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Analgesics during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Among 78 infants exposed to oxycodone during the first trimester, the frequency of birth defects was not increased above population background levels (3.5–5 percent) (Schick et al., 1996). In an unpublished study, the frequency of birth defects among 281 infants born to women who were prescribed oxycodone during the first trimester was not increased (Briggs et al., 2021). The frequency of birth defects among infants whose mothers used oxycodone in the first trimester was increased in The National Birth Defects Prevention Study, specifically for pulmonary valve stenosis (Broussard et al., 2011).
Drugs Affecting the Musculoskeletal System
Published in Radhwan Nidal Al-Zidan, Drugs in Pregnancy, 2020
Risk Summary: The use of Oxycodone should be avoided, if possible, in pregnant women because the pregnancy experience in humans has shown a low risk of congenital birth defects associated with the use of this drug. Furthermore, its use near delivery is associated with a risk of neonatal respiratory depression.
Opioids Analgesics and Antagonists
Published in Sahab Uddin, Rashid Mamunur, Advances in Neuropharmacology, 2020
R. Rachana, Tanya Gupta, Saumya Yadav, Manisha Singh
Hydrocodone and codeine are structurally similar but it, is a weak µ receptor agonist. However, after its demethylation by hydrogen bromide (HBr), it results into hydromorphone, having a comparatively stronger affinity for µ opioid receptor (Otton et al., 1993). It also possesses unique anti-sedative effect owing to its affinity toward multiple opioid receptors (Poyhia et al., 1992). It is metabolized by two cytochrome P450 (CYP) enzymes, that is, CYP3A4 and CYP2D6, which leads to synthesis of noroxycodone and oxymorphone metabolites, respectively, by demethylation (Prude Pharma, 2007). The drug hydrocodone and oxycodone are potent analgesics and are closer to morphine. They cause more respiratory depression and addiction liability than morphine, but ventricular standstill is resolved, preceded by nausea after first time oral administration of hydrocodone (Sudhakaran et al., 2014).
Evaluating the effectiveness of reformulated extended-release oxycodone with abuse-deterrent properties on reducing non-oral abuse among individuals assessed for substance abuse treatment with the Addiction Severity Index-Multimedia Version (ASI-MV)
Published in Current Medical Research and Opinion, 2023
Rachelle D. Rodriguez, Taryn Dailey Govoni, Venkat Rajagopal, Jody L. Green
An extended-release (ER) oral tablet formulation of oxycodone hydrochloride (OxyContin) is approved for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate1. When taken as intended (tablet swallowed intact), OxyContin is designed to provide delivery of oxycodone over 12 h. Oxycodone is classified as a Schedule II drug under the Controlled Substances Act due to its potential for abuse, as well as for psychological and physical dependence. Original OxyContin became a target of abuse after it was recognized that breaking, crushing, or chewing could rapidly release oxycodone from the extended-release matrix of the tablet, at which point it was commonly manipulated for abuse via non-oral routes2,3.
Opioid epidemic: lessons learned and updated recommendations for misuse involving prescription versus non-prescription opioids
Published in Expert Review of Clinical Pharmacology, 2022
Ajda Bedene, Albert Dahan, Frits R. Rosendaal, Eveline L.A. van Dorp
The APS had a key role in the US opioid epidemic – by advising ‘safe and effective’ opioid pain treatment they drove sales of opioid analgesics, manufactured by different pharmaceutical companies, including Purdue Pharma [34,35]. The APS was dissolved in 2019 after facing several lawsuits due to their financial ties with the pharmaceutical industry [36]. Furthermore, the pharmaceutical industry, particularly Purdue Pharma, employed an aggressive marketing strategy to promote oxycodone (OxyContin®) prescription for the treatment of chronic non-malignant pain, while the addictive properties of the medication were downplayed. Addiction to OxyContin® was considered highly unlikely, a claim that was mostly based on the letter by Porter and Jick [25], as well as assumed because of the controlled-release formulation of OxyContin® [37]. However, it has been shown that the controlled-release formulations do not have favorable safety profiles over other formulations [38]. When controlled-release oxycodone was introduced in clinical practice in Ontario, Canada, the associated overdose mortality increased about five-fold between 2000 and 2003 [39]. Physicians were led to believe (by the pharmaceutical industry and the medical and scientific community) that opioids have low addictive potential that provided false reassurance of opioid safety profile in the treatment of chronic non-malignant pain. This is considered to be one of the reasons behind the US opioid epidemic [26].
Considerations for single- versus multiple-drug pharmacotherapy in the management of painful diabetic neuropathy
Published in Expert Opinion on Pharmacotherapy, 2021
Kalliopi Pafili, Nikolaos Papanas
Severe and refractory pain requires the administration of more potent pharmacological agents such as oxycodone [62]. In moderate to severe painful DPN, oxycodone controlled release achieved 9% more pain relief in comparison with placebo and a 7% more improvement of sleep quality than placebo [62]. In a similar manner, 20–80 mg daily oxycodone controlled release resulted in significantly lower mean daily pain, steady pain, brief pain, total pain and disability, in comparison with placebo in a cross-over clinical study [63]. A similar incidence of adverse events was reported for both treatment arms, with nausea, constipation, dizziness and sweating being most frequently reported among oxycodone recipients. The NNT to obtain one patient with a minimum of 50% pain relief was 2.6 [63].