Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Despite the recent introduction of a number of new compounds, there has of late been a cooling of interest by pharmaceutical companies in the development of centrally-active, selective kappa opioid agonists for therapeutic purposes. This is reflected in the discontinuation of a number of clinical trials, for reasons that are often not completely clear to outside observers. Spiradoline and enadoline have apparently been abandoned as potential analgesics because they induce dose-limiting central side-effects (i.e., dysphoria) in models of post-surgical pain. The development of niravoline as an aquaretic for the treatment of cirrhosis with ascites and other hyponatraemic disorders has also been halted. Enadoline may yet find some application against ischaemic stroke and severe head injury, presumably in comatose patients in whom psychiatric side-effects are taken to be immaterial, while apadoline and TRK 820 remain in Phase II clinical testing against cancer pain. The peripherally-selective kappa agonists, asimadoline, and the atypical compound, fedotozine, are well-tolerated in man. Results of Phase III trials of fedotozine against irritable bowel syndrome and dyspepsia have, however, ultimately been disappointing, whereas asimadoline is currently in Phase II clinical trials against pain of rheumatic and osteoarthritic origin. The results of these trials are eagerly awaited.
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PMID:Novel developments with selective, non-peptidic kappa-opioid receptor agonists. 1598 6

A 63-year-old man with liver cirrhosis and hepatocellular carcinoma presented with abrupt encephalopathy with markedly elevated blood ammonia levels. He was found lying down in front of the hospital 2 days after treatment of right hypochondrial pain with sustained-release oral morphine sulfate. He tended to be constipated before receiving morphine sulfate. The excess production of ammonia due to his constitutional constipation exacerbated by the use of oral morphine was thought to be the causal association with transient hepatic encephalopathy. He regained consciousness by receiving aminoleban intravenously and anticonstipating suppository. We realized that much care should be taken to avoid such opioid-related constipation at the time of pain management for quality of life improvement in patients with cancer pain.
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PMID:[A case of hepatic encephalopathy induced by adverse effect of morphine sulfate]. 1863 39

Hepatocellular carcinoma (HCC) remains the most common primary liver malignancy. Pain comprises one of the most pervasive and troubling symptoms of HCC and may have severely negative effects on patient's quality of life. Furthermore, because HCC frequently arises in the setting of cirrhosis, treating pain related to this malignancy poses a clinical challenge. This article summarizes manifestations of hepatocellular cancer pain, common obstacles to treatment, and practical HCC pain management.
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PMID:Hepatocellular cancer pain: impact and management challenges. 3005 Aug 80