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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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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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Related Experiment Video

Updated: Jun 17, 2025

The Tibial Fracture-Pin Model: A Clinically Relevant Mouse Model of Orthopedic Injury
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Pain Medication and Pain Intensity Following Hip Fractures-Analyses Based on the ProFem Cohort Study.

Kathrin Jobski1, Michaela Ritschel2, Katja Pöggel-Krämer2

  • 1Department of Health Services Research, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany.

Pharmacoepidemiology and Drug Safety
|August 13, 2024
PubMed
Summary

Many proximal femoral fracture patients experience high pain levels, yet a significant portion receive inadequate pain management, including no or only as-needed medication. Improved pain treatment strategies and medication plan utilization are needed for better patient outcomes.

Keywords:
analgesichip fracturemedication planpain intensitypro re nata medication

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Determining Pain Detection and Tolerance Thresholds Using an Integrated, Multi-Modal Pain Task Battery
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Area of Science:

  • Orthopedics
  • Pharmacology
  • Geriatrics

Background:

  • Proximal femoral fractures (PFF) commonly cause significant pain.
  • Optimal pain management following PFF requires understanding current medication practices.
  • Information on analgesic agents and usage patterns (scheduled vs. PRN) post-PFF is limited.

Purpose of the Study:

  • To investigate pain medication regimens in relation to pain intensity after PFF.
  • To explore the use of medication plans among PFF patients.

Main Methods:

  • Analysis of data from the German population-based prospective "ProFem" cohort study.
  • Inclusion of 444 participants (mean age 81.2 years, 71.0% female) from baseline interviews (3 months post-PFF).
  • Data collected via health insurance records and individual surveys on medication use.

Main Results:

  • Half of participants reported high-intensity pain (mean EQ-VAS 50.8).
  • Metamizole and tilidine/naloxone were the most common analgesics.
  • Among high-pain patients, 21.9% received only PRN medication, and 17.2% received none.
  • 61.5% had a medication plan, but only 25.2% had a standardized federal plan (BMP).

Conclusions:

  • A substantial number of PFF patients experience high pain 3 months post-fracture.
  • The high prevalence of inadequate pain medication (PRN or none) suggests potential therapeutic deficits.
  • Low utilization of standardized medication plans indicates a need for improvement in care coordination.