tilidine / Aoxing - LARVOL DELTA

Basic knowledge of drug pain therapy in the palliative situation (PubMed, Dtsch Med Wochenschr) - "Among all opioids are Tilidine and Tramadol prodrugs, which only relieve pain after activation in the liver. Transdermal opioid applications are recommended in case of swallowing disorders, but usually not to initiate pain control. An opioid change can be performed if side effects such as hallucinations for the selected opioid are more pronounced than the pain reduction."

Journal • Review • Neuralgia • Oncology • Otorhinolaryngology • Pain

Effect of transversus abdominis plane blocks in abdominoplasties on postoperative outcomes. (PubMed, BJS Open) - "Use of the transversus abdominis plane block in patients who had an abdominoplasty was associated with improved postoperative outcomes, highlighting its potential as an effective pain management strategy and supporting its broader clinical application."

Journal • Aesthetic Medicine • Pain

Opioid prescriptions for insured individuals without cancer in Germany: data from the BARMER (PubMed, Schmerz) - "Opioid therapy for non-cancer-related pain is predominantly carried out by general practitioners in older and multi-morbid patients. The indication for or against opioid therapy requires shared decision-making with patients and, if necessary, their relatives, as well as a review of possible drug interactions."

Journal • Oncology • Pain

Studying drug excretion into exhaled breath aerosol - A workflow based on an impaction sampling device and LC-HRMS/MS analysis. (PubMed, Anal Chim Acta) - "The procedure was finally used to analyze a total of 31 patient EB samples and demonstrated that e.g., tilidine and its metabolite nortilidine as well as tramadol and its active metabolite O-desmethyltramadol can be detected in EB aerosol. The work shows a comprehensive workflow for elucidating drug excretion into exhaled breath aerosol. This bioanalytical strategy and the corresponding novel data from this study are the foundation for further method development and to better understand, which drugs and their metabolites can be addressed by exhaled breath aerosol bioanalysis."

Journal • Pain

Pain Medication and Pain Intensity Following Hip Fractures-Analyses Based on the ProFem Cohort Study. (PubMed, Pharmacoepidemiol Drug Saf) - "As a substantial number of patients reports high intensity pain about 3 months following a PFF, the large proportion of those receiving no or only PRN pain medication raises questions regarding the appropriateness of the therapy. The overall low utilization of the BMP indicates potential for improvement."

Journal • Musculoskeletal Diseases • Orthopedics • Pain

Intoxications involving methoxyacetylfentanyl and U-47700: a study of 3 polydrug fatalities. (PubMed, Int J Legal Med) - "NSOs include fentanyl-related compounds, e.g. methoxyacetylfentanyl (MeACF), and non-fentanyl analogs, e.g. "U compounds" including U-47700...A toxicological significance score (TSS), weighing the role of the NSO in each death case, was assigned.Case 1 died at the hospital after consumption of U-47700, methadone (serum levels: 2,600 ng/ml and 37 ng/ml), tilidine and benzodiazepines. In case 2, U-47700 (204 ng/ml) together with methadone (290 ng/ml), flubromazepam (480 ng/ml) and diazepam (300 ng/ml) were detected in peripheral blood. In case 3, methoxyacetylfentanyl (266 ng/ml), furanylfentanyl (4.3 ng/ml) 4-ANPP (15 ng/ml) and alprazolam (69 ng/ml) were quantified in femoral blood. In all cases, the NSO likely contributed to the death (TSS = 3).NSOs appear to be often consumed in the setting of polydrug intoxications, especially in combination with other opioids and benzodiazepines, which often exert..."

Journal

Matrix Effects of Urine Marker Substances in LC-MS/MS Analysis of Drug of Abuse. (PubMed, Ther Drug Monit) - "Matrix effects were observed for drugs with approximately the same retention times as the individual PEGs. The influence of the different workup methods was not as clear, which may be because of the similar solubilities of the PEGs and some analytes. At low PEG concentrations, the matrix effect was always below 60%, except for nortilidine. All the drugs were detectable. The effect on quantification was less than 15% for substances with deuterated analytes as internal standards and less than 32% for analytes without their own internal standards."

Journal • CNS Disorders

Global, regional, and national consumption of controlled opioids: a cross-sectional study of 214 countries and non-metropolitan territories. (PubMed, Br J Pain) - "Oxycodone (35%) was the most heavily consumed controlled opioid globally, followed by morphine (15.9%), methadone (15.8%) and tilidine (14%). Large disparities persist in most of the world in accessing essential opioid medicines. Consumption patterns should continue to be monitored, and collaborative strategies should be developed to promote access and the appropriate prescribing of opioids in all countries and non-metropolitan territories."

Journal • Observational data • Anesthesia • Cough • Oncology • Pain • Palliative care • Respiratory Diseases

Tilidine and dipyrone (metamizole) in cold pressor pain: A pooled analysis of efficacy, tolerability, and safety in healthy volunteers. (PubMed, Clin Transl Sci) - "These results indicate that the combination of dipyrone and the CPT provides a safe, tolerable, and effective experimental model for the study of pharmacological analgesia. In combination with a CPT, dipyrone may be useful as a positive control, or baseline medication for the study of analgesic modulation."

Journal • Retrospective data • Pain

Dataset of the first report of pharmacogenomics profiling in an outpatient spine setting. (PubMed, Data Brief) - "These medications included both non-opioid analgesics (i.e., aspirin, diclofenac, nabumetone, indomethacin, meloxicam, piroxicam, tenoxicam, lornoxicam, celecoxib, ibuprofen, flurbiprofen, ketoprofen, fenoprofen, naproxen, and mefenamic acid) and opioid analgesics (i.e., morphine, codeine, dihydrocodeine, ethylmorphine, hydrocodone, hydromorphone, oxycodone, oxymorphone, alfentanil, fentanyl, sufentanil, meperidine, ketobemidone, dextropropoxyphene, levacetylmethadol, loperamide, methadone, buprenorphine, dextromethorphan, tramadol, tapentadol, and tilidine). In supplemental spreadsheets, the raw and analysed pharmacogenomics data for all 30 patients evaluated in the primary research article are additionally provided. Collectively, the presented data offer significant reuse potential in future investigations of pharmacogenomics for pain management."

Biomarker • Clinical • Journal • Back Pain • Musculoskeletal Pain • Orthopedics • Pain • CYP1A2 • CYP2C19 • CYP2C9 • CYP3A4 • CYP3A5

Opioid painkiller dependence in a sample of elderly medical inpatients. (PubMed, Psychogeriatrics) - "Further research is warranted, to better understand the possible risk factors of prescription drug misuse, abuse, and addiction in this vulnerable population. Clinicians should be updated and informed regarding both prescription medication misuse potential and safe prescribing practices in the elderly."

Clinical • Journal • Addiction (Opioid and Alcohol) • CNS Disorders • Pain • Psychiatry

Barriers to adequate analgesia in paediatric burns patients. (PubMed, S Afr Med J) - "Burn-injured children commonly receive inadequate analgesia in our setting. The reasons for this are multifactorial. The correct dose and the correct drugs for burn-related background pain are deficits in the knowledge of doctors who deal with this common problem. Furthermore, even if the correct drug and dose are prescribed, the correct volume of medication is often not issued by the pharmacy. This study highlights barriers to achieving adequate analgesia in children with burns being managed as outpatients. Potential strategies to overcome barriers include improving education with regard to pain management and burns at an undergraduate and postgraduate level, and improved supply chain management."

Clinical • Journal • Complement-mediated Rare Disorders • Pain • Pediatrics • Thermal Injury

Basic Knowledge of Drug Pain Therapy in the Palliative Situation (PubMed, Dtsch Med Wochenschr) - "Among all opioids are tilidine and tramadol prodrugs, which only relieve pain after activation in the liver...Transdermal opioid applications are recommended for swallowing disorders, but usually not to initiate pain control. An opioid switch can be performed if side effects such as hallucinations for the selected opioid are more pronounced than the pain reduction."

Journal • Neuralgia • Oncology • Pain

An audit of paediatric pain prevalence, intensity, and treatment at a South African tertiary hospital. (PubMed, Pain Rep) - "Pharmacological treatments included WHO step 1 (paracetamol and ibuprofen) and step 2 (tramadol, tilidine, and morphine) analgesics...There is an urgent need for pain education and development of guidelines and protocols, to achieve better pain outcomes for children. This audit will be repeated as part of a quality-improvement initiative."

Clinical • Journal

Post-mortem analysis of prescription opioids-A follow-up examination by LC-MS/MS with focus on fentanyl. (PubMed, Forensic Sci Int) - "Detection rates in DRD, however, increased for fentanyl 3.4-fold from 1.2% to 4.1%, buprenorphine from 5.9% to 7.6%, oxycodone from 0% to 1.8%, tilidine from 1.8% to 2.4%. The most frequently detected opioids in DRD cases were methadone (39.4%) and heroin (20%)... Despite the global problem of opioid abuse, there are significant regional differences in the nature and extent of opioid abuse. It is necessary to collect data at the national level to develop appropriate prevention strategies."

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