Más de opioides / More on opioids

Enero 14, 2017. No. 2569

Oxicodona DETERx®: una nueva opción de analgésico de liberación prolongada para el tratamiento de pacientes con dolor crónico. Oxycodone DETERx®: A Novel Abuse-Deterrent, Extended-Release Analgesic Option for the Treatment of Patients with Chronic Pain. Gudin J1. Pain Ther. 2016 Dec;5(2):171-186. Epub 2016 Nov 21. Abstract BACKGROUND: Extended-release (ER) opioid analgesics are commonly used to provide safe and effective pain relief to treat pain severe enough to require around-the-clock, long-term dosing. These ER opioid formulations usually contain more drug per dosage unit than immediate-release (IR) agents, and therefore bring with them challenges related to both opioid abuse and misuse, often through manipulation of the dosage form. Oxycodone DETERx® (Xtampza® ER, Collegium Pharmaceutical, Inc.) is a novel abuse-deterrent, ER formulation developed to deter common methods of manipulation. In addition to having abuse-deterrent properties, oxycodone DETERx was developed to provide alternative modes of administration for patients with chronic pain and difficulty swallowing. SCOPE: Using published articles, abstracts, and prescribing information, data supporting the use of oxycodone DETERx are reviewed. FINDINGS: Oxycodone DETERx was effective at reducing chronic pain in patients enrolled in a pivotal clinical trial, and had a tolerability profile expected of opioids. In addition to administration of the intact capsule, oxycodone DETERx can also be administered by sprinkling directly into the mouth from a dosing cup, onto soft foods, or through nasogastric or gastrostomy tubes, thus providing flexible dosing options for patients who have difficulty swallowing. In vitro studies demonstrated the reduced ability of oxycodone DETERx to be manipulated by common techniques used by abusers to defeat the ER characteristics or prepare the formulation for injection. Pharmacokinetic studies demonstrated that the ER characteristics of oxycodone DETERx are maintained if chewed or crushed. As a result, oxycodone DETERx is currently the only ER-formulated opioid without a boxed warning against crushing or chewing. Human abuse-potential studies conducted in a population of recreational opioid users demonstrated lower drug-liking scores for oxycodone DETERx administered intranasally and orally when compared with IR oxycodone. KEYWORDS: Abuse deterrence; Chronic pain; Drug abuse; Extended-release opioids; Opioid analgesics; Oxycodone PDF   ¿Es el tapentadol diferente a los opioides clásicos? Revisión de la evidencia Is tapentadol different from classical opioids? A review of the evidence. Langford RM1, Knaggs R2, Farquhar-Smith P3, Dickenson AH4. Br J Pain. 2016 Nov;10(4):217-221. Epub 2016 Jul 25. Abstract Tapentadol is a single molecule able to deliver analgesia by two distinct mechanisms, a feature which differentiates it from many other analgesics. Pre-clinical data demonstrate two mechanisms of action: mu-opioid receptor agonist activity and noradrenaline re-uptake inhibition. From these, one may predict that tapentadol would be applicable across a broad spectrum of pain from nociceptive to neuropathic. The evidence in animal models suggests that norepinephrine re-uptake inhibition (NRI) is a key mechanism and may even predominate over opioid actions in chronic (and especially neuropathic) pain states, reinforcing that tapentadol is different to classical opioids and may, therefore, be an a priori choice for the treatment of neuropathic and mixed pain. The clinical studies and subsequent practice experience and surveillance support the concept of opioid and non-opioid mechanisms of action. The reduced incidence of some of the typical opioid-induced side effects, compared to equianalgesic doses of classical opioids, supports the hypothesis that tapentadol analgesia is only partially mediated by opioid agonist mechanisms. Both the pre-clinical and clinical profiles appear to be differentiated from those of classical opioids. KEYWORDS: Tapentadol; analgesic mechanisms of action; analgesics; opioids; pain pharmacology PDF Papel de los opioides en el manejo de los ancianos con dolor The Role of Opioid Analgesics in Geriatric Pain Management. Naples JG1, Gellad WF2, Hanlon JT3. Clin Geriatr Med. 2016 Nov;32(4):725-735. doi: 10.1016/j.cger.2016.06.006. Epub 2016 Aug 9. Abstract When possible, chronic noncancer pain (CNCP) in older adults should be managed by nonpharmacologic modalities in conjunction with nonopioid analgesics. If moderate-to-severe pain persists despite these approaches, however, nonparenteral opioids may be considered as adjunctive therapy. This article reviews the epidemiology of opioid use and their effectiveness for CNCP in older adults and summarizes important age-related changes in opioid pharmacokinetics and pharmacodynamics that increase the risks of adverse effects in the elderly. Finally, to assist clinicians with selecting appropriate therapy, the article concludes with an evidence-based approach to optimize opioid prescribing in older adults with CNCP. KEYWORDS: Adverse drug event; Aged; Opioid; Pharmacokinetics PDF Farmacología de los analgésicos opioides PDF Analgésicos opioides Opioid Analgesics Maree T. Smith, Wei H. Goh PDF 5to Curso Internacional de Anestesiología cardiotorácica, vascular, ecocardiografía y circulación extracorpórea. SMACT Mayo 4-6, 2017, Ciudad de México Informes Dr. Hugo Martínez Espinoza bajamed@hotmail.com  Regional Anesthesiology and Acute Pain Medicine Meeting April 6-8, 2017, San Francisco, California, USA ASRA American Society of Regional Anesthesia and Pain Medicine Información / Information California Society of Anesthesiologists Annual Meeting April 27-30, 2017 San Francisco California Información / Information

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org Copyright © 2015

Microbioma y enfermedad broncopulmonar

Estimado Ciberpediatra te invito al Seminario de Pediatría, Cirugía Pediátrica y Lactancia Materna. El día 18 de Enero 2017 las 21hrs (Centro, México DF, Guadalajara y Lima Perú) a la Conferencia: “Microbioma y enfermedad broncopulmonar”, por el Dr. “José Antonio Ortega Martell”, Alergólogo Pediatra de la Cd. de Pachuca Hgo. La sesión inicia puntualmente las 21 hrs.
Para entrar a la Sala de Conferencia:
1.- hacer click en la siguiente liga, o cópiala y escríbela en tu buscador
http://connectpro60196372.adobeconnect.com/microbioma_enfpulmonar/
2.- “Entra como Invitado” Escribes tu nombre y apellido en el espacio en blanco
3.- Hacer click en el espacio que dice “Entrar en la Sala”
5.- A disfrutar la conferencia
6.- Recomendamos que dejes tu Nombre Completo, Correo electrónico y que participes.

Henrys


Dr. Enrique Mendoza López Webmaster: CONAPEME Coordinador Nacional: Seminario Ciberpeds-Conapeme Av La clinica 2520-310 Colonia Sertoma ,Mty N.L. México CP 64710 Tel-Fax 52 81 83482940 y 52 81 81146053 Celular 8183094806 www.conapeme.org www.pediatramendoza.com enrique@pediatramendoza.com emendozal@yahoo.com.mx

Ciática

Ciática

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Este artículo es originalmente publicado en:

https://youtu.be/XS2BTLYsn5w

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Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA

Dr. Ebraheim’s educational animated video describing disc herniation of the lumbo sacral spine, the etiology, signs and symptoms, diagnopsis, and treatment options.

it explains the anatomy of the spine the structure of the disc and types ,site ,level of disc prolapse bulge herniation

L4_L5 AND L5-S1 are the most common levels causing sciatica and positive SLR OR STRETCH TEST .

.https://twitter.com/#!/DrEbraheim_UTMC

Donate to the University of Toledo Foundation Department of Orthopaedic Surgery Endowed Chair Fund:

https://www.utfoundation.org/foundati…

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Técnica de Reconstrucción anatómica del ligamento coracoclavicular asistida artroscopicamente usando fijación con injerto coracoclavicular e injerto de tejido suave.

Técnica de Reconstrucción anatómica del ligamento coracoclavicular asistida artroscopicamente usando fijación con injerto coracoclavicular e injerto de tejido suave.

bibliomanazteca

ortopediaenpediatrica.com.mx

Técnica de Reconstrucción anatómica del ligamento coracoclavicular asistida artroscopicamente usando fijación con injerto coracoclavicular e injerto de tejido suave.

Arthroscopically Assisted Anatomic Coracoclavicular Ligament Reconstruction Technique Using Coracoclavicular Fixation and Soft-Tissue Grafts Fuente Este artículo es originalmente publ…

http://www.ortopediaenpediatrica.com.mx/academia/tecnica-de-reconstruccion-anatomica-del-ligamento-coracoclavicular-asistida-artroscopicamente-usando-fijacion-con-injerto-coracoclavicular-e-injerto-de-tejido-suave/

Arthroscopically Assisted Anatomic Coracoclavicular Ligament Reconstruction Technique Using Coracoclavicular Fixation and Soft-Tissue Grafts

Fuente
Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/26900558/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4722491/

http://www.arthroscopytechniques.org/article/S2212-6287(15)00088-2/abstract

De:

Millett PJ¹, Warth RJ¹, Greenspoon JA¹, Horan MP¹.

Arthrosc Tech. 2015 Oct 21;4(5):e583-7. doi: 10.1016/j.eats.2015.06.007. eCollection 2015

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© 2015 by the Arthroscopy Association of North America.Abstract

Acromioclavicular joint injuries are common and are often seen in contact athletes. Good to excellent clinical results have been reported using soft-tissue grafts to reconstruct the coracoclavicular ligaments; however, complications remain. Some complications are unique to the surgical technique, particularly clavicle and coracoid fractures that are associated with drilling large or multiple bone tunnels. The described technique allows for an anatomic coracoclavicular reconstruction using a large soft-tissue graft while minimizing the risk of clavicle fracture by avoiding large bone tunnels.

Resumen
Las lesiones de la articulación acromioclavicular son comunes y se observan a menudo en atletas de contacto. Se han descrito resultados clínicos buenos a excelentes con injertos de tejido blando para reconstruir los ligamentos coracoclaviculares; Sin embargo, las complicaciones persisten. Algunas complicaciones son únicas en la técnica quirúrgica, particularmente las fracturas de clavícula y coracoides que se asocian con la perforación de túneles óseos grandes o múltiples. La técnica descrita permite una reconstrucción coracoclavicular anatómica utilizando un gran injerto de tejido blando, minimizando al mismo tiempo el riesgo de fractura de la clavícula evitando grandes túneles óseos.

PMID: 26900558  PMCID: PMC4722491  DOI:  10.1016/j.eats.2015.06.007

[PubMed]

Free PMC Article

Fuente:ortopediaenpediatrica.com.mx

#ligamento#coracoclavicular#acromioclavicular#artroscopia#injertos