Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Narcotics”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 307 records · Page 17Linked to original sources
PubMed1989

Nursing management of patients receiving epidural narcotics.

Epidural analgesia is an important intervention in patients with pain after surgery. This article presents a brief overview of the anatomy of the epidural space and the physiology of pain transmission, including the action of narcotics in pain relief. The importance of written nursing protocols and in-service education for nursing staff members is discussed as being a necessary prerequisite for the safe use of epidural analgesia. A flow diagram with rationale illustrates the epidural injection technique. Nursing care of patients receiving epidural narcotics is detailed. The discussion emphasizes the management of potential side effects from epidural narcotics (respiratory depression, urinary retention, pruritus, pain on injection, dizziness, nausea, and vomiting) and includes information on the use of a narcotic antagonist. Recommendations are made for preoperative and postoperative teaching of the patient and family. A variety of tools for assessing patients' pain levels are described, and a comprehensive nursing care plan with nursing diagnoses and nursing interventions is provided.

Analgesia, Epidural↗
PubMed1978

Antagonism by naloxone of narcotic-induced respiratory depression and analgesia.

Receptor mechanisms for narcotic-induced respiratory depression and analgesia were compared by apparent pA2 values of morphine-naloxone, levorphanol-naloxone and pentazocine-naloxone. The similarity of apparent pA2 values of the three compunds for respiratory depression suggests that morphine, levorphanol and pentazocine may interact with similar receptors to produce this effect. Significant differences between apparent pA2 values of pentazocine-naloxone and morphine-naloxone or levor-phanol-naloxone for analgesia suggest, as previously shown, that narcotic and narcotic-antagonist analgesics appear to interact with receptors in different manners. Significant differences between apparent pA2 values for respiratory depression and analgesia suggest that these two effects of the narcotic drugs are mediated by different receptor interactions.

Analgesics, Opioid↗
PubMed1986

The assessment of risks, benefits and availability of non-narcotic analgesics. A commonsense approach.

In Indonesia, about 50% of all available non-narcotic analgesics are marketed as single drugs and the other half comprise fixed combination products. Each country should decide through a national drug policy which drugs are to be available, but it is important such policies be flexible and cognisant of the needs of the public and of the pharmaceutical industry. A drug should not be withdrawn from the market without an objective scientific assessment of its benefit-risk ratio. However, reevaluation of some drugs marketed previously should be undertaken, including combinations of non-narcotic analgesics. Although it is often said that evaluation of drugs should be left to experts in the established drug control agencies and that the third world countries should follow their decisions, there is a good argument for the developing countries to formulate and implement their own drug policies. In evaluating a non-narcotic analgesic, efficacy and safety must be carefully considered and a drug with marginal efficacy should not be approved for use. However, a non-narcotic analgesic with superior efficacy should probably be approved for use even if there is some risk associated with usual therapeutic dosages. Commonsense reasoning demands that drugs should be for the layperson to treat common ailments, although such drugs must fulfil exacting criteria of efficacy, safety and simplicity of use.

Analgesics↗
PubMed1983

Narcotic dosage and central nervous system opiate receptor binding.

Increasing doses of lofentanil (0, 0.08, 0.16, 0.31, 0.63, 1.25, 2.50, 5.00, and 10.0 micrograms/kg), a potent long-acting narcotic, were administered intravenously to rats to examine the relationship among narcotic dosage, degree of analgesia (inhibition of tail withdrawal reflex), anesthesia (no response to bone-crush injury), and central nervous system (CNS) opiate-receptor occupancy (inhibition of [3H] sufentanil binding). Our results demonstrate that increasing doses of lofentanil produce increasing analgesia and anesthesia and eventually complete opiate receptor occupancy. Analgesia occurs with doses of lofentanil (0.31 micrograms/kg) that result in levels of CNS opiate-receptor binding too low to be measured and anesthesia occurs with doses of lofentanil (1.25 micrograms/kg) that produce occupancy of about 25% of the available opiate receptors in subcortical areas and cortex. These findings in rats cannot be applied to narcotic usage in humans, but the data do indicate that in rats a dose eight times the anesthetic dose of lofentanil is needed to saturate virtually all available CNS opiate receptors (10.0 micrograms/kg). Whether saturation of most or all available CNS opiate receptors during narcotic anesthesia is of clinical importance remains to be determined.

Analgesia↗
PubMed1977

Some observations concerning blood morphine concentrations in narcotic addicts.

Blood samples from deceased narcotic addicts were analyzed for morphine, and the results form persons who died from narcotic addiction were compared with those from homicide victims. In most instances morphine was detectable in both types of death, and usually the values obtained were less than 30 microgram/dl. Narcotic addiction deaths involving only morphine, or morphine plus a combination of ethanol, quinine, or diazepam (Valium), were also evaluated. In some cases high quantities of ethanol were present, and death could be attributed to the combined CNS depressant effects of morphine and ethanol. The quinine levels would not normally be considered toxic, however, and it could not be ascertained that the quantity of this drug present contributed to death. Diazepam was present in elevated concentrations, and its depressant effect may have been a factor in some narcotic addiction deaths.

Diazepam↗
PubMed1993

Does ketorolac tromethamine, a new analgesic, decrease postoperative recovery time, narcotic requirements, nausea and/or vomiting, and unscheduled hospital admissions: a retrospective analysis.

This study retrospectively evaluated patients receiving intramuscular ketorolac for postoperative analgesia as compared to intravenous narcotics. Ninety-eight patients' charts were reviewed. Forty-nine subjects who received ketorolac postoperatively (intramuscularly) when entering the post anesthesia recovery unit, were matched with forty-nine subjects who had had similar diagnoses (operated on during the same eight months) who did not receive ketorolac (groups 1 and 2). All subjects received narcotics (intravenously) when complaining of pain. Variables recorded were type and duration of procedure, patient age, gender, post anesthesia recovery time, unscheduled admissions, ketorolac dose, narcotic requirements and doses, and nausea and/or vomiting. Data for each of the two groups were compared by Wilcoxon signed-rank test. Groups 1 and 2 did not differ in type or duration of surgery, patient age or gender. Procedures ranged from dilatation and curettage to major spinal surgeries. Post anesthesia recovery unit times, narcotic dosages and nausea and/or vomiting were not different between group 1 and 2. The timing of administration for the ketorolac may be a reason for these results; it may be beneficial if administered intraoperatively, or intravenously (when FDA approved in the United States) during the postoperative period.

Adolescent↗
PubMed1984

[The new narcotic drug law and its effects on the panorama change of the drug scene of the Aachen border district].

The situation in the region of Aix la Chapelle with its borders towards The Netherlands and Belgium has presented us with increasing problems in drug and narcotic delinquency during recent years. Because of the revised law on narcotic drugs in 1982 and recent decisions by the German Federal Supreme Court, forensic toxicologists are expected not only to define drugs qualitatively as well as quantitatively, but also to provide expertise on problems of effective doses, pharmacokinetics, toxicity and tolerance development with various narcotic drugs. Based on our own experience in this special forensic field, as well as on the data compiled by investigation authorities, our analytical findings are presented with regard to toxicological interpretation and the legal consequences.

Drug and Narcotic Control↗
PubMed1978

Animal-human correlates of narcotic dependence: a brief review.

Knowledge of opiate action in laboratory animals can be of great value in developing a rational clinical approach to the treatment of narcotic dependence. Physiological alterations experimentally produced by narcotics have been confirmed in human subjects, and classical laboratory effects of conditioning and operant behavior also have clinical counterparts. Realization of animal-human correlates of narcotic dependence allows a better understanding of the strengths and weaknesses of existing therapeutic modalities.

Animals↗
PubMed1988

Implications of methadone maintenance for theories of narcotic addiction.

Clinical success in rehabilitation of heroin addicts with maintenance treatment requires stability of the blood level in a pharmacologically effective range (optimally, 150 to 600 ng/mL)-a phenomenon that emphasizes the central importance of narcotic receptor occupation. It is postulated that the high rate of relapse of addicts after detoxification from heroin use is due to persistent derangement of the endogenous ligand-narcotic receptor system and that methadone in an adequate daily dose compensates for this defect. Some patients with long histories of heroin use and subsequent rehabilitation on a maintenance program do well when the treatment is terminated. The majority, unfortunately, experience a return of symptoms after maintenance is stopped. The treatment, therefore, is corrective but not curative for severely addicted persons. A major challenge for future research is to identify the specific defect in receptor function and to repair it. Meanwhile, methadone maintenance provides a safe and effective way to normalize the function of otherwise intractable narcotic addicts.

Drug Administration Schedule↗
PubMed1996

Clonidine prophylaxis for narcotic and sedative withdrawal syndrome following laryngotracheal reconstruction.

OBJECTIVE: To determine the efficacy of transdermal clonidine hydrochloride for prophylaxis of withdrawal syndromes that are common following more than 7 days of deep sedation after single-stage laryngotracheal reconstruction (LTR) surgery. DESIGN: Consecutive case series. SETTING: Pediatric intensive care unit at tertiary care referral center, university-affiliated children's hospital. PATIENTS: Ten consecutive patients who had undergone single-stage LTR and received sedation with a combination of narcotics and benzodiazepines. INTERVENTIONS: A sustained release transdermal clonidine hydrochloride patch (50-100 micrograms/d; mean, 5.8 micrograms/kg per day; range, 4.2-8.5 micrograms/kg per day) was applied to 8 consecutive patients before discontinuation of sedative infusions and elective extubation. Physicians continued to treat patients for withdrawal symptoms, if seen, at their discretion. MAIN OUTCOME MEASURES: Seventeen characteristic narcotic and sedative withdrawal symptoms recorded at baseline and serially for at least 48 hours following discontinuation of deep sedation. RESULTS: No severe symptoms of narcotic or sedative withdrawal (seizure, choreoathetosis, tremors, or dehydration) were seen in any patient during treatment with clonidine. Not more than 2 minor withdrawal symptoms (lethargy and respiratory rate > 40 breaths/min) occurred simultaneously during treatment with clonidine in any patient. Two of 8 patients had clonidine patches removed prematurely. Both patients experienced withdrawal symptoms within hours, and these symptoms subsided in the 1 patient whose clonidine patch was reinstituted. No significant sustained side effects, bradycardia, or dysrhythmia necessitated discontinuation of clonidine therapy, and no rebound withdrawal was seen with routine discontinuation of clonidine after 7 days of therapy. CONCLUSIONS: Transdermal clonidine prophylaxis may be a safe and efficacious adjunct to prevent withdrawal symptoms in pediatric patients who have undergone single-stage LTR. Use of a validated withdrawal symptom scoring tool is indicated for patients undergoing single-stage LTR and requiring prolonged, deep sedation in the pediatric intensive care unit.

Administration, Cutaneous↗
PubMed1984

Continuous naloxone infusion in pediatric narcotic overdose.

A 31-month-old girl required constant intravenous (IV) infusion of naloxone hydrochloride to treat codeine-induced respiratory and CNS depression. The infusion rate was 0.4 mg/hr (27 micrograms/kg/hr) over nine hours, without apparent side effects or evidence of toxic effects, for a total naloxone hydrochloride dose of 4.1 mg (280 micrograms/kg). Constant naloxone hydrochloride infusion at an initial rate of 0.4 mg/hr in pediatric narcotic poisoning should be considered if the patient responds inadequately to an initial 0.01-mg/kg bolus, requires repeated administration to reverse narcotic-induced effects, or has ingested long-acting agents. Continuous IV naloxone infusion is a convenient, safe, and effective method to treat narcotic overdose.

Acetaminophen↗
PubMed1978

Human pharmacology and abuse potential of the analgesic buprenorphine: a potential agent for treating narcotic addiction.

Buprenorphine was evaluated for its abuse potential and utility in treating narcotic addiction. The drug was morphine-like but was 25 to 50 times more potent than morphine and was longer-acting. Little if any physical dependence of clinical significance was produced by buprenorphine. The effects of morphine to 120-mg doses were blocked by buprenorphine, a blockade that persisted for 29 1/2 hours. In man, buprenorphine has less intrinsic activity than morphine, and as such, as a low abuse potential. Moreover, the drug has potential for treating narcotic addiction since it is acceptable to addicts, is long-acting, produces a low level of physical dependence such that patients may be easily detoxified, is less toxic than drugs used for maintenance therapy, and blocks the effects of narcotics.

Adult↗
PubMed1987

Drug delivery for intractable cancer pain. Use of a new disposable parenteral infusion device for continuous outpatient epidural narcotic infusion.

Administration of narcotic analgesics through the epidural route has proven useful for treating pain of acute and chronic nature. This route of narcotic administration is frequently chosen for cancer patients with intractable pain that may be refractory to treatment by conventional oral or parenteral therapy. Implantable constant infusion devices have been commonly described as an alternative drug delivery system for this type of patient. This case report describes the use of the Travenol Infusor (Travenol Laboratories Inc., Deerfield, Illinois) an external, lightweight, disposable, drug delivery device for delivering continuous epidural morphine infusion to a patient with severe cancer pain. The patient has achieved stable pain relief for greater than 8 months without hospital admission for pain control, or management of complications due to the drug delivery system. The Travenol Infusor may prove to be an alternative drug delivery system for patients requiring continuous epidural narcotic infusion.

Aged↗
PubMed2005

Frequent monthly use of selected non-prescription and prescription non-narcotic analgesics among U.S. adults.

PURPOSE: Analgesics offer many benefits, however, chronic, long-term use may pose risks of adverse drug events. The objective of this study was to estimate frequent monthly non-narcotic analgesic use among U.S. adults, identifying socio-demographic trends and potentially at-risk groups. METHODS: Analysis of adult medication use data from the 1999-2000 National Health and Nutrition Examination Survey household interview (n = 4880). RESULTS: Some 20% of U.S. adults used non-prescription or prescription non-narcotic analgesics on a frequent basis, that is nearly every day for a month, at some point during their lifetime. Also, 14% of U.S. adults were currently using analgesics frequently. Aspirin was most commonly used (8%), followed by non-aspirin non-steroidal anti-inflammatory drugs (NANSAID, 3%) and acetaminophen (3%). Three-quarters of aspirin, 46% of NANSAID and 63% of acetaminophen users were long-term frequent monthly users (1+ years). Seven percent of frequent monthly analgesic users reported using two or more analgesics nearly every day during the month. Frequent analgesic use was most common among older adults and non-Hispanic whites with no differences by gender or education. Use patterns, however, varied by analgesic subgroups. CONCLUSIONS: Frequent monthly non-narcotic analgesic use, especially of over-the-counter analgesics, is widely prevalent among U.S. adults. Health-care providers should heighten their awareness of this trend, and routinely monitor both non-prescription and prescription analgesic use in their patients to prevent adverse drug effects and inappropriate use.

Acetaminophen↗
PubMed1995

A randomized, crossover evaluation of methylphenidate in cancer patients receiving strong narcotics.

Sedation may be a dose-limiting side-effect of opioid therapy in some cancer patients. This study was designed to evaluate further the use of the psychostimulant, methylphenidate, an agent that has been reported to counter-act opioid-induced sedation, in patients with cancer-related pain. Patients receiving a stable dose of an opioid for cancer-related pain were recruited for this randomized, double-blind, crossover clinical trial. In addition to their regular dose of narcotics, they received 5 days of methylphenidate followed by 5 days of placebo, or vice versa. Our data did not definitively demonstrate any statistically significant benefit for methylphenidate, but did suggest that this drug could mildly decrease narcotic-induced drowsiness and could increase night-time sleep. These data, in conjunction with other published data, suggest that methylphenidate can counteract narcotic-induced daytime sedation to a limited degree.

Adolescent↗
PubMed1977

Specific action of narcotics on reflex activation of rat alpha-motoneurones.

Specific effects of narcotics (opiates) were studied on rat extensor alpha-motoneurones. The animals were anaesthetized with halothane, artificially ventilated and immobilized with N,N'-diallyl nortoxiferinium-HCl. The alpha-motoneurones were activated by tetanic stimulation of the cut ipsilateral gastrocnemius-soleus (GS) nerve. Morphine (2 and 4 mg/kg) administered intravenously, significantly increased the frequency of reflex discharges. In most of the neurones tested, naloxone (0.25 mg/kg) given intravenously, abolished the effect of morphine. In some neurones, however, naloxone induced a further activation. The dose of naloxone employed was ineffective when given alone. The effect of morphine was mimicked by an intravenous injection of levorphanol (1 mg/kg), but not by an equimolar dose of the stereoisomer dextrorphan, which suggests that the activating effect on alpha-motoneurones is a specific one. An intraperitoneal injection of apomorphine (1 mg/kg) reduced the effect of morphine. The effect of narcotics on alpha-motoneurones parallels narcotic-induced catalepsy and muscular rigidity, with regard to dose-dependence as well as to the antagonism of naloxone and apomorphine, and suggests that both catalepsy and muscular rigidity are mainly due to an activation of extensor alpha-motoneurones. Since this activation can be inhibited by spinalization of the rats, it can be inhibited by spinalization of the rats, it can be concluded that the activation is due to a supraspinal action of morphine, resulting in a decreased dopaminergic neurotransmission in the brain.

Action Potentials↗
PubMed1991

A model of additive effects of mixtures of narcotic chemicals.

Biological effects data with single chemicals are far more abundant than with mixtures. Yet, environmental exposures to chemical mixtures, for example near hazardous waste sites or non point sources, are very common and using test data from single chemicals to approximate effects of mixtures can be useful in environmental risk assessment. To facilitate the linkage, the Weibull function was used as a common model to link responses of single chemicals with the response of their mixtures. The present paper addresses the response of fish to mixtures of narcotic chemicals and a second paper addresses the developmental malformation of frog embryos when exposed to defined mixtures of teratogenic chemicals. Biological effects data with singly tested chemicals cannot be used directly to predict effects of mixtures. However, narcotic chemicals are known to produce an additive concentration effects in fish and the Weibull function with an additive concentration variable was used to model the effects of mixtures of these chemicals. The model produced good agreement with data over a wide range of chemicals and mixture ratios and provides a useful initial assessment of environmental effects of mixtures of narcotic chemicals.

Animals↗
PubMed1977

Recovery from anaesthesia in outpatients: a comparison of narcotic and inhalational techniques.

Forty-one patients undergoing outpatient anaesthesia and operation were studied. Nineteen received inhalation agents. Twenty-two received narcotics. Up to one hour post-operatively, patients who received inhalation anaesthesia performed significantly better than did those who received narcotics. After 60 minutes there was no significant difference between the two groups. It is suggested that narcotics be avoided in patients who will be discharged within one hour of anaesthesia. A small number of patients exhibited slow recovery. It is suggested that these may be patients at risk and that special care be exercised.

Ambulatory Care↗