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Keywords Opioid induced respiratory dep...

Opioid induced respiratory depression

https://read.qxmd.com/read/38241153/peripheral-mu-opioid-receptor-activation-by-dermorphin-d-arg2-lys4-1-4-amide-alleviates-behavioral-and-neurobiological-aberrations-in-rat-model-of-chemotherapy-induced-neuropathic-pain
#21
JOURNAL ARTICLE
Anagha Gadepalli, Obulapathi Ummadisetty, Akhilesh, Deepak Chouhan, Krushna Eknath Yadav, Vinod Tiwari
Paclitaxel, a frequently utilized chemotherapeutic agent, often gives rise to severe and distressing sensory neuropathy in patients undergoing chemotherapy. Unfortunately, current therapeutics for chemotherapy-induced neuropathic pain (CINP) demonstrate limited effectiveness and are burdened with the potential for central side effects such as sedation, respiratory depression, cognitive impairment, and addiction, posing substantial clinical challenges. In light of these limitations, present study is designed to investigate the therapeutic potential of Dermorphin [D-Arg2, Lys4] (1-4) amide (DALDA), a preferential peripherally acting mu-opioid receptor agonist, in rat model of CINP...
January 2024: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
https://read.qxmd.com/read/38184918/role-of-continuous-pulse-oximetry-and-capnography-monitoring-in-the-prevention-of-postoperative-respiratory-failure-postoperative-opioid-induced-respiratory-depression-and-adverse-outcomes-on-hospital-wards-a-systematic-review-and-meta-analysis
#22
REVIEW
Ashish K Khanna, Akshat Banga, Joseph Rigdon, Brian N White, Christian Cuvillier, Joao Ferraz, Fredrik Olsen, Loren Hackett, Vikas Bansal, Roop Kaw
OBJECTIVE: The current standards of postoperative respiratory monitoring on medical-surgical floors involve spot-pulse oximetry checks every 4-8 h, which can miss the opportunity to detect prolonged hypoxia and acute hypercapnia. Continuous respiratory monitoring can recognize acute respiratory depression episodes; however, the existing evidence is limited. We sought to review the current evidence on the effectiveness of continuous pulse oximetry (CPOX) with and without capnography versus routine monitoring and their effectiveness for detecting postoperative respiratory failure, opioid-induced respiratory depression, and preventing downstream adverse events...
January 6, 2024: Journal of Clinical Anesthesia
https://read.qxmd.com/read/38182835/latent-neural-population-dynamics-underlying-breathing-opioid-induced-respiratory-depression-and-gasping
#23
JOURNAL ARTICLE
Nicholas Edward Bush, Jan-Marino Ramirez
Breathing is vital and must be concurrently robust and flexible. This rhythmic behavior is generated and maintained within a rostrocaudally aligned set of medullary nuclei called the ventral respiratory column (VRC). The rhythmic properties of individual VRC nuclei are well known, yet technical challenges have limited the interrogation of the entire VRC population simultaneously. Here we characterize over 15,000 medullary units using high-density electrophysiology, opto-tagging and histological reconstruction...
January 5, 2024: Nature Neuroscience
https://read.qxmd.com/read/38174010/postoperative-opioid-induced-respiratory-depression-or-oversedation-requiring-naloxone-treatment-in-a-community-hospital-a-case-series
#24
JOURNAL ARTICLE
Olivia R Newgaard, Toby N Weingarten, Juraj Sprung, Alex T Suginaka, Carmelina Gurrieri
BACKGROUND: Postoperative opioid-induced respiratory depression and oversedation can lead to fatal events and increase perioperative mortality. In reports from major academic centers, naloxone administration has been used as a proxy for severe opioid overdose. Herein, we studied the incidence, clinical characteristics, and outcomes of postoperative naloxone use in a mid-size community hospital. METHODS: This was a retrospective review of adult patients who received naloxone within 48 postoperative hours between July 9, 2017, and May 31, 2022...
2024: Proceedings of the Baylor University Medical Center
https://read.qxmd.com/read/38156970/molecular-pharmacology-profiling-of-phenylfentanil-and-its-analogues-to-understand-the-putative-involvement-of-an-adrenergic-mechanism-in-fentanyl-induced-respiratory-depression
#25
JOURNAL ARTICLE
Mengchu Li, Piyusha P Pagare, Hongguang Ma, Celsey M St Onge, Rolando E Mendez, James C Gillespie, David L Stevens, William L Dewey, Dana E Selley, Yan Zhang
While there are approved therapeutics to treat opioid overdoses, the need for treatments to reverse overdoses due to ultrapotent fentanyls remains unmet. This may be due in part to an adrenergic mechanism of fentanyls in addition to their stereotypical mu-opioid receptor (MOR) effects. Herein, we report our efforts to further understanding of the functions these distinct mechanisms impart. Employing the known MOR neutral antagonist phenylfentanil as a lead, 17 analogues were designed based on the concept of isosteric replacement...
December 29, 2023: Journal of Medicinal Chemistry
https://read.qxmd.com/read/38090026/the-effect-of-dezocine-on-the-median-effective-dose-of-sufentanil-induced-respiratory-depression-in-patients-undergoing-spinal-anesthesia-combined-with-low-dose-dexmedetomidine
#26
JOURNAL ARTICLE
Yong-Kang Gui, Xiao-Hui Zeng, Rui Xiao, Wen-Feng Xi, Dan Zhang, Yang Liu, Si-Hui Zhu, Xin Da, De-Wen Shi, Xu-Dong Hu, Guang-Hong Xu
PURPOSE: The application of sedation and analgesia in spinal anesthesia has many benefits, but the risk of respiratory depression (RD) caused by opioids cannot be ignored. We aimed to observe the effect of dezocine, a partial agonist of μ-receptor, on the median effective dose (ED50) of sufentanil-induced RD in patients undergoing spinal anesthesia combined with low-dose dexmedetomidine. PATIENTS AND METHODS: Sixty-two patients were randomly assigned to dezocine group (DS) and control group (MS)...
2023: Drug Design, Development and Therapy
https://read.qxmd.com/read/38074147/comparison-of-the-effects-of-fentanyls-and-other-%C3%AE-opioid-receptor-agonists-on-the-electrical-activity-of-respiratory-muscles-in-the-rat
#27
JOURNAL ARTICLE
Damiana Cavallo, Eamonn Kelly, Graeme Henderson, Ana Paula Abdala Sheikh
Introduction: Deaths due to overdose of fentanyls result primarily from depression of respiration. These potent opioids can also produce muscle rigidity in the diaphragm and the chest muscles, a phenomenon known as Wooden Chest Syndrome, which further limits ventilation. Methods: We have compared the depression of ventilation by fentanyl and morphine by directly measuring their ability to induce muscle rigidity using EMG recording from diaphragm and external and internal intercostal muscles, in the rat working heart-brainstem preparation...
2023: Frontiers in Pharmacology
https://read.qxmd.com/read/38054162/perioperative-ultrasound-guided-continuous-caudal-epidural-analgesia-in-newborns-a-case-series-in-a-tertiary-medical-center
#28
JOURNAL ARTICLE
Filipa Portela, Gabriela Costa, Teresa Cenicante
Background Caudal epidural anesthesia technique is a relevant method for postoperative analgesia in newborns, allowing for the reduction of drug-induced respiratory depression. The threading of a catheter is, however, uncommon in clinical practice. Our main purpose was to describe our experience regarding caudally inserted epidural catheters in neonates undergoing major abdominal surgery. Methods We included every full-term neonate undergoing surgery under combined caudal epidural-general anesthesia from 2017 to 2022 in our institution...
November 2023: Curēus
https://read.qxmd.com/read/38052779/investigation-of-monoclonal-antibody-csx-1004-for-fentanyl-overdose
#29
JOURNAL ARTICLE
Paul T Bremer, Emily L Burke, Andrew C Barrett, Rajeev I Desai
The opioid crisis in the United States is primarily driven by the highly potent synthetic opioid fentanyl leading to >70,000 overdose deaths annually; thus, new therapies for fentanyl overdose are urgently needed. Here, we present the first clinic-ready, fully human monoclonal antibody CSX-1004 with picomolar affinity for fentanyl and related analogs. In mice CSX-1004 reverses fentanyl antinociception and the intractable respiratory depression caused by the ultrapotent opioid carfentanil. Moreover, toxicokinetic evaluation in a repeat-dose rat study and human tissue cross-reactivity study reveals a favorable pharmacokinetic profile of CSX-1004 with no safety-related issues...
December 5, 2023: Nature Communications
https://read.qxmd.com/read/38032491/strong-opioids-induced-cardiac-neurologic-and-respiratory-disorders-a-real-world-study-from-2004-to-2023-based-on-faers
#30
JOURNAL ARTICLE
Maosha Dai, Xiaoke Dou, Min Chen, Juexi Yang, Junhao Long, Yun Lin
Opioids are mainly used as adjuncts to the induction and maintenance of general anesthesia, postoperative analgesia, and treating moderate to severe cancer pain and chronic pain. However, the hazards of these drugs to various organ organs still need to be further explored. This study used the US FDA Adverse Event Reporting System (FAERS) database to determine whether commonly receiving opioids was higher than the baseline risk for all other medications. FAERS was asked about adverse events (AEs) for the opioids "morphine," "fentanyl," "oxycodone," "hydromorphone," "sufentanil," and "remifentanil" from the first quarter of 2004 (2004Q1) through the second quarter of 2023 (2023Q2)...
November 30, 2023: Naunyn-Schmiedeberg's Archives of Pharmacology
https://read.qxmd.com/read/37938943/a-wearable-device-towards-automatic-detection-and-treatment-of-opioid-overdose
#31
JOURNAL ARTICLE
Juan C Mesa, Michael D MacLean, Maria Ms, Alan Nguyen, Rujuta Patel, Timothy Diemer, Jongcheon Lim, Chi Hwan Lee, Hyowon Lee
Opioid-induced overdose is one of the leading causes of death among the US population under the age of 50. In 2021 alone, the death toll among opioid users rose to a devastating number of over 80,000. The overdose process can be reversed by the administration of naloxone, an opioid antagonist that rapidly counteracts the effects of opioid-induced respiratory depression. The idea of a closed-loop opioid overdose detection and naloxone delivery has emerged as a potential engineered solution to mitigate the deadly effects of the opioid epidemic...
November 8, 2023: IEEE Transactions on Biomedical Circuits and Systems
https://read.qxmd.com/read/37927032/opioids-and-the-kidney-a-compendium
#32
JOURNAL ARTICLE
Steven Didik, Daria Golosova, Biyang Xu, Alexander Staruschenko
Opioids are a class of medications used in pain management. Unfortunately, long-term use, overprescription, and illicit opioid use have led to one of the greatest threats to mankind: the opioid crisis. Accompanying the classical analgesic properties of opioids, opioids produce a myriad of effects, including euphoria, immunosuppression, respiratory depression, and organ damage. It is essential to ascertain the physiological role of the opioid/opioid receptor axis to gain an in-depth understanding of the effects of opioid use...
November 6, 2023: Kidney360
https://read.qxmd.com/read/37890984/-clinical-emergencies-in-inpatient-hospice-simulation-based-training-to-improve-nursing-confidence
#33
JOURNAL ARTICLE
Amy Jane Thompson, Amy Charlotte Boswell, Tricia Evans, Beverley Clarke
OBJECTIVES: This study aims to assess whether a simulation-based training programme focusing on palliative care emergencies conducted in a hospice setting could improve the self-reported confidence and competence of nursing staff. METHODS: A training programme was developed to enable nursing professionals to practice clinical skills necessary for recognising and managing palliative care emergencies including opioid induced respiratory depression, catastrophic haemorrhage, anaphylaxis, seizure and acute airway obstruction...
October 27, 2023: BMJ Supportive & Palliative Care
https://read.qxmd.com/read/37886350/role-of-mu-opioid-receptor-mor-agonist-efficacy-as-a-determinant-of-opioid-antinociception-in-a-novel-assay-of-pain-depressed-behavior-in-female-and-male-mice
#34
JOURNAL ARTICLE
S Stevens Negus, Hamid I Akbarali, Minho Kang, Young K Lee, Samuel A Marsh, Edna J Santos, Yan Zhang
INTRODUCTION: Intermediate efficacy mu opioid receptor (MOR) agonists have potential to retain analgesic effectiveness while improving safety, but the optimal MOR efficacy for effective and safe opioid analgesia is unknown. Preclinical assays of pain-depressed behavior can assess effects of opioids and other candidate analgesics on pain-related behavioral depression, which is a common manifestation of clinically relevant pain and target of pain treatment. Accordingly, the present study goal was to validate a novel assay of pain-depressed locomotor behavior in mice and evaluate the role of MOR efficacy as a determinant of opioid analgesic effects and related safety measures...
2023: Front Pain Res (Lausanne)
https://read.qxmd.com/read/37885800/effects-of-sub-lethal-doses-of-fentanyl-on-vital-physiologic-functions-and-withdrawal-like-behaviors-in-adult-goats
#35
JOURNAL ARTICLE
Suzanne E Neumueller, Nicole Buiter, Grace Hilbert, Kirstyn Grams, Reiauna Taylor, John Desalvo, Grace L Hodges, Madeline M Hodges, Lawrence G Pan, Stephen J Lewis, Hubert V Forster, Matthew R Hodges
Synthetic opioids like fentanyl have improved the standard of care for many patients in the clinical setting, but their abuse leads to tens of thousands of overdose deaths annually. The current opioid epidemic underscores a critical need for insights into the physiological effects of fentanyl on vital functions. High doses of opioids in small mammals cause opioid-induced respiratory depression (OIRD) leading to hypoventilation, hypoxemia, and hypercapnia. In addition, opioids can also increase the alveolar to arterial oxygen (A-a) gradient and airway dysfunction...
2023: Frontiers in Physiology
https://read.qxmd.com/read/37838390/systems-of-care-delivery-and-optimization-in-the-postoperative-care-wards
#36
REVIEW
Connor Snarskis, Arna Banerjee, Andrew Franklin, Liza Weavind
A third of all patients are at risk for a serious adverse event, including death, in the first month after undergoing a major surgery. Most of these events will occur within 24 hours of the operation but are unlikely to occur in the operating room or postanesthesia care unit. Most opioid-induced respiratory depression events in the postoperative period resulted in death (55%) or anoxic brain injury (22%). A future state of mature artificial intelligence and machine learning will improve situational awareness of acute clinical deterioration, minimize alert fatigue, and facilitate early intervention to minimize poor outcomes...
December 2023: Anesthesiology Clinics
https://read.qxmd.com/read/37820929/intravenous-ketamine-for-pain-control-in-first-trimester-surgical-abortion-interim-analysis-of-a-randomized-controlled-trial
#37
JOURNAL ARTICLE
Taylor Nelles-McGee, Ashley Waddington, Jessica Pudwell, Irene Zouros, Sophie M E Gibson
OBJECTIVES: Surgical abortion is common, with most completed in the first trimester. Gold standard pain control is intravenous (IV) fentanyl and midazolam, requiring continuous cardio-respiratory monitoring, a potential challenge where this monitoring is unavailable. Ketamine is a sedative and analgesic without the cardio-respiratory depression risk associated with IV opioids, representing a potential alternative. Investigating non-opiate pain control methods is imperative given the context of the opioid crisis...
October 10, 2023: Journal of Obstetrics and Gynaecology Canada: JOGC
https://read.qxmd.com/read/37795596/pharmacology-of-viable-mechanism-agnostic-respiratory-stimulants-for-the-reversal-of-drug-induced-respiratory-depression-in-humans
#38
REVIEW
Maarten van Lemmen, Rutger van der Schrier, Albert Dahan, Monique van Velzen, Elise Sarton, Marieke Niesters
INTRODUCTION: Drug-induced respiratory depression is potentially fatal and can be caused by various drugs such as synthetic opioids and tranquilizers. The only class of respiratory depressants that has a specific reversal agent are opioids, such as naloxone. These reversal agents have limited utility in situations of polysubstance ingestion with agents from multiple respiratory depressant classes. Hence, there is an unmet need for drugs that stimulate breathing irrespective of the underlying cause of respiratory depression, i...
October 5, 2023: Expert Opinion on Drug Metabolism & Toxicology
https://read.qxmd.com/read/37795030/fentanyl-induced-reward-seeking-is-sex-and-dose-dependent-and-is-prevented-by-d-cysteine-ethylester
#39
JOURNAL ARTICLE
Zackery T Knauss, Caden J Hearn, Nathan C Hendryx, Fanan S Aboalrob, Yazmin Mueller-Figueroa, Derek S Damron, Stephen J Lewis, Devin Mueller
Introduction: Despite their inclination to induce tolerance, addictive states, and respiratory depression, synthetic opioids are among the most effective clinically administered drugs to treat severe acute/chronic pain and induce surgical anesthesia. Current medical interventions for opioid-induced respiratory depression (OIRD), wooden chest syndrome, and opioid use disorder (OUD) show limited efficacy and are marked by low success in the face of highly potent synthetic opioids such as fentanyl. D-Cysteine ethylester (D-CYSee) prevents OIRD and post-treatment withdrawal in male/female rats and mice with minimal effect on analgesic status...
2023: Frontiers in Pharmacology
https://read.qxmd.com/read/37794334/incidence-of-postoperative-opioid-induced-respiratory-depression-episodes-in-patients-on-room-air-or-supplemental-oxygen-a-post-hoc-analysis-of-the-prodigy-trial
#40
JOURNAL ARTICLE
Anthony G Doufas, Mariana L Laporta, C Noelle Driver, Fabio Di Piazza, Marco Scardapane, Sergio D Bergese, Richard D Urman, Ashish K Khanna, Toby N Weingarten
BACKGROUND: Supplemental oxygen (SO) potentiates opioid-induced respiratory depression (OIRD) in experiments on healthy volunteers. Our objective was to examine the relationship between SO and OIRD in patients on surgical units. METHODS: This post-hoc analysis utilized a portion of the observational PRediction of Opioid-induced respiratory Depression In patients monitored by capnoGraphY (PRODIGY) trial dataset (202 patients, two trial sites), which involved blinded continuous pulse oximetry and capnography monitoring of postsurgical patients on surgical units...
October 4, 2023: BMC Anesthesiology
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