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Classical nail surgery and removal of the proximal nail fold
Published in Robert Baran, Dimitris Rigopoulos, Chander Grover, Eckart Haneke, Nail Therapies, 2021
Immediately after the dressing has been applied the operated extremity is elevated, which minimizes bleeding, inhibits swelling, prolongs the anesthetic action, and reduces overall pain during the entire healing phase. Analgesics are chosen according to the type of surgery, beginning with paracetamol or metamizole, adding codeine till tilidine. Certain operations involving the phalangeal bone may elicit extreme pain even after 24 hours, this is best treated with another anesthetic digital block.
Inhibitors of Human CYP2D6
Published in Shufeng Zhou, Cytochrome P450 2D6, 2018
Alfentanil, fentanyl, and dextropropoxyphene are found to competitively inhibit CYP2D6-mediated 2-hydroxylation of desmethylimipramine (Figure 4.6) (Henthorn et al. 1989). However, other narcotics including codeine, meperidine, methadone, morphine, or nalbuphine do not inhibit this reaction. Because of the rapid elimination of atomoxetine, its average steady-state concentrations are well below the Ki. Tilidine and nortilidine (both narcotics) inhibit CYP2D6, 2C19, and 3A4 in vitro (Weiss et al. 2008).
Comparative risk-benefit profiles of weak opioids in the treatment of osteoarthritis: a network meta-analysis of randomized controlled trials
Published in Postgraduate Medicine, 2022
Wei Li, Hongyi He, Zidan Yang, Ziying Wu, Dongxing Xie
Referring to the detailed study characteristics as listed in Table 1, the sample size of the included RCTs ranged from 57 to 1,011 subjects, the mean age ranged from 57.6 to 69.1 years, the ratio of female subjects ranged from 29.8% to 100%, and the follow-up period ranged from 1 to 13 weeks. The number of trials involving one arm for each specific weak opioid (or two arms if two opioids were included) was as follows: tramadol, 11 trials; codeine, 4 trials; dextropropoxyphene, 2 trials; and dihydrocodeine, 1 trial. No trial comparing pentazocine, tilidine, butorphanol or nalbuphine with placebo or with other weak opioids was included. Figure 2 and Figure 3 demonstrate the network for pain relief and the risk of total number of AEs, respectively. The efficacy was compared between tramadol, codeine and dextropropoxyphene, whereas the safety was compared between tramadol, codeine, dextropropoxyphene and dihydrocodeine. The methodologic quality of the included RCTs is summarized in Additional file 2.
Prevalence of drug-induced constipation and severity of associated biopsychosocial effects in patients with nonmalignant pain: a cross-sectional review of depersonalized data from the German Pain e-Registry
Published in Current Medical Research and Opinion, 2022
Michael A. Ueberall, Ute Essner, Gerhard Müller-Schwefe, Johannes Horlemann, Martin Storr
Table 2 gives an overview of the prevalence of analgesic and adjuvant treatments reported by patients with different pain indications. NMP patients reported analgesic monotherapy in 56.8% (n = 85,502) and polytherapy with up to five different analgesics in 43.2% (n = 64,986). NOA were the most frequently reported analgesics, used by 122,945 patients (81.7%), followed by AA (n = 54,756, 36.4%), MOA (n = 37,569, 25.0%; tilidine 13.4%, tramadol 11.3%, and codeine 0.3%), and SOA (n = 31,116, 20.7%; fentanyl 6.6%, oxycodone 4.9%, hydromorphone 3.3%, tapentadol 1.6%, buprenorphine 1.4%, and methadone 0.9%). The prevalence of the various analgesics and co-analgesics varied in the different indication groups and followed (more or less) the usual therapy recommendations and treatment guidelines for NMP in Germany.
The interpretation of hair analysis for drugs and drug metabolites
Published in Clinical Toxicology, 2018
Eva Cuypers, Robert J. Flanagan
In an attempt to reduce the impact of surface contamination on the results and minimise the amount of hair used in the analysis, new analytical methods have been evaluated. Matrix-assisted laser desorption/ionization-mass spectrometry (MALDI-MS) has been used to detect cocaine and its metabolites after pulverizing and extracting hair [55–57]. More recently, mass spectrometric imaging (MSI) techniques have been used, for example in the analysis of ketamine in a single scalp hair [58]. Porta et al. [59] reported the analysis of cocaine and its metabolites in a single hair using MALDI-triple quadrupole linear ion trap MS. By longitudinal scanning of a single intact hair, information concerning drug disposition throughout the hair was obtained. The measurement of cocaine and cannabinoids in single intact hairs using a MALDI-LTQ Orbitrap XL instrument [60] has also been reported, and Poetzsch et al. [61] monitored the distribution of tilidine in intact hair samples from children thought to have been poisoned with this drug by MALDI-MS/MS imaging.