Journal of opioid management
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Randomized Controlled Trial Multicenter Study
Analgesic and adverse effects of a fixed-ratio morphine-oxycodone combination (MoxDuo) in the treatment of postoperative pain.
To compare efficacy and safety profiles of an immediate-release morphine and oxycodone Dual-Opioid combination (MoxDuo) versus its individual components and versus its morphine-equivalent doses in moderate to severe postoperative pain patients. ⋯ MoxDuo produced superior analgesic effects when compared with its individual components, but comparable efficacy when compared with its morphine-equivalent doses. Common AEs were reduced at least 50 percent with MoxDuo when compared with its morphine-equivalent doses. MoxDuo may be an improved intervention in the management of moderate to severe acute pain.
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Review
Current status and evolving role of abuse-deterrent opioids in managing patients with chronic pain.
Opioids are widely used for the treatment of patients with chronic pain; yet, the increase in their abuse, misuse, and diversion is an ongoing focus of regulatory, governmental, and legal scrutiny. As a consequence, clinicians are faced with numerous challenges in an effort to use opioids in appropriate patients with pain while minimizing the potential for opioid abuse, misuse, and diversion. Policies and programs such as state prescription monitoring programs, which have been in existence for decades, are but one attempt to address some of the issues regarding the prescribing of opioids. ⋯ This approach can also include the use of abuse-deterrent and abuse-resistant formulations designed to reduce the nonmedical use of opioids. Several of these opioid formulations have been approved or should soon be on the market for use in the United States; however, their role and other questions regarding their use remain unanswered. The authors offer their clinical perspective on several of these key questions.
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Pain is a common complaint among emergency medical services patients. When compared with the most commonly used morphine, fentanyl has a shorter onset of action, shorter duration, and far fewer side effects making it an appealing candidate for prehospital pain management. This study's intent is to prospectively assess the feasibility and safety of fentanyl for pain in prehospital patients in comparison with morphine. ⋯ Fentanyl can be used safely and effectively for pain control in the prehospital setting.
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Oxycodone immediate-release, alone or in combination (hereafter, oxycodone), is widely used to treat pain and is often associated with bothersome side effects. The objective was to assess side effect frequency, degree of bother, and impact on health-related quality of life (HRQoL). ⋯ The majority of survey respondents experienced side effects of oxycodone, with a majority being bothered by side effects and impacting their QoL. This raises a question about the unmet need for pain medications with improved side effect profiles.