Physical Medicine Rehabilitation

Managing Patients with Chronic Pain and Opioid Addiction by Donald R Taylor

By Donald R Taylor

This textual content will offer readers with a radical evaluation of the advanced situation of persistent discomfort and addictions. The e-book was once initially commissioned because of the want within the box for extra literature at the subject. This concise notebook will overview epidemiology, medical good points, analysis, and scientific administration of either persistent ache and habit. Busy healthcare execs will reap the benefits of this article, to be able to not just hide the basis of the administration of either stipulations and jointly, yet talk about updated nationwide and foreign remedy directions, upcoming cures and REMS.

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ArticleNumber=58. Published October 29, 2011. Accessed September 18, 2014. 2 Savage SR, Horvath R. Opioid Therapy of Pain, In: Ries R, ed. Principles of Addiction Medicine. 4th edn. Philadelphia, PA: Lippincott Williams & Wilkins; 2009:1329-1353. 3 Weaver M, Schnoll S. Abuse liability in opioid therapy for pain treatment in patients with an addiction history. Clin J Pain. 2002;18:S61-S69. 4 Policy Impact: Prescription Painkiller Overdoses. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention.

In 2002, buprenorphine and buprenorphine/naloxone were approved for opioid addiction treatment in the US. Currently, buprenorphine is available for parenteral, sublingual, buccal, and transdermal administration and is being studied as a sub-dermal implant and depot formulation for injection. Analgesic action of buprenorphine Buprenorphine’s primary analgesic action is thought to occur through activation of the mu-opioid receptor [3,11]. Sublingual buprenorphine reaches its peak plasma concentration 90 mins after administration [12].

Com. Accessed September 18, 2014. Chapter 4 Managing patients with chronic pain and opioid addiction There are various opioids used to manage chronic (noncancer) pain (CP) and their availability varies depending on each country’s marketing approval status. Some available opioids in the US include: buprenorphine, morphine, oxymorphone, hydromorphone, fentanyl, codeine, hydrocodone, oxycodone, methadone, meperidine, tramadol, tapentadol, butorphanol tartrate, pentazocine, and levorphanol. Most of the opioids function primarily as full, partial, or mixed mu-receptor agonists with the exception of levorphanol and methadone, which both have effects at the N-Methyl-D-aspartate receptor, and tapentadol and tramadol, which both block norepinephrine and serotonin reuptake.

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