabok, Croatia.

Successful pain management requires the delivery of analgesia with minimal risk of adverse drug reactions. Nonsteroidal anti-inflammatory drugs and opioids remain the mainstay of treatment for the majority of patients. Unfortunately, almost 50% of all patients experience inadequate pain relief and serious side effects. Read More

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http://dx.doi.org/10.2217/pme-2018-0116DOI Listing
November 2018
6 Reads

Safety and Efficacy of Bupivacaine HCl Collagen-Matrix Implant (INL-001) in Open Inguinal Hernia Repair: Results from Two Randomized Controlled Trials.

Adv Ther 2019 Jan 22;36(1):200-216. Epub 2018 Nov 22.

Innocoll, Newtown Square, PA, USA.

Introduction: Surgical site infiltration with bupivacaine results in short-lived analgesia. The MATRIX-1 and MATRIX-2 studies examined the efficacy and safety of the bioresorbable bupivacaine HCl collagen-matrix implant (INL-001) for postsurgical pain after open inguinal hernia repair. INL-001, designed to provide early and extended delivery of bupivacaine, provides prolonged duration of perioperative analgesia. Read More

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http://dx.doi.org/10.1007/s12325-018-0836-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6318344PMC
January 2019
12 Reads

The Protective and Restorative Effects of Growth Hormone and Insulin-Like Growth Factor-1 on Methadone-Induced Toxicity In Vitro.

Int J Mol Sci 2018 Nov 17;19(11). Epub 2018 Nov 17.

The Beijer Laboratory, Department of Pharmaceutical Biosciences, Division of Biological Research on Drug Dependence, Uppsala University, Uppsala, SE-751 24, Sweden.

Evidence to date suggests that opioids such as methadone may be associated with cognitive impairment. Growth hormone (GH) and insulin-like growth factor-1 (IGF-1) are suggested to be neuroprotective and procognitive in the brain and may therefore counteract these effects. This study aims to explore the protective and restorative effects of GH and IGF-1 in methadone-treated cell cultures. Read More

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http://dx.doi.org/10.3390/ijms19113627DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6274959PMC
November 2018
1 Read

Safety and performance of current abuse-deterrent formulations.

Expert Opin Drug Metab Toxicol 2018 Dec 2;14(12):1255-1271. Epub 2018 Dec 2.

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

Introduction: Prescription opioid abuse is now an epidemic that has forced the government and industries to take initiatives. These include developing abuse-deterrent formulations (ADFs), issuing regulatory guidances and allocating massive budgets to ensure the safety and effectiveness of these medications. Areas covered: This review covers the regulatory guidance on evaluation and labeling of the branded and generic ADFs. Read More

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https://www.tandfonline.com/doi/full/10.1080/17425255.2018.1
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http://dx.doi.org/10.1080/17425255.2018.1546289DOI Listing
December 2018
18 Reads

Eslicarbazepine acetate reduces trigeminal nociception: Possible role of adrenergic, cholinergic and opioid receptors.

Life Sci 2018 Dec 27;214:167-175. Epub 2018 Oct 27.

Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, P.O. Box 146, 11221 Belgrade, Serbia.

Aims: Eslicarbazepine acetate (ESL) is a novel dibenzazepine antiepileptic, that has demonstrated efficacy against trigeminal pain, both in preclinical and clinical studies. However, ESL's mechanism of antinociceptive action remains uncertain. Here, we aimed to examine the contribution of adrenergic/cholinergic/opioid receptors to the antinociceptive effects of ESL in a trigeminal pain model, as these neurotransmitter systems are known to have an important role in the modulation of trigeminal nociception. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00243205183069
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http://dx.doi.org/10.1016/j.lfs.2018.10.059DOI Listing
December 2018
12 Reads

Pharmacologic Treatment of Opioid Use Disorder: a Review of Pharmacotherapy, Adjuncts, and Toxicity.

J Med Toxicol 2018 Dec 30;14(4):306-322. Epub 2018 Oct 30.

Harvard Medical Toxicology Program, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.

Opioid use disorder continues to be a significant source of morbidity and mortality in the USA and the world. Pharmacologic treatment with methadone and buprenorphine has been shown to be effective at retaining people in treatment programs, decreasing illicit opioid use, decreasing rates of hepatitis B, and reducing all cause and overdose mortality. Unfortunately, barriers exist in accessing these lifesaving medications: users wishing to start buprenorphine therapy require a waivered provider to prescribe the medication, while some states have no methadone clinics. Read More

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http://link.springer.com/10.1007/s13181-018-0685-1
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http://dx.doi.org/10.1007/s13181-018-0685-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6242798PMC
December 2018
8 Reads

Opioid switching and variability in response in pain cancer patients.

Support Care Cancer 2018 Oct 24. Epub 2018 Oct 24.

Palliative Care and Pain Therapy Unit, ASST Nord Milano, E. Bassini Hospital, Cinisello Balsamo, Italy.

Introduction: Opioid switching is a possible strategy for inadequate analgesia or unmanageable side effects. Its effectiveness ranges from 50 to 90% and is still debated.

Purpose: We analyzed the impact of opioid switching in a cancer pain population treated with strong opioids for pain. Read More

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http://dx.doi.org/10.1007/s00520-018-4485-6DOI Listing
October 2018
2 Reads

Adolescent morphine exposure induces immediate and long-term increases in impulsive behavior.

Psychopharmacology (Berl) 2018 Dec 23;235(12):3423-3434. Epub 2018 Oct 23.

Department of Physiology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

Rationale: Adolescence in humans represents a unique and critical developmental time point associated with increased risk-taking behavior. Converging clinical and epidemiological studies report a peak of drug use during adolescence, leading to the hypothesis that the developing adolescents brain is at risk to lose control over drug intake. Both adolescence and drug abuse are associated with significant cognitive and psychological changes such as lack of impulse control. Read More

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http://link.springer.com/10.1007/s00213-018-5051-0
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http://dx.doi.org/10.1007/s00213-018-5051-0DOI Listing
December 2018
8 Reads

Cancer Pain Management: Opioid Analgesics, Part 2.

Authors:
Rita J Wickham

J Adv Pract Oncol 2017 Sep-Oct;8(6):588-607. Epub 2017 Sep 1.

Rush University College of Nursing (Adjunct Faculty), Chicago, Illinois.

Opioid analgesics are the cornerstone of moderate to severe cancer pain management, and do not have ceiling doses unless unmanageable adverse effects occur. Oral, short-acting pure μ agonists such as morphine are most frequently used, but other agents and administration formulations allow finding the right opioid and dose for most patients. In addition, clinicians must understand the metabolism, pharmacokinetics, and elimination of particular drugs to individualize opioid selection, select initial doses, and appropriately escalate doses to satisfactory pain relief or uncontrollable toxicity. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6167083PMC
September 2017
14 Reads

A central role for glial CCR5 in directing the neuropathological interactions of HIV-1 Tat and opiates.

J Neuroinflammation 2018 Oct 10;15(1):285. Epub 2018 Oct 10.

Department of Anatomy and Neurobiology, Virginia Commonwealth University School of Medicine, 1217 E. Marshall St, Richmond, VA, 23298-0709, USA.

Background: The collective cognitive and motor deficits known as HIV-associated neurocognitive disorders (HAND) remain high even among HIV+ individuals whose antiretroviral therapy is optimized. HAND is worsened in the context of opiate abuse. The mechanism of exacerbation remains unclear but likely involves chronic immune activation of glial cells resulting from persistent, low-level exposure to the virus and viral proteins. Read More

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https://jneuroinflammation.biomedcentral.com/articles/10.118
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http://dx.doi.org/10.1186/s12974-018-1320-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6180355PMC
October 2018
4 Reads

Biodegradation study of methadone by adapted activated sludge: Elimination kinetics, transformation products and ecotoxicological evaluation.

Chemosphere 2019 Jan 28;214:719-728. Epub 2018 Sep 28.

Division of Marine and Environmental Research, Rudjer Boskovic Institute, Bijenicka 54, 10000, Zagreb, Croatia. Electronic address:

The biotransformation study of difficult-to-degrade opioid analgesic methadone (MTHD) was performed by activated sludge culture adapted to high concentration of methadone (10 mg/L). The study included determination of elimination kinetics of the parent compound, taxonomic characterization of microbial culture, identification of biotransformation products (TPs) and assessment of ecotoxicological effects of biotransformation processes. The chemical analyses were performed by ultra-performance liquid chromatography/quadrupole-time-of-flight mass spectrometry, whereas the ecotoxicological assessment was made based on determinations of toxicity to freshwater algae. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00456535183181
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http://dx.doi.org/10.1016/j.chemosphere.2018.09.153DOI Listing
January 2019
3 Reads

The analgesic effects of buprenorphine (Vetergesic or Simbadol) in combination with carprofen in dogs undergoing ovariohysterectomy: a randomized, blinded, clinical trial.

BMC Vet Res 2018 Oct 5;14(1):304. Epub 2018 Oct 5.

Department of Clinical Sciences and Animal Pharmacology Research Group of Quebec (GREPAQ; Groupe de recherche en pharmacologie animale du Québec), Faculty of Veterinary Medicine, Université de Montréal, 3200 rue Sicotte, Saint-Hyacinthe, QC, J2S 2M2, Canada.

Background: Buprenorphine is a potent lipophilic opioid analgesic that is largely used in the multimodal treatment of acute pain. Simbadol (buprenorphine hydrochloride) is the first and only FDA-approved high-concentration formulation of buprenorphine for use in cats. The aim of this study was to evaluate the analgesic efficacy of carprofen in combination with one of two commercial formulations of buprenorphine (Simbadol and Vetergesic, 1. Read More

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http://dx.doi.org/10.1186/s12917-018-1628-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6173890PMC
October 2018
7 Reads

Economic evaluation of the randomised, double-blind, placebo-controlled study of subcutaneous ketamine in the management of chronic cancer pain.

Palliat Med 2019 Jan 1;33(1):74-81. Epub 2018 Oct 1.

10 Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW, Australia.

Background:: Treating chronic, uncontrolled, cancer pain with subcutaneous ketamine in patients unresponsive to opioids and co-analgesics remains controversial, especially in light of recent evidence demonstrating ketamine does not have net clinical benefit in this setting.

Aim:: To evaluate the cost-effectiveness of subcutaneous ketamine versus placebo in this patient population.

Design And Setting:: A within-trial cost-effectiveness analysis of the Australian Palliative Care Clinical Studies Collaborative's randomised, double-blind, placebo-controlled trial of ketamine was conducted from a healthcare provider perspective. Read More

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http://journals.sagepub.com/doi/10.1177/0269216318801754
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http://dx.doi.org/10.1177/0269216318801754DOI Listing
January 2019
13 Reads

Analgesic effect of morphine and tramadol in standard toxicity assays in mice injected with venom of the snake Bothrops asper.

Toxicon 2018 Nov 27;154:35-41. Epub 2018 Sep 27.

Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica. Electronic address:

Routine laboratory animal tests necessary to assess the toxicity of snake venoms and the preclinical neutralizing ability of antivenoms and other inhibitory substances induce significant pain and distress. This has prompted initiatives to introduce the routine use of analgesia. In this study, the analgesic effect of morphine and tramadol was assessed in tests assessing the lethal, hemorrhagic, myotoxic and edema-forming activities of the venom of the viperid snake Bothrops asper. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00410101183039
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http://dx.doi.org/10.1016/j.toxicon.2018.09.012DOI Listing
November 2018
4 Reads

Attenuation of Remifentanil-Induced Hyperalgesia by Betulinic Acid Associates with Inhibiting Oxidative Stress and Inflammation in Spinal Dorsal Horn.

Pharmacology 2018 25;102(5-6):300-306. Epub 2018 Sep 25.

Department of Anesthesiology and Pain Clinic, The First Affiliated Hospital of Jiaxing University, Jiaxing,

Remifentanil-induced hyperalgesia (RIH) is known to be associated with oxidative stress and inflammation. Betulinic acid (BA) was reported to reduce visceral pain owing to its anti-oxidative and anti-inflammatory potential. Here, we -explored whether BA can attenuate RIH through inhibiting oxidative stress and inflammation in spinal dorsal horn. Read More

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https://www.karger.com/Article/FullText/493144
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http://dx.doi.org/10.1159/000493144DOI Listing
December 2018
7 Reads

The molecular and biochemical insight view of lycopene in ameliorating tramadol-induced liver toxicity in a rat model: implication of oxidative stress, apoptosis, and MAPK signaling pathways.

Environ Sci Pollut Res Int 2018 Nov 24;25(33):33119-33130. Epub 2018 Sep 24.

Department of Forensic Medicine and Toxicology, Faculty of Veterinary Medicine, Damanhour University, Damanhour, Egypt.

The influence of tramadol (TD) on hepatic tissue and the potential efficiency of lycopene to mitigate TD-induced hepatotoxic impacts were determined. Forty male albino rats were allocated into four groups: group I, untreated (placebo); group II, injected with TD (15 mg kg) intraperitoneally (i.p. Read More

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http://link.springer.com/10.1007/s11356-018-3265-7
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http://dx.doi.org/10.1007/s11356-018-3265-7DOI Listing
November 2018
2 Reads

The Health Threat Posed by the Hidden Epidemic of Anabolic Steroid Use and Body Image Disorders Among Young Men.

J Clin Endocrinol Metab 2018 Sep 17. Epub 2018 Sep 17.

Harvard Medical School Director, Research Program in Men's Health: Aging and Metabolism Director, Boston Claude D. Pepper Older Americans Independence Center Brigham and Women's Hospital, Boston, MA.

Context: The prevalence of body image disorders and anabolic-androgenic steroid (AAS) use is increasing, despite the evidence of their serious adverse health effects and despite the passage of laws regulating their sales. Here we review the evolution of the dual emerging epidemics of body image disorders and AAS use, adverse health effects of AAS, and the need for an integrated health policy and regulatory response to stem these epidemics.

Evidence Acquisition: We searched for studies published in English language prior to June 2018. Read More

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http://dx.doi.org/10.1210/jc.2018-01706DOI Listing
September 2018
6 Reads

Multimodal analgesia in crotalid snakebite envenomation: A novel use of femoral nerve block.

Am J Emerg Med 2018 Dec 14;36(12):2340.e1-2340.e2. Epub 2018 Sep 14.

Division of Medical Toxicology, Department of Emergency Medicine, University of Pittsburgh, Iroquois Building Suite 400, 3600 Forbes Ave, Pittsburgh, PA 15213, USA.

Snakebite envenomations occur throughout the United States, with most envenomations resulting from Crotalid bites. These envenomations can result in severe pain despite aggressive analgesia due to effects of venom toxins. We report a case in which we treated a 44- year-old man who sustained a Copperhead (Agkistrodon contortrix) bite to his left hallux with progressive local toxicity, including severe pain radiating into his upper leg, without evidence of compartment syndrome or coagulopathy. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07356757183075
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http://dx.doi.org/10.1016/j.ajem.2018.09.020DOI Listing
December 2018
7 Reads

A dopamine D1 receptor agonist improved learning and memory in morphine-treated rats.

Neurol Res 2018 Dec 17;40(12):1080-1087. Epub 2018 Sep 17.

d Department of Pathogenic Biology , Chengdu Medical College , Chengdu , China.

Objective: The objective of this article is to study the role of the dopamine (DA) D1 receptor in the midbrain periaqueductal grey (PAG) on learning and memory in morphine-addicted rats.

Methods: DA D1 receptor agonist SKF81297 and D1 receptor antagonist SCH SCH23390 were administrated into the PAG, respectively, and the learning and memory behavioral changes of morphine addicted rats were detected by water maze. Western blot and immunohistochemistry were used to detect glutamate decarboxylase 67 (GAD67) and tyrosine receptor kinase B (TrkB) in PAG. Read More

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http://dx.doi.org/10.1080/01616412.2018.1519946DOI Listing
December 2018
5 Reads

The Opioid Epidemic: Moving Toward an Integrated, Holistic Analytical Response.

J Anal Toxicol 2019 Jan;43(1):1-9

University of Florida, Gainesville, FL, USA.

In many jurisdictions, public safety and public health entities are working together to enhance the timeliness and accuracy of the analytical characterization and toxicology testing of novel synthetic opioids. The improved sharing and early detection of these analytical data are intended to inform surveillance, interdiction efforts, patient intervention and treatment, all of which are critical to curbing the opioid epidemic. Forensic practitioners working to identify novel synthetic opioids struggle to provide timely results when encountering new or unknown substances, such as the fentanyl analogs. Read More

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http://dx.doi.org/10.1093/jat/bky049DOI Listing
January 2019
3 Reads

Occurrence of bacterial and toxic metals contamination in illegal opioid-like drugs in Iran: a significant health challenge in drug abusers.

Daru 2018 Sep 29;26(1):77-83. Epub 2018 Jun 29.

Department of Pharmacology and Toxicology, School of Pharmacy, Hamadan University of Medical Sciences, P.O. Box 8678-3-65178, Hamadan, Iran.

Background: The toxic metals and/or bacterial contaminants in illicit drugs are the main health problems in drug users worldwide. Hence, the potential risks of these contaminants were evaluated in some of the illicit drugs during 2015 and 2016.

Methods: The metals analysis were performed using graphite furnace atomic absorption spectrophotometry. Read More

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http://dx.doi.org/10.1007/s40199-018-0205-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6154484PMC
September 2018
14 Reads

Addressing the Fentanyl Analogue Epidemic by Multiplex UHPLC-MS/MS Analysis of Whole Blood.

Ther Drug Monit 2018 12;40(6):738-748

Department of Forensic Sciences, Division of Laboratory Medicine, Oslo University Hospital.

Background: Fentanyl and fentanyl analogues (fentanyls) are very potent opioids posing a serious threat to the public health. Thousands of overdose deaths across the world are caused by fentanyls, and the numbers are increasing. Rapid mapping of current trends in opioid abuse is necessary to accelerate preventive measures. Read More

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http://dx.doi.org/10.1097/FTD.0000000000000564DOI Listing
December 2018
17 Reads

Adult Zebrafish (Danio rerio) As a Model for the Study of Corneal Antinociceptive Compounds.

Zebrafish 2018 12 28;15(6):566-574. Epub 2018 Aug 28.

2 Núcleo de Biologia Experimental (NUBEX), Universidade de Fortaleza (UNIFOR) , Fortaleza, Brazil .

Zebrafish is an excellent model that can be utilized as an adjunct to current rodent models for studies of eye diseases because the anatomy and ultrastructural characterization of its cornea show much similarity with the human cornea. Therefore, we developed a behavioral model of corneal nociception using the adult zebrafish (Danio rerio). We analyzed the nociceptive effect of hypertonic saline (0. Read More

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https://www.liebertpub.com/doi/10.1089/zeb.2018.1633
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http://dx.doi.org/10.1089/zeb.2018.1633DOI Listing
December 2018
17 Reads

Opioid toxicity with underlying tumour lysis syndrome in a patient with CMML: a diagnostic and therapeutic challenge.

BMJ Case Rep 2018 Aug 27;2018. Epub 2018 Aug 27.

Oncoanaesthesia and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India.

Use of strong opioids like morphine as analgesics for painful conditions in haematological malignancies is a challenging task. We report a unique case of chronic myelomonocytic leukaemia presenting with opioid toxicity overlapping with tumour lysis syndrome. The patient was on hydroxyurea-based chemotherapy for the primary disease. Read More

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http://dx.doi.org/10.1136/bcr-2018-225646DOI Listing
August 2018
2 Reads

Optimal concentration of the transversus abdominis plane block in enhanced recovery after surgery protocols for patients of advanced age undergoing laparoscopic rectal cancer surgery.

J Int Med Res 2018 Nov 15;46(11):4437-4446. Epub 2018 Aug 15.

1 Anesthesiology Department, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.

Objective: The transversus abdominis plane (TAP) block ameliorates visual analogue scale scores and decreases morphine requirements, but its role remains unclear. Patients of advanced age are susceptible to local anesthetic intoxication. We aimed to identify an optimal concentration that can be used in enhanced recovery after surgery (ERAS) without compromising analgesic efficacy. Read More

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http://dx.doi.org/10.1177/0300060518790699DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6259369PMC
November 2018
9 Reads

Retrospective study of the digestive tract mucositis derived from myeloablative and non-myeloablative/reduced-intensity conditionings with busulfan in hematopoietic cell transplantation patient.

Support Care Cancer 2019 Mar 14;27(3):839-848. Epub 2018 Aug 14.

General Pathology Department, School of Dentistry, University of São Paulo, Avenida Professor Lineu Prestes 2227 Cidade Universitaria, Sao Paulo, 05508-000, Brazil.

Busulfan is a major component of chemotherapy conditioning in hematopoietic cell transplantation (HCT). This alkylating agent is highly toxic at myeloablative doses, exposing HCT patients to risks of mortality. Non-myeloablative (NMA) and reduced-intensity conditioning (RIC) using busulfan have shown impaired toxicity. Read More

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http://dx.doi.org/10.1007/s00520-018-4362-3DOI Listing
March 2019
3 Reads

Fatal Poisonings Associated with New Psychoactive Substances.

Handb Exp Pharmacol 2018 Aug 14. Epub 2018 Aug 14.

Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden.

This chapter describes how new psychoactive substances (NPS) have been involved in fatal intoxications from 2010 and onwards. It summarizes the circumstances, antemortem symptoms, and adverse effects that have led to death after ingestion of one or more NPS and tabulates concentrations, and postmortem findings from these intoxications.Consumption of NPS exerts health problems and unknown risks for the users. Read More

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http://dx.doi.org/10.1007/164_2018_110DOI Listing
August 2018
17 Reads

Daclatasvir Plasma Levels in a Cohort of Patients with Hepatitis C Virus Infection Taking Methadone: A Prospective Analysis.

Eur Addict Res 2018 10;24(4):184-188. Epub 2018 Aug 10.

Backround: The effect of methadone (MET) during therapy with novel direct-acting antiviral agents is still not fully understood. Currently, no data are available about the influence of MET on daclatasvir (DCV) plasma levels in patients affected by chronic hepatitis C (CHC). The aim of this study was to assess the DCV plasma concentrations in patients treated with sofosbuvir (SOF) plus DCV, with or without ribavirin (RBV) and with or without MET. Read More

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https://www.karger.com/Article/FullText/491646
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http://dx.doi.org/10.1159/000491646DOI Listing
December 2018
8 Reads

Comparing the contribution of prescribed opioids to opioid-related hospitalizations across Canada: A multi-jurisdictional cross-sectional study.

Drug Alcohol Depend 2018 10 31;191:86-90. Epub 2018 Jul 31.

Institute for Clinical Evaluative Sciences, 2075 Bayview Ave, Toronto, Ontario M4N 3M5, Canada; Department of Medicine at the University of Toronto, 1 King's College Circle, Medical Sciences Building, Toronto, Ontario M5S 1A8, Canada.

Background: The Canadian opioid crisis is a complex, multifaceted problem involving prescribed, diverted and illicitly manufactured opioids. This study sought to characterize the contribution of prescribed opioids to opioid-related hospitalizations in Canada.

Methods: We conducted a cross-sectional study of all individuals who were admitted to hospital for opioid toxicity in British Columbia (BC), Manitoba and Ontario between April 2015 and March 2016. Read More

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http://dx.doi.org/10.1016/j.drugalcdep.2018.06.028DOI Listing
October 2018
5 Reads
3.423 Impact Factor

Antinociception by intrathecal delivery of the novel non-opioid 1-amino-1-cyclobutanecarboxylic acid.

Eur J Pain 2019 Feb 17;23(2):260-271. Epub 2018 Sep 17.

Hugill Anesthesia Research Centre, Department of Anesthesiology, Pharmacology & Therapeutics, The University of British Columbia, Vancouver, British Columbia, Canada.

Background: Neuraxial opioids are widely used for intraoperative and post-operative analgesia. The risk of severe adverse effects including respiratory depression accompanies this analgesia, prompting the need for effective non-opioid alternatives. Systemic 1-amino-1-cyclobutanecarboxylic acid showed promise in preliminary studies to produce antinociception without observable toxicity. Read More

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http://dx.doi.org/10.1002/ejp.1301DOI Listing
February 2019
2 Reads

Oxidative stress in opium users after using lead-adulterated opium: The role of genetic polymorphism.

Food Chem Toxicol 2018 Oct 3;120:571-577. Epub 2018 Aug 3.

Department of Toxicology & Pharmacology, School of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran; Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran. Electronic address:

Use of lead-adulterated opium has become one of the major sources of lead poisoning in Iran. This study was designed to assess clinical effects and oxidative stress and its association with GSTM1, GSTT1, NQO1, and ALAD genes polymorphisms and blood lead level (BLL) in lead-adulterated opium users. The oxidative stress status in 192 opium users with lead poisoning symptoms measured and compared with 102 healthy individuals. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S02786915183050
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http://dx.doi.org/10.1016/j.fct.2018.07.061DOI Listing
October 2018
9 Reads

Toxicity of tapentadol: a systematic review.

Pain Manag 2018 Sep 6;8(5):327-339. Epub 2018 Aug 6.

Medical School, The University of Western Australia, Perth, Western Australia.

Background: Tapentadol is a novel atypical opioid. Anecdotal evidence suggests that tapentadol has a lower toxicity than conventional opioids.

Objectives: To evaluate all single-drug mortality due to tapentadol and assess serious adverse events caused by tapentadol. Read More

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http://dx.doi.org/10.2217/pmt-2018-0027DOI Listing
September 2018
1 Read

Determining the effective dose of street-level heroin: A new way to consider fluctuations in heroin purity, mass and potential contribution to overdose.

Forensic Sci Int 2018 Sep 19;290:219-226. Epub 2018 Jul 19.

Department of Forensic Medicine, Monash University, Melbourne, Australia.

Background & Aims: Heroin use is associated with a disproportionately high level of morbidity and mortality with most deaths attributable to drug overdose. Aggregate heroin purity data has been used to examine the relationship between overdose and variability in street-level heroin, however heroin purity data alone may not be the most appropriate nor a sensitive enough measurement tool for this assessment. The aim of this study was to measure the variability in effective dose of street-level heroin seizures, accounting for variation in both purity and mass, and determine the proportion of samples with higher than expected effective dose that would not be detected using a purity-only measure. Read More

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http://dx.doi.org/10.1016/j.forsciint.2018.07.009DOI Listing
September 2018
13 Reads