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At least 649 records · Page 36Linked to original sources
PubMed1982

[Interactions between buprenorphine, narcotic analgesic, and centrally acting drugs in prolongation of halothane-induced sleeping and analgesia (author's transl)].

Interactions between buprenorphine, narcotic analgesic, and centrally acting drugs were studied in prolongation of halothane-induced sleeping and analgesia using the D'Amour-Smith method in mice, and the effect of buprenorphine on monoamine metabolism was studied in rat brain. Diazepam and chlorpromazine prolonged the halothane-induced sleeping time dose-dependently. Buprenorphine (0.01, 0.1, and 1 mg/kg s.c.) inhibited the effect of diazepam, but not that of chlorpromazine. Pentazocine and naloxone also inhibited the effect of diazepam, but morphine did not. It is suggested that the inhibitory effect of buprenorphine on prolongation of halothane-induced sleeping time by diazepam is due to its opiate antagonistic property. Since narcotic antagonists inhibited the effect of diazepam, the endogenous opiate system seems to be involved in this effect. Diazepam or droperidol had no effect on the analgesia of buprenorphine, morphine, and pentazocine. Buprenorphine analgesia was inhibited by reserpine and p-chlorophenylalanine, potentiated by 5-hydroxytryptophan, and not affected by alpha-methyl-p-tyrosine or 3,4-dihydroxyphenylalanine. These results suggest that the serotonergic system plays a modulating role in buprenorphine analgesia. Imipramine and nialamide inhibited buprenorphine analgesia in the test at low stimulus intensity, but potentiated at high stimulus intensity. Buprenorphine (0.1, 1 and 10 mg/kg s.c.) increased the dopamine metabolites, 3,4-dihydroxyphenylacetic acid and homovanillic acid, in various brain areas and the serotonin metabolite, 5-hydroxyindoleacetic acid, in midbrain.

Analgesia↗
PubMed1983

New narcotics in anesthesia.

Recent research has led to the development of a new family of synthetic narcotic fentanyl derivatives. Two of these, sufentanil and alfentanil, are already in clinical use abroad and are presently under clinical investigation in the United States. Sufentanil is more potent than fentanyl and is claimed to have fewer side effects and less variability in patient cardiovascular responses under stress. It appears that its primary application will be for high-dose narcotic anesthesia in patients with cardiovascular disease. Alfentanil has a shorter duration of action and is claimed to have less postoperative ventilatory depression than fentanyl. It is being recommended for use via continuous intravenous infusion. It will probably become a popular anesthetic agent for outpatient and short surgical procedures. It should be remembered that at this time very little information concerning these agents is in print. Most of the research has been done by a handful of investigators and much has not been published in peer review publications. Based on the clinical impressions of our European colleagues, one can say that these agents should be as safe and as reliable as fentanyl, but any clinically significant advantages over their parent compound, especially in the case of sufentanil, will have to await more widespread use and controlled investigation.

Alfentanil↗
PubMedDate not supplied

[Effect of narcotic analgesics on the cortical control process of impulse transmission in the afferent pathways of the sciatic nerve].

The effect produced by narcotic analgetics with their intravenous administration on the process of cortical control over the transmission of impulses along specific routes of the sciatic nerve was studied. The conditioning stimulation of the cortex was effected by using a monopolar electrode through single electric impulses. The interval between conditioning and test (on sciatic nerve) impulses was of 80-120 ms. Morphine (1-2 mg/kg), promedol (trimeperidin) (1-2 mg/kg) and phentanyl (100 gamma/kg) potentiated the inhibition of evoked potentials in the nucleus gracilis and in VPL, observed upon stimulation of the cortex of optic lobuses. The intensification of inhibitory corticifugal mechanisms occurring under the effect of narcotic analgetics takes place both on the level of the medulla oblongata and of the thalamic one.

Afferent Pathways↗
PubMed1983

Urinary sex-dependent low molecular weight proteins as a sign of narcotic dependence in male rats.

The relationship between urinary excretion of sex-dependent low molecular weight proteins (LMWP) in male rats and narcotic dependence has been investigated in this study. Chronic administration of codeine (0.5 mg/g food) caused a significant decrease in urinary excretion of LMWP from the third day, without any change in urinary high molecular weight proteins. The decrease recovered to the control level after the withdrawal of codeine. Withdrawal symptoms including loss of body weight and diarrhea were observed following codeine withdrawal. In animals chronically treated with pethidine (1.0 mg/g food), however, neither changes in urinary LMWP excretion nor withdrawal symptoms were observed. These present findings suggest that the decrease in urinary excretion of sex-dependent LMWP is related to narcotic dependence in male rats, since we previously reported the decrease in urinary excreted LMWP in morphine-dependent rats.

Albuminuria↗
PubMed1983

Relief of continuous chronic pain by intraspinal narcotics infusion via an implanted reservoir.

Ten patients with intractable pain (five cancer and five nonmalignant) were treated with continuous intraspinal morphine delivered by an implanted continuous infusion system. Both patient groups were evaluated and compared using an identical battery of psychometric examinations administered before and 12 weeks after therapy. The cancer-pain group reported significant reduction in pain on serial visual pain analogue scales at 12 weeks compared with no change in the nonmalignant-pain group reports despite a much lower baseline report in the cancer group. Both groups of patients reduced their oral narcotic requirement significantly during continuous intraspinal morphine infusion. While the cancer patients took more oral narcotic at baseline, at 12 weeks no difference existed in oral intake between the two groups. Both groups required significant serial increases in infused morphine, indicating that spinal opiate receptor tolerance occurs. The results of this study confirm the sustained analgesic efficacy reported earlier in cancer-related pain syndromes, thus supporting further cautious expansion of this therapy within the cancer-related pain population. In contrast, a poor response was seen in the nonmalignant-pain group, consistent with the unsatisfactory responses to many potentially analgetic approaches to chronic nonmalignant pain. We are thus discouraged from further use of this therapy in the patient with chronic nonmalignant pain.

Administration, Oral↗
PubMed1984

Potentiation of narcotic-induced antinociception by tripelennamine in morphine-tolerant and drug-naive mice.

The ability of tripelennamine and chlorpheniramine to potentiate morphine- and pentazocine-induced antinociception in drug-naive and morphine-tolerant mice was tested utilizing the hot-plate method. Both tripelennamine and chlorpheniramine alone produced dose-dependent increases in hot plate latency which were naloxone reversible. Cross-tolerance developed between tripelennamine and morphine, whereas no cross-tolerance developed between chlorpheniramine and morphine. Neither tripelennamine nor chlorpheniramine significantly potentiated morphine-induced antinociception in drug-naive mice. The effects of tripelennamine and morphine were additive. Tripelennamine but not chlorpheniramine, however, significantly potentiated antinociception produced by low but not high doses of pentazocine in drug-naive mice. Furthermore, in morphine-tolerant mice, tripelennamine, but not chlorpheniramine, potentiated both morphine- and pentazocine-induced antinociception. It is concluded that the abuse of various narcotic-tripelennamine combinations can be attributed, at least in part, to a specific property of tripelennamine to potentiate narcotic effects in the drug-naive and morphine-tolerant state.

Analgesia↗
PubMed1980

Blockade by l-lysine of non-narcotic analgesics.

The antinociceptive effects of the non-narcotic analgesics clonixin, flunixin, acetylsalicylic acid, aminopyrine and phenylbutazone in the yeast paw test were blocked by l-lysine. Blockade occurred at doses of l-lysine which did not affect pain threshold. The site(s) or mechanism of action of blockade could not be determined with certainty. It appears unlikely that l-lysine prevented the analgesics from getting to active sites since plasma or brain levels of flunixin were not altered for up to 2 hr after drug administration and binding of flunixin to plasma protein was not affected. Blockade by l-lysine appears to occur at least in part at a peripheral site since it was not blockade by l-arginine or l-ornithine which compete for a common transport system with l-lysine and, hence, would have reduced the effect of l-lysine if its actions were central. However, blockade within the central nervous system cannot be ruled out. Antagonism by l-lysine does not seem to involve endogenous serotonin since it was not reversed by the serotonin precursor, 5-hydroxytryptophan, or by fluoxetine, a specific blocker of serotonin uptake. In contrast to the block of non-narcotic analgesics, l-lysine potentiated the antinociceptive effects of morphine.

Aminopyrine↗
PubMed1982

[Pharmacology of narcotics administered by the epidural or intrathecal route (author's transl)].

Owing to the presence of specific opiate receptors in the spinal cord, analgesia can be obtained with epidural or intrathecal injections of morphine derivatives. The duration of analgesia depends upon the degree of water solubility of the compound. Compounds with low coefficient of distribution in lipids (e.g. morphine) do not readily cross the blood-brain barrier and have a prolonged action, whereas the duration of analgesia induced by highly lipid-soluble compounds, such as dextromoramide and phenoperidine, is not very different from that obtained with more conventional routes of administration. The fact that large amounts of narcotics are taken up by the spinal cord explains that central effects are relatively rare. However, side-effects may be observed, and their frequency mainly depends upon the quantity of narcotic injected. These side-effects reduce the number of indications, which cannot yet be precisely determined. Epidural and intrathecal analgesia appears to be particularly useful during the post-operative period in patients liable to respiratory complications.

Analgesia↗
PubMed1980

Naloxone: underdosage after narcotic poisoning.

A case of propoxyphene hydrochloride (Darvon) poisoning was unresponsive to therapeutic doses of naloxone hydrochloride in a 2 1/2-year-old girl. Following prolonged coma and artificial ventilation for three hours, the patient responded immediately to the intravenous administration of 2 mg of naloxone hydrochloride, which is 20 times the manufacturer's recommended dosage. Naloxone is the agent of choice in reversing the effects of narcotics and synthetic opiate derivatives, such as propoxyphene and pentazocine. The manufacturer's present recommended dosage may not be sufficient to reverse the effects of large narcotic ingestions. We therefore recommend that if there is no response within two minutes of the initial 0.01 mg/kg dosage of naloxone hydrochloride, a second dose 0.1 mg/kg (ten times the manufacturer's suggested dose) be given.

Child, Preschool↗
PubMed1980

Dense deposit disease with rapidly progressive renal failure in a narcotic addict.

A girl aged 17 developed a nephrotic syndrome with renal insufficiency after narcotic abuse. Renal biopsy showed a diffuse glomerulonephritis with crescents and dense deposits within the glomerular basement membrane; glomerular C3 deposits were present without immunoglobulin. The serum complement profile was typical of activation via the alternative pathway, and tests for C3 nephritic factor were strongly positive. Terminal renal failure occurred within 6 months and required chronic hemodialysis. It is likely that the narcotics used or their contaminants were responsible for the renal damage, presumably by activating the complement system via the alternative pathway.

Adolescent↗
PubMed1995

Comfortable labor with intrathecal narcotics.

Aggressive pursuit of high-quality health care had guided the Health Service of the United States Army to establish a labor analgesia program within its hospitals. A dedicated Labor Epidural Service can be quite expensive, especially from the manpower standpoint. Therefore, the Anesthesia Service at Reynolds Army Community Hospital, Fort Sill, Oklahoma, implemented a program of intrathecal narcotic injection as an alternative to costly labor epidural analgesia. After reviewing a patient fact sheet, 150 laboring patients volunteered for labor intrathecal analgesia (LIA). Once active labor began, the patient received intrathecal morphine (0.25 mg) and fentanyl (25 micrograms). The pain level before and after the LIA was evaluated by the visual analog schedule method. At 2 weeks follow-up the intrathecal narcotic-assisted labor was subjectively reported by the patients. Ninety-four percent of the patients agreed that the LIA worked well and that they would do it again. LIA was found to be a well-accepted, cost-saving, very effective approach to labor analgesia.

Adolescent↗
PubMed1995

Blunt needle infusion of local anesthetics or narcotic analgesics into operative wounds or joints.

Local anesthetics or narcotic analgesics introduced into surgical wounds have been noted to provide pain relief. These agents are typically infused into the postoperative joint or wound using a standard beveled needle or by pressing the syringe hub against the incision without a needle. We present an alternative method of administering these agents to provide pain relief in the orthopedic patient. A blunt needle is used to infiltrate the postoperative joint or wound with local anesthetics or narcotic analgesics.

Analgesics, Opioid↗
PubMed1996

Comparison of two techniques of narcotic-induced anesthesia for use during recording of magnetic motor evoked potentials in dogs.

OBJECTIVE: To compare 2 types of narcotic-induced anesthesia for recording of transcranial magnetic motor evoked potentials (TMMEP) in dogs. DESIGN: The effect of different doses of sufentanil and midazolam and of sufentanil and nitrous oxide on onset latencies and peak-to-peak, amplitudes of TMMEP was evaluated and compared. ANIMALS: 18 neurologically normal dogs. PROCEDURE: Premedication with droperidol and fentanyl. Induction and maintenance of anesthesia either with sufentanil and midazolam or with sufentanil and nitrous oxide. Recording of TMMEP from the extensor carpi radialis muscle of the forelimb and from the cranial tibial muscle of the hind limb. RESULTS: Both types of narcotic anesthesia induced dose-dependent suppression of TMMEP; compared with baseline recordings, latencies increased, amplitudes decreased, and reproducibility became poorer with increasing dose of the anesthetics. Using surgical-depth doses of the anesthetics, TMMEP could still be recorded in all dogs with sufentanil and nitrous oxide, but not with sufentanil and midazolam anesthesia. CONCLUSIONS: Sufentanil and nitrous oxide anesthesia was superior to sufentanil and midazolam anesthesia for TMMEP recording. CLINICAL RELEVANCE: In small animal medicine, and in dogs in particular, spinal cord diseases are among the most frequently encountered neurologic disorders. The development of techniques for recording TMMEP in anesthetized dogs allows noninvasive evaluation of transmission along descending motor pathways of the spinal cord.

Anesthesia↗
PubMed1996

Evaluation of continuous intraspinal narcotic analgesia for chronic pain from benign causes.

Intraspinal narcotic analgesia (INA) has been used for chronic pain from nonmalignant causes with moderate success. To ascertain the efficacy of the morphine pump, we reviewed the 2-year results of continuous INA in 18 patients with failed back syndrome or arachnoiditis and intractable, debilitating pain that was unrelieved by conventional means. All patients underwent a trial screening of single-dose intrathecal narcotics with good pain relief. After 2 years, 8 pumps were still functioning, 8 patients had the pump removed or turned off, and 2 patients were lost to follow-up. Our patients averaged 1.4 additional procedures or hospitalizations after initial pump insertion. Overall, only 4 patients had objective evidence of benefit from INA, for a success rate of 25%. Results of this review suggest INA should not be used for the long-term management of chronic pain from nonmalignant causes.

Analgesia, Epidural↗
PubMedDate not supplied

Do dentists prescribe narcotics excessively?

Dealing with pain is an inevitable sequela to dental treatment. Although several drug regimens primarily involving narcotics have been used in the past, availability of nonsteroidal anti-inflammatory drugs (NSAIDs) has increased recently. A study was conducted to analyze dental prescribing patterns for analgesics. Data analysis of a survey of 130 dentists revealed that respondents still rely on narcotic analgesics for pain relief and generally exceed needed potency and quantities in their prescribing habits. Dentists are treating rather than preventing pain, and NSAIDs are underused.

Analgesics, Opioid↗
PubMedDate not supplied

Pulmonary vascular complications in narcotic addicts.

Perfusion deficits on lung scanning in narcotic addicts are frequently demonstrable. To determine the angiographic and hemodynamic correlates of these deficits, right heart catheterization with selective pulmonary angiography was carried out in 7 addicts with abnormal lung scans, and one with normal scan. Four had angiographic abnormalities corresponding to the regions of perfusion defects on lung scan. These consisted of large vessel cut-offs, intraluminal filling defects and/or considerably reduced vascularity. Three subjects had normal angiograms in the presence of abnormal perfusion scans. One subject had normal angiogram and scan. All eight patients had normal pulmonary artery pressures and calculated pulmonary vascular resistances. This study demonstrates that (1) angiographic abnormalities in larger pulmonary arteries may be found in narcotic addicts with perfusion defects on lung scanning, and (2) these findings may be present without significant hemodynamic alterations.

Adult↗