- Methylphenidate and Morphine Combination Therapy in a Rat Model of Chronic Pain. [Journal Article]
- A&AAnesth Analg 2019 Jun 12
- CONCLUSIONS: Our data suggest that a combination therapy using low-dose MPH and MOR may produce a MOR-sparing effect in chronic pain management.
- Prospective Association of Serum Opioid Levels and Clinical Outcomes in Patients With Cancer Pain Treated With Intrathecal Opioid Therapy. [Journal Article]
- A&AAnesth Analg 2019 Jun 12
- CONCLUSIONS: ITT for cancer pain was associated with a marked reduction in serum opioid concentrations, with the majority of patients having undetectable serum levels. Reducing serum opioid concentrations in cancer patients may have implications with respect to restoring bowel function, improving fatigue, and promoting the integrity of antitumor immune function and warrants further study.
- A new azo-azomethine sensor for detection of CN- and AcO- anions: Highly selective chemosensor for naked eye detection of sodium diclofenac. [Journal Article]
- SASpectrochim Acta A Mol Biomol Spectrosc 2019 May 28; 222:117157
- New azo-azomethine sensor, HL, has been synthesized and characterized using standard spectroscopic methods. HL was found to sense CN- and AcO- in DMSO and semi-aqueous media over other anions such as…
New azo-azomethine sensor, HL, has been synthesized and characterized using standard spectroscopic methods. HL was found to sense CN- and AcO- in DMSO and semi-aqueous media over other anions such as F-, Cl-, Br-, I-, H2PO4- and HSO4-. The anions recognition ability of HL was also evaluated using UV-Vis absorption and 1H NMR spectroscopy. Importantly, HL can detect CN- and AcO- in DMSO even at 0.7 ppm and 1.3 ppm, respectively. The binding stoichiometry between HL and the mentioned anions was found to be 1:1 with binding constants of 8.81 × 103 M-1 and 3.64 × 104 M-1 for CN- and AcO-, respectively. Successfully, HL was used for the detection of sodium diclofenac over the other opiate drugs such as codeine phosphate, noscapine hydrochloride, papaverine hydrochloride, and morphine sulfate. The designed chemosensor has also shown highly promising results for the qualitative and quantitative detection of sodium diclofenac in oral pills.
- Monitoring, prevention and treatment of side effects of long-acting neuraxial opioids for post-cesarean analgesia. [Journal Article]
- IJInt J Obstet Anesth 2019 Apr 26
- Long-acting neuraxial opioids such as morphine and diamorphine, administered via spinal or epidural routes, are staple components of a multimodal approach for postoperative analgesia following cesare…
Long-acting neuraxial opioids such as morphine and diamorphine, administered via spinal or epidural routes, are staple components of a multimodal approach for postoperative analgesia following cesarean delivery. The widespread use of neuraxial opioids is due largely to their significant analgesic efficacy and favorable safety profile. The most common side effects of neuraxial opioids are pruritus, nausea and vomiting. These symptoms appear to be dose-related. The most serious complication of neuraxial opioids is respiratory depression, which occurs in 0-0.9% of cases. Hypothermia has also been reported in association with neuraxial morphine use at cesarean delivery. This article will review recent advances in prophylaxis, treatment and monitoring of the side effects of long-acting neuraxial opioids.
- A Novel Mu-Delta Opioid Agonist Demonstrates Enhanced Efficacy with Reduced Tolerance and Dependence in Mouse Neuropathic Pain Models. [Journal Article]
- JPJ Pain 2019 Jun 12
- Numerous studies have demonstrated a physiological interaction between the mu opioid receptor (MOR) and delta opioid receptor (DOR) systems. A few studies have shown that dual MOR-DOR agonists could …
Numerous studies have demonstrated a physiological interaction between the mu opioid receptor (MOR) and delta opioid receptor (DOR) systems. A few studies have shown that dual MOR-DOR agonists could be beneficial, with reduced tolerance and addiction liability, but are nearly untested in chronic pain models, particularly neuropathic pain. In this study, we tested the MOR-DOR agonist SRI-22141 in mice in the clinically relevant models of HIV Neuropathy and Chemotherapy-Induced Peripheral Neuropathy (CIPN). SRI-22141 was more potent than morphine in the tail flick pain test, and had equal or enhanced efficacy vs. morphine in both neuropathic pain models, with significantly reduced tolerance. SRI-22141 also produced no jumping behavior during naloxone-precipitated withdrawal in CIPN or naïve mice, suggesting that SRI-22141 produces little to no dependence. SRI-22141 also reduced Tumor Necrosis Factor-α and Cyclooxygenase-2 in CIPN in the spinal cord, suggesting an anti-inflammatory mechanism of action. The DOR-selective antagonist naltrindole strongly reduced CIPN efficacy and anti-inflammatory activity in the spinal cord, without affecting tail flick antinociception, suggesting the importance of DOR activity in these models. Overall, these results provide compelling evidence that MOR-DOR agonists could have strong efficacy with reduced side effects and an anti-inflammatory mechanism in the treatment of neuropathic pain. Perspective: This study demonstrates that a MOR-DOR dual agonist given chronically in chronic neuropathic pain models has enhanced efficacy with strongly reduced tolerance and dependence, with a further anti-inflammatory effect in the spinal cord. This suggests that MOR-DOR dual agonists could be effective treatments for neuropathic pain with reduced side effects.
- Predictors of postoperative urinary retention in outpatient minimally invasive hysterectomy. [Journal Article]
- JMJ Minim Invasive Gynecol 2019 Jun 12
- CONCLUSIONS: In patients undergoing minimally invasive outpatient hysterectomy, longer operative time and increased perioperative narcotic use increases the risk of postoperative urinary retention.
- The Current Practice of Opioid for Cancer Dyspnea: The Result from the Nationwide Survey of Japanese Palliative Care Physicians. [Journal Article]
- JPJ Pain Symptom Manage 2019 Jun 12
- CONCLUSIONS: Among Japanese palliative care physicians, using oxycodone for cancer dyspnea was relatively popular practice, while fentanyl was not. Oxycodone was the most preferred opioid for cancer dyspnea in the setting of renal insufficiency among Japanese palliative care physicians. We should conduct studies to confirm the safety and effectiveness of these opioid practices for cancer dyspnea.
- Multimodal opioid sparing postoperative pain regimen compared to the standard postoperative pain regimen in vaginal pelvic reconstructive surgery: a multicenter randomized controlled trial. [Journal Article]
- AJAm J Obstet Gynecol 2019 Jun 12
- CONCLUSIONS: The ICE-T multimodal pain regimen offers improved pain control the morning after surgery and 96 hours postoperatively compared to the Standard regimen with no differences in patient satisfaction and quality of recovery. ICE-T can significantly limit post-operative inpatient narcotic use and eliminate outpatient narcotic use in patients undergoing vaginal pelvic reconstructive surgery.
- Cell-type and region-specific nucleus accumbens AMPAR plasticity associated with morphine reward, reinstatement, and spontaneous withdrawal. [Journal Article]
- BSBrain Struct Funct 2019 Jun 14
- Despite evidence that morphine-related pathologies reflect adaptations in NAc glutamate signaling, substantial gaps in basic information remain. The current study examines the impact of non-contingen…
Despite evidence that morphine-related pathologies reflect adaptations in NAc glutamate signaling, substantial gaps in basic information remain. The current study examines the impact of non-contingent acute, repeated, and withdrawal-inducing morphine dosing regimens on glutamate transmission in D1- or D2-MSNs in the nucleus accumbens shell (NAcSh) and core (NAcC) sub-regions in hopes of identifying excitatory plasticity that may contribute to unique facets of opioid addiction-related behavior. Following an acute morphine injection (10 mg/kg), average miniature excitatory postsynaptic current (mEPSC) amplitude mediated by AMPA-type glutamate receptors was increased at D1-MSNs in the both the NAcShl and NAcC, whereas only the frequency of events was elevated at D2-MSNs in the NAcSh. In contrast, spontaneous somatic withdrawal induced by escalating dose of repeated morphine twice per day (20, 40, 60, 80, 100 mg/kg) enhanced mEPSC frequency specifically at D2-MSNs in the NAcSh. Similar to previous findings, excitatory drive was elevated at NAcSh D1-MSNs after 10-14 days home cage abstinence. Following abstinence, an acute drug re-exposure produced a rapid and enduring endocytosis of GluA2-containing AMPARs at D1-MSNs in the shell, that when blocked by an intra-NAc shell infusion of the Tat-GluA23Y peptide, increased reinstatement of morphine place preference-a phenomenon distinctly different than effects previously found with cocaine. The present study is the first to directly identify unique circuit specific adaptations in NAc glutamate synaptic transmission associated with morphine-related acute reward and somatic withdrawal as well as post-abstinence short-term plasticity. Moreover, while differing classes of abused drugs (i.e., psychostimulants and opioids) produce seemingly similar bidirectional plasticity in the NAc following drug re-exposure, our findings indicate this plasticity has distinct behavioral consequences.
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- Naloxegol for opioid-induced sphincter of Oddi spasm/dysfunction. [Journal Article]
- BSBMJ Support Palliat Care 2019 Jun 14
- The paper describes a case report of a patient with a significant history of opioid-induced dysfunction of the sphincter of Oddi, who required morphine sulfate to manage oral mucositis pain, and who …
The paper describes a case report of a patient with a significant history of opioid-induced dysfunction of the sphincter of Oddi, who required morphine sulfate to manage oral mucositis pain, and who was successfully treated with concomitant oral naloxegol (Moventig: Kyowa Kirin, Galashiels, UK).