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September 28, 2019

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Euphorbia Bicolor (Euphorbiaceae) Latex Phytochemicals Induce Long-Lasting Non-Opioid Peripheral Analgesia in a Rat Model of Inflammatory Pain

The negative side effects of opioid-based narcotics underscore the search for alternative non-opioid bioactive compounds that act on the peripheral nervous system to avoid central nervous system-mediated side effects. The transient receptor potential V1 ion channel (TRPV1) is a peripheral pain generator activated and sensitized by heat, capsaicin, and a variety of endogenous ligands. TRPV1 contributes to peripheral sensitization and hyperalgesia, in part, via triggering the release of proinflammatory peptides, such as calcitonin gene-related peptide (CGRP), both locally and at the dorsal horn of the spinal cord.

Rethinking Opioid Dose Tapering, Prescription Opioid Dependence, and Indications for Buprenorphine

The expanded use of opioids for chronic pain has created a population of patients prescribed long-term opioid therapy lasting years or decades. Doses are often above the thresholds suggested in the 2016 Centers for Disease Control and Prevention (CDC) guideline (morphine-equivalent dose >50 or >90 mg/d). Long-term opioid therapy is associated with adverse effects, morbidity, and overdose death; some risks are dose-dependent. At the same time, evidence indicates that long-term opioid therapy confers little benefit versus nonopioid therapy, particularly for function. Opioid use disorder (OUD) occurs in a subset of patients, and quality of life may be adversely affected despite perceived pain benefits.
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Pain Medicine Journal
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AAPM

American Academy of Pain Medicine