Articles: opioid.
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To evaluate the degree of knowledge about pain management and opioids use by professionals working at three pediatric units. ⋯ Problems in the processes of pain identification, measurement, and treatment have been found. Results suggest that there is a need for both an investment in continuing education of professionals and the development of protocols to optimize the analgesic therapy, thus preventing increased child suffering.
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Phys Med Rehabil Clin N Am · May 2014
ReviewOpioid syndrome: failed opioid therapy for chronic noncancer pain.
Treatment of chronic noncancer pain (CNCP) with high-dose opioids (HDOs) has burgeoned over the past 2 decades in the United States. Characteristic domains and features of the failed CNCP management patient using long-term HDOs are described herein as the/an opioid syndrome (Schreiber AL, personal communication. 2013). Reversing or even modulating HDO use in patients with CNCP requires a paradigm shift on the part of physician, patient, and the societal "quick fix" medical culture. This review offers measures, agents, and strategies to consider in management of this pervasive, erosive medical and societal challenge.
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Clin. Exp. Pharmacol. Physiol. · May 2014
GABAA receptors are involved in the analgesic effects of morphine microinjected into the central nucleus of the amygdala.
The central nucleus of the amygdala (CeA) has an important role in pain perception and analgesia. Opioid and GABAA receptors, which are both involved in pain modulation, are found in high concentration in the CeA. The present study was designed to examine the interaction of opioidergic and GABAergic systems in the CeA during modulation of acute thermal pain. ⋯ The results revealed that microinjection of morphine into the CeA significantly increased TFL in a dose-dependent manner. Microinjection of bicuculline or muscimol in combination with morphine into the CeA increased and decreased TFL, respectively. It seems that morphine in the CeA facilitates the function of descending inhibitory systems by interacting with the activity of local GABAA receptors.
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Deaths related to opioid overdose have increased in the past decade. Community-based pharmacy practitioners have worked toward overcoming logistic and cultural barriers to make naloxone distribution for overdose prevention a standard and accepted practice. ⋯ Outpatient administration of intramuscular and intranasal naloxone represents a means of preventing opioid-related deaths. Pharmacists can play a vital role in contacting providers, provision of products, education of patients and providers, and dissemination of information throughout the community. Preventing opioid overdose-related deaths should become a major focus of the pharmacy profession.
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Comparative Study
Evaluation of the resistance of a geopolymer-based drug delivery system to tampering.
Tamper-resistance is an important property of controlled-release formulations of opioid drugs. Tamper-resistant formulations aim to increase the degree of effort required to override the controlled release of the drug molecules from extended-release formulations for the purpose of non-medical use. In this study, the resistance of a geopolymer-based formulation to tampering was evaluated by comparing it with a commercial controlled-release tablet using several methods commonly used by drug abusers. ⋯ Moreover, in the drug-release test, the geopolymer-based formulation maintained its controlled-release characteristics after milling, while the drug was released immediately from the milled commercial tablets, potentially resulting in dose dumping. Although the tampering methods used in this study does not cover all methods that abuser could access, the results obtained by the described methods showed that the geopolymer matrix increased the degree of effort required to override the controlled release of the drug, suggesting that the formulation has improved resistance to some common drug-abuse tampering methods. The geopolymer matrix has the potential to make the opioid product less accessible and attractive to non-medical users.