Articles: opioid.
-
Clinical Trial
Pharmacokinetic-pharmacodynamic modelling of intravenous buprenorphine in conscious horses.
Describe the pharmacokinetics of buprenorphine and norbuprenorphine in horses and to relate the plasma buprenorphine concentration to the pharmacodynamic effects. ⋯ The suitability of the use of buprenorphine for peri-operative analgesia in the horse is supported by the present study.
-
Expert Opin Drug Metab Toxicol · Jan 2015
Unique pharmacology of tapentadol for treating acute and chronic pain.
Even though pain is a complex process involving many different mediators, enzymes, receptors and ion channels, pain medications usually address only individual targets. Nucynta, which addresses multiple pain targets, was the first new centrally acting analgesic to be approved by the FDA in 2008. ⋯ Although future improved, well-designed prospective, randomized double-blind controlled studies are needed to determine both the relative efficacy of tapentadol and its safety, we believe that tapentadol has the potential to become a uniquely suited opioid medication in the multi-modal management of moderate-to-severe acute and chronic pain conditions.
-
Indian J Palliat Care · Jan 2015
Is mechanism and symptom-based analgesia an answer to opioid-induced hyperalgesia?
"Cancer Pain" and "Pain in cancer patient" are not synonymous. Opioid-induced Hyperalgesia (OIH) is a paradoxical state of nociceptive sensitization caused by exposure to opioids. Neuropathic pain is only partially responsive to opioids; injudicious increase in dose of opioids in neuropathic pain may not only result in inadequate pain relief but also OIH. ⋯ We describe the development and successful treatment of OIH in a 55-year-old male patient with Small cell Carcinoma Lung. Opioid tapering, rotation, systemic desensitization helps in combatting OIH. The use of anti-neuropathic adjuvant analgesics helps not only in preventing and treating OIH but also in understanding putative mechanisms underlying neuropathic pain and OIH.
-
Am J Drug Alcohol Abuse · Jan 2015
Methadone versus buprenorphine for the treatment of opioid abuse in pregnancy: science and stigma.
The past decade has seen an increase in rates of opioid abuse during pregnancy. This clinical challenge has been met with debate regarding whether or not illicit and prescription opioid-dependent individuals require different treatment approaches; whether detoxification is preferable to maintenance; and the efficacy of methadone versus buprenorphine as treatment options during pregnancy. The clinical recommendations resulting from these discussions are frequently influenced by the comparative stigma attached to heroin abuse and methadone maintenance versus prescription opioid abuse and maintenance treatment with buprenorphine. ⋯ Both methadone and buprenorphine are important treatment options for opioid abuse during pregnancy. Methadone may still remain the preferred treatment choice for some women who require higher doses for stabilization, have a higher risk of treatment discontinuation, or who have had unsuccessful treatment attempts with buprenorphine. As treatment providers, we should advocate to expand available treatment options for pregnant women in all States.
-
J Subst Abuse Treat · Jan 2015
Recent trends in treatment admissions for prescription opioid abuse during pregnancy.
Prescription opioid abuse is a significant and costly public health problem among pregnant women in the United States. We investigated recent trends in substance abuse treatment admissions for prescription opioids during pregnancy using the Treatment Episodes Data Set. ⋯ About a third received medication assisted therapy despite this being the standard of care for opioid abuse in pregnancy. While substance abuse treatment centers have increased treatment volume to address the increase in prescription opioid dependence among pregnant women, targeting certain risk groups and increasing utilization of medication assisted therapy should be emphasized.