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Related Concept Videos

Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

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Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
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Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
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Prescription drugs require a prescription from a medical practitioner and can only be obtained from a pharmacy. They have many applications, including treating pain, anxiety, and hypertension.
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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
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In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
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Opioid stewardship in pediatric surgery: Approaching zero.

Thais Calderon1, Elizabeth Hedges2, Michael H Livingston3

  • 1University of Rochester School of Medicine and Dentistry, Rochester, NY.

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PubMed
Summary

Most children achieve adequate pain control after surgery with non-opioid medications. This study suggests limiting opioid prescriptions at discharge can reduce community opioid use while maintaining patient comfort.

Keywords:
AnalgesicsGeneral surgeryNarcoticsOpioid epidemicPain managementPediatricStewardship

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Area of Science:

  • Pediatric Surgery
  • Pain Management
  • Public Health

Background:

  • The opioid epidemic necessitates reduced opioid prescribing.
  • Hypothesis: Adequate pain control is achievable post-pediatric surgery with minimal discharge opioid prescriptions.

Purpose of the Study:

  • To evaluate the efficacy of non-opioid pain management post-pediatric surgery.
  • To assess the impact of limited opioid discharge prescriptions on pain control and patient outcomes.

Main Methods:

  • Retrospective cohort study of pediatric patients (0-15 years) undergoing surgery.
  • Data collected on opioid prescriptions, emergency department visits, and readmissions.
  • Postoperative pain assessed via phone calls within three days of discharge.

Main Results:

  • 352 patients (394 procedures) reviewed; only 3 received opioid discharge prescriptions.
  • No pain-related readmissions; one emergency department visit for pain.
  • Most patients reported low pain scores (59% reported 0, 27% reported 1-3).
  • Higher pain scores correlated with increased age; hernia repair patients reported low pain.

Conclusions:

  • Non-opioid medications effectively manage pain for most pediatric surgical patients at discharge.
  • A small subset may benefit from limited opioid analgesia.
  • This approach can significantly decrease community opioid prevalence.