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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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Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
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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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Analgesia and Pain Management01:25

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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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Updated: Jun 5, 2025

An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
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Evaluation of a mobile application to decrease opioid misuse in patients undergoing cesarean section: a randomized

Annabelle Abdo1, Mariel O'Connor2, Jessica Kelley Morgan3

  • 1Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA. annabelle.abdo@gmail.com.

BMC Pregnancy and Childbirth
|December 5, 2024
PubMed
Summary
This summary is machine-generated.

A mobile app significantly reduced opioid misuse in women after cesarean section. The CPMRx app lowered misuse odds by 92%, highlighting technology's role in combating the opioid epidemic.

Keywords:
Cesarean sectionObstetricsOpioid misusePrescriptionPrimary preventionSubstance use

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Area of Science:

  • Medical Informatics
  • Public Health
  • Pharmacology

Background:

  • Opioid misuse and addiction present a significant public health challenge in the US.
  • Postoperative opioid prescribing practices, particularly after cesarean sections, are often inconsistent and excessive.
  • Technological interventions, like mobile applications, show promise in mitigating opioid use and misuse.

Purpose of the Study:

  • To evaluate the preliminary impact of the Continuing Precision Medicine (CPM) mobile application on reducing opioid pain medication use in women undergoing cesarean section.
  • To assess the primary outcome of morphine milligram equivalents (MME) and secondary outcomes including dosage delay, usage reduction, and pain scores.

Main Methods:

  • Patients undergoing cesarean section were randomized into a control group or an experimental group using the CPMRx mobile app.
  • Logistic regression and log-binomial regression analyses were employed to predict and estimate the odds and relative risk of opioid misuse by group.
  • The study involved two phases, assessing eligibility and participation of patients undergoing cesarean section.

Main Results:

  • The CPMRx group demonstrated a significant 92% reduction in the odds of opioid misuse compared to the control group (OR=0.08, p=0.03).
  • Patients in the control group faced a 7-fold higher risk of opioid misuse compared to those using the CPMRx app (RR=7.00, p=0.05).
  • Among non-misusing participants in Phase I, the average opioid pill usage was 2.7, with 50% using 1 or fewer pills.

Conclusions:

  • The CPMRx mobile application was associated with a lower likelihood of opioid misuse in the postoperative period following cesarean section.
  • A standardized prescription of 7 tablets of 5mg oxycodone may be more appropriate for this patient subgroup.
  • Systematic adjustment of prescription quantities, including for specific patient groups, can reduce opioid misuse risks and public health burdens.