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At least 19 recordsLinked to original sources
PubMed1991

Vecuronium infusion requirements in children during halothane-narcotic-nitrous oxide, isoflurane-narcotic-nitrous oxide, and narcotic-nitrous oxide anesthesia.

We were interested in determining the infusion rate of vecuronium required to maintain approximately 95% neuromuscular blockade in children during halothane-narcotic-nitrous oxide (0.8% end-tidal concentration), isoflurane-narcotic-nitrous oxide (1.0% end-tidal concentration), or narcotic-nitrous oxide anesthesia. Neuromuscular blockade was monitored by recording the electromyographic activity (Datex NMT) of the adductor pollicis muscle resulting from supramaximal stimulation of the ulnar nerve at 2 Hz for 2 s at 10-s intervals. Effective vecuronium infusion requirements averaged 1.5 +/- 0.1 micrograms.kg-1.min-1 (mean +/- SEM) during isoflurane-narcotic-nitrous oxide anesthesia, 1.9 +/- 0.1 micrograms.kg-1.min-1 during halothane-narcotic-nitrous oxide anesthesia, and 2.4 +/- 0.3 micrograms.kg-1.min-1 during narcotic-nitrous oxide anesthesia. Infusion requirements significantly decreased after the first 30 min of infusion in the presence of both potent inhalation anesthetics, but did not change with time during narcotic-nitrous oxide anesthesia. There was no evidence of decreasing infusion requirements during prolonged vecuronium infusion (2.5 h). There was no difference in the rate of spontaneous or pharmacologically induced recovery between anesthetic groups. The mean recovery index (T25-75) after termination of the infusion was 13.7 min.

Anesthesia, General↗
PubMed1990

[Narcotic abuse in Jylland. A study based on narcotics and deaths of addicts examined at the Institute of Forensic Medicine, University of Aarhus during the period 1981-1988. 1. Narcotics].

On the basis of analysis of 1,879 samples of narcotics confiscated in Jutland and Funen during the period 1981-1988, the individual types of drugs are described as regards occurrence and quality. Cannabis and heroin were found in the illegal market during the entire period. Amphetamine was rarely observed prior to 1985 but comprised half of the illegal drugs examined in 1988. Cocaine was encountered in only 1% of the samples. Designer drugs were not seen. Heroin occurred relatively most frequently in Aarhus, Odense and Esbjerg while amphetamine and cannabis were found in all parts of Jutland and Funen. The samples of heroin and amphetamine varied greatly as regards strength and the types and quantities of cutting agents. The majority of the samples were adulterated and/or diluted with substances such as caffeine and phenazone and the sugars, glucose and lactose.

Amphetamine↗
PubMed1997

Oral narcotic protocol to reduce narcotic injections in refractory migraine patients.

Refractory headache patients who require narcotic injections for acute attacks frequently utilize health care facilities. The experience is often unpleasant and costly to the patient and health care system. We have developed an oral narcotic protocol for home administration. The patient starts with an antiemetic suppository, followed in 30 minutes by oral metoclopramide. After controlling nausea and vomiting, the patient administers a high dose of oral narcotic plus a hypnotic. The dosing of the narcotic analgesics incorporates seldom-used, but well-published pharmacokinetics. This protocol allows the patient to successfully treat a severe headache without using a health care facility. Eleven patients in our practice were prescribed the oral narcotic protocol. Their need for narcotic injections at our office or emergency department was monitored for up to 1 year before and after the start of the protocol. Combined office visits were reduced from 81 to 53 (34.6%) and emergency department visits from 47 to 26 (44.7%). An annual cost savings of $1960 for office visits and $3024 for emergency department visits was realized. This was offset by an oral narcotic protocol medication cost of only $392. This treatment method has been well accepted by patients and has proven to be a safe and cost-effective approach to treating refractory migraine patients.

Administration, Oral↗
PubMedDate not supplied

The activities of the Narcotics Laboratory Section of the Division of Narcotic Drugs in supporting national laboratories. United Nations Secretariat.

Since the establishment of the Narcotics Laboratory Section of the Division of Narcotic Drugs of the United Nations Secretariat in 1954, in accordance with resolution 834 (IX) of the United Nations General Assembly, the activities of the Narcotics Laboratory Section have developed according to the recommendations of the Commission on Narcotic Drugs. The Narcotics Laboratory Section carried out research on opium, cannabis, khat and codeine. The current programme of the Laboratory Section includes the following activities: Providing training in drug identification techniques to scientists, primarily from developing countries, and developing training standards; Strengthening national narcotics laboratories in developing countries, including the procurement of basic laboratory equipment; Developing standard testing methods applicable in developing countries; Providing reference samples for analytical and research purposes; Providing scientific and technical information on drugs of abuse; Collaborating with national narcotics laboratories.

Developing Countries↗
PubMedDate not supplied

Effects of narcotic and non-narcotic continuous epidural anesthesia on intrapartum fetal heart rate tracings as measured by computer analysis.

OBJECTIVE: To evaluate the effect of narcotic and non-narcotic continuous epidural anesthesia on intrapartum fetal heart rate (FHR) tracings as measured by computer analysis. METHODS: We studied 37 women with uncomplicated pregnancies at term with reactive FHR tracings. The women were randomized to receive epidural anesthesia with either bupivicaine with fentanyl or bupivicaine alone. One-hour FHR tracings were obtained before epidural anesthesia. Thirty minutes after the initial bolus of the epidural a repeat computer analysis of 60-minute FHR tracing was obtained. Median values are reported for FHR parameters with statistical analysis performed by the Mann-Whitney U and Wilcoxon signed rank tests where appropriate. A power calculation was performed using a power of 90% to determine a required sample size of 28 patients. Statistical significance was set at P < .05. RESULTS: In early first stage of labor, there was no significant difference in pre- and postepidural anesthesia FHR baseline, accelerations of 10 and 15 beats per minute, episodes of high and low variation, and short- and long-term variation when using either narcotic or non-narcotic anesthetic agents. CONCLUSIONS: Thus, the clinician can consider the use of narcotic as well as non-narcotic continuous epidural anesthesia in the dosages used in our study with its attendant advantages without fear of obscuring the fetal heart rate tracing.

Anesthesia, Epidural↗
PubMed1970

Quantitative studies on the antagonism by naloxone of some narcotic and narcotic-antagonist analgesics.

1. Naloxone was used to study the antagonism of the analgesic effects of some narcotics (morphine sulphate, levorphanol tartrate, and methadone hydrochloride) and narcotic antagonists (pentazocine, cyclazocine, and nalorphine hydrochloride). The analgesic assay used was the mouse phenylbenzoquinone stretching test.2. The in vivo equivalent of a pA(2) value (apparent pA(2)) for naloxone was determined with each agonist. These values were found to be significantly larger with the narcotics than with the narcotic antagonists.3. The slopes in the apparent pA(2) plots were also found to be significantly different. It was concluded that this difference in slopes was probably not due to a lack of equilibrium in one of the two groups of analgesics.4. The results suggest that the narcotic and the narcotic-antagonist analgesics may inhibit stretching in this assay by interacting either with two different receptors or with the same receptor in a different manner.

Animals↗
PubMed1975

Narcotic antagonists: a reasonable method of treating narcotic dependency.

Historically, narcotic dependence has been treated primarily by substituting one narcotic drug for another. One alternative chemical treatment for narcotic dependency is through the use of a narcotic antagonist. The present study involves the observed side effects and outcome results of treating 40 male heroin addicts with the narcotic antagonist, cyclazocine, in the context of a comprehensive psychotherapeutic program. It is concluded that the side effects of cyclazocine are minimal, that cyclazocine is not diverted to the streets, and that it is an effective tool in the context of a comprehensive treatment program for narcotic-dependent individuals.

Aftercare↗
PubMed1992

Availability of narcotics and pharmacists' attitudes toward narcotic prescriptions for cancer patients.

OBJECTIVE: To determine narcotic availability and pharmacist apprehension toward dispensing narcotics for cancer patients. DESIGN: Mailing of a one-page survey. SETTING: All pharmacies in the state of New Mexico. PARTICIPANTS: Of the 309 pharmacies, 76.1 percent (235) completed the survey. MEASUREMENTS AND MAIN RESULTS: Apprehension was significantly elevated for methadone, hydromorphone, and for morphine doses greater than 500 mg/d (p less than 0.001). The most common reasons listed for apprehension were forgery (46.4 percent), theft (40.4 percent), high dosages (23.8 percent), narcotic investigations (18.7 percent), and patient addiction (9.4 percent). Hydromorphone was available (in stock) in 80.5 percent of the pharmacies, followed by morphine 30-mg sustained-release tablets (64.5 percent) and methadone (53.4 percent). The vast majority of pharmacists were willing to order strong narcotics for specific patients. Pharmacists working in chain stores expressed a higher level of apprehension toward dispensing methadone and more frequently cited forgery as a reason for apprehension. Distance from a metropolitan area and practice setting best predicted apprehension to forgery (p = 0.01). CONCLUSIONS: Pharmacists do not appear to be a major obstruction to adequate analgesia for cancer patients in New Mexico but may require further education regarding lack of narcotic addiction and dosing in patients with cancer.

Attitude of Health Personnel↗
PubMed1975

Narcotic and narcotic antagonist pKa's and partition coefficients and their significance in clinical practice.

The pKa's, partition coefficients and drug distribution coefficients (apparent partition coefficients) have been investigated for a number of narcotics and where possible for their congener narcotic antagonist. These studies were carried out by a novel microelectrometric titration technique as a function of temperature and pH. This method enables one to determine not only the dissociation constants to deconvolute overlapping pKa's, but also to determine the solubilities and oil-water distribution of these various drugs. The drug distribution coefficients displayed marked sensitivity to pH at values which span the range of attainable human physiological pH values. This has significant pharmacological implications for proper choice and scaling of drug dosages under various clinical situations among which are cited hyperventilation under a general anesthetic while concomitantly under a narcotic analgesic, obstetetrical analgesia, and medical and anti-abuse usage of narcotic antagonists. The partition coefficients and drug distribution coefficients were noticeably different at 20degreesC (where such measurements are customarily made) from those at 37degreesC (body temperature). Furthermore, various drugs exhibit very non-equivalent increases in drug distribution coefficients with increasing temperature, ranging from 21% for naltrexone. This non-regularity indicates that it will not be valid to extrapolate by any constant factor the measurements made at lower temperatures. Even the true partition coefficients increase with temperature from 20degrees to 37degreesC.

Chemical Phenomena↗
PubMedDate not supplied

Theoretic significance of pH dependence of narcotics and narcotic antagonists in clinical anesthesia.

Determination of the effect of pH and temperature on pKa partition, and drug distribution coefficients in a series of common narcotics and their antagonists has shown that within the range of blood pH (7.1 to 7.7) encountered in the practice of anesthesiology, marked differences of distribution of the drugs between a model lipid (octanol) and water can occur. When these data are considered in the light of clinical experience with narcotics used in patients undergoing or recovering from surgical procedures, a correlation between the depth and duration of narcosis or the efficacy of narcotic antidotes and ventilatory status is seen. This correlation can be explained in part if the influence of blood pH on the probable CNS/blood distribution of a given drug is taken into consideration. Support is given to this proposal by representative studies in the literature. The very different drug distribution coefficients of two closely related narcotic antagonists, naloxone and naltrexone, correctly predicted the faster onset and shorter duration of the former, which was confirmed by reported clinical observations.

Anesthesia↗
PubMed1976

A test for antinociceptive activity of narcotic and narcotic antagonist analgesics in the guinea pig.

Ethylenediamine tetraacetic acid (EDTA) was used as a nociceptive stimulus intradermally in the guinea pig. The responses evoked by EDTA included vocalization, biting and scratching at the site of injection and escape behavior. Nociception by EDTA was shown to be the result of its cation chelating activity. The suppression of EDTA-induced responses proved to be a rapid and effective antinociceptive test. The narcotic analgesics morphine, codeine, meperidine and methadone and the narcotic antagonist analgesics cyclazocine, cyclorphan, nalorphine and pentazocine were active. The slopes of the dose-response curves of the narcotic antagonist analgesics were significantly shallower than those of the narcotic analgesics. The test was highly specific for these analgesics. Antipyretic analgesics and various nonanalgesic drugs were inactive.

Analgesics↗
PubMed1978

Narcotic cuing and analgesic activity of narcotic analgesics: associative and dissociative characteristics.

By using a discrete-trial, two-lever, food-reinforced discrimination learning paradigm, rats were trained to discriminate the narcotic analgesic fentanyl (0.05 mg/kg) from saline. Stimulus generalization experiments with lower fentanyl doses (0.0025 to 0.02 mg/kg) were carried out to generate individual threshold doses. The latter were compared with the sensitivity of the same rats to the analgesic effect of fentanyl, and it was found that there is no correlation between these two sets of data. In a time-effect experiment, the duration of fentanyl's cuing effect was compared with that of its analgesic effect, and it was found that the time-effect characteristics of the narcotic cue are similar to those of analgesia. Again, however, there was no correlation between the duration of both effects within the same group of animals. The results further deliniate the associative and dissociative characteristics of the narcotic cue and narcotic analgesia.

Analgesics↗
PubMed1981

Effects of narcotic and non-narcotic analgesics on the abdominal or tail stimulation-induced struggling in rats.

As a model, we used struggling induced by a repetitive stimulation of the tail or abdomen and two types of pseudoaffective responses were evoked in rats. The effects of narcotic and non-narcotic analgesics on these responses were alternately assessed. Narcotics were markedly effective in inhibiting struggling elicited by tail stimulation and slightly less effective in suppressing the abdominal stimulation-induced struggling. These effects on two types of struggling differed quantitatively but not qualitatively. On the other hand, non-narcotics such as aspirin (200 mg/kg, i.p.), aminopyrine (160 mg/kg, i.p.) and indomethacin (20 mg/kg, i.p.) had an inhibitory action on the struggling elicited by the tail stimulation but showed equivocal and far less inhibition on the abdominal stimulation-induced response. These two effects were quantitatively and qualitatively different because the slope of the dose-response curves were not in parallel. The action of baclofen appears to be ambiguous since it had distinctive inhibitory actions on both typed of struggling. However, baclofen can be classified into the latter group in that it exerted an inhibitory action on two types of struggling, in a quantitatively different manner. These results suggest that two types of struggling in rats provide a convenient means to assess the potency of analgesics.

Abdomen↗
PubMed1976

On the ability of narcotic antagonists to produce the narcotic cue.

The ability of narcotic antagonists to produce the narcotic cue was investigated in rats trained to discriminate fentanyl (0.04 mg/kg) from solvent. The partial antagonists pentazocine, cyclazocine and nalorphine were found to possess narcotic cuing activity whereas naloxone lacked any such action at doses up to 160 mg/kg. The relationship between the present findings and the ability of these drugs to produce opiate-like subjective effects in humans is discussed. The conclusion was reached that the experimental procedure used may contribute significantly to the preclinical evaluation of drug abuse liability.

Analgesics, Opioid↗
PubMed1977

Toxic interactions of stimulants, narcotics and narcotic antagonists.

This study examines the lethality of combinations of central nervous system stimulants, narcotics and narcotic antagonists in rodents housed individually. The lethality of mice and rats from d-amphetamine was potentiated by methadone, cyclazocine and morphine, in that order of potency. Naloxone did not enhance lethality from d-amphetamine in mice, whereas it did antagonize lethality from morphine-d-amphetamine interactions. Naloxone did slightly enhance lethality from d-amphetamine in rats, but at a higher dose than those found to antagonize the lethality from morphine-d-amphetamine combinations. Methadone also enhanced the lethality from cocaine. These results have important implications for drug abusers and for patients being treated for narcotic addiction with either a methadone maintenance program or a cyclazocine administration program.

Animals↗