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Related Concept Videos

Analgesia and Pain Management01:25

Analgesia and Pain Management

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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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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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Opioid Receptors: Overview01:22

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Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2,...
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Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
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Pain01:20

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Pain serves as a critical warning signal that alerts the body to potential or actual harm. When mechanical pressure on the skin is intense, such as from a sharp pinch, the sensation transitions from touch to pain. Similarly, extreme temperatures, like a hot pot handle, convert the sensation of heat into pain. Pain can also result from overstimulation of other senses, such as blinding light, loud noise, or the intense heat from habañero peppers. This ability to sense pain is essential for...
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Acute Pain Management in People With Opioid Use Disorder : A Systematic Review.

Michele J Buonora1, Katherine Mackey2, Laila Khalid3

  • 1National Clinician Scholars Program, Yale School of Medicine, New Haven, Connecticut; Section of General Internal Medicine, Department of Medicine, Yale School of Medicine, New Haven, Connecticut; General Internal Medicine, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut; Montefiore Medical Center, Division of General Internal Medicine, Bronx, New York; and Albert Einstein College of Medicine, Division of General Internal Medicine, Bronx, New York (M.J.B.).

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Evidence suggests continuing buprenorphine for acute pain in opioid use disorder (OUD) may improve outcomes. Further research is needed on interventions and their effects on OUD.

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Area of Science:

  • Pain Management
  • Addiction Medicine
  • Evidence Synthesis

Background:

  • Limited guidance exists for managing acute pain in individuals with opioid use disorder (OUD).
  • This review synthesizes current evidence on pain interventions for OUD patients.

Purpose of the Study:

  • To evaluate the benefits and harms of acute pain interventions in people with opioid use disorder (OUD).
  • To identify effective pain management strategies for OUD patient populations.

Main Methods:

  • Comprehensive literature search across 12 major databases up to July 2024.
  • Included studies of any design evaluating acute pain interventions in adults with OUD.
  • Employed independent dual screening, data extraction, and quality assessment.

Main Results:

  • Seventy-seven studies (17 RCTs, 20 controlled observational, 78 uncontrolled observational) met criteria.
  • Continuing buprenorphine for acute pain may yield similar or better outcomes than discontinuation.
  • Clonidine, haloperidol/midazolam/morphine, and lidocaine show potential in specific settings.

Conclusions:

  • Overall evidence for pain outcomes in people with OUD is low.
  • Continuing buprenorphine appears beneficial for acute pain management in OUD.
  • The impact of interventions on OUD outcomes remains a significant evidence gap.