Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0344307 (analgesia)
 28,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The combination of dextroamphetamine and morphine has been shown to be synergistic for analgesia and antagonistic for most other effects. However, the claim that dextroamphetamine antagonizes the respiratory depression caused by morphine has not been well substantiated. In this double-blind study, we investigated respiratory effects, including resting respiration, isohypercapnic ventilation, CO2 response, dose response, and duration of these effects with dextroamphetamine alone and in combination with morphine. Dextroamphetamine alone (0.215 mg/kg) caused increases in minute ventilation and a leftward shift of the CO2 response curve that lasted for less than 2 hours. Dextroamphetamine combined with low-dose morphine (0.15 mg/kg) antagonized respiratory depression throughout the 5-hour observation period. Dextroamphetamine combined with high-dose morphine (0.30 mg/kg) was unable to completely antagonize depressed ventilation, and some residual effects of morphine persisted at 23 hours.
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PMID:Dextroamphetamine with morphine: respiratory effects. 640 51

Maternal stress on gestational day 8 (GD8) in the CD-1 mouse can induce a syndrome of fetal anomalies, including encephalocele, supernumerary ribs, fused ribs and vertebral anomalies. Two forms of restraint were compared for their ability to induce these defects. The two types of restraint differed in the degree of mobility afforded the dam during confinement, either total restraint in a supine position or a less confining restraint in which restrained dams could move from a supine to a non-supine position, but could not turn from front to back. Dams were exposed to either form of restraint for 12 h on GD8 and their near-term fetuses examined for external and skeletal abnormalities. As both types of restraint precluded normal eating and drinking, an additional control group deprived of food/water was included for evaluation. Cohorts of dams were restrained for 3, 6 or 12 h on GD8 and end points commonly used to gauge the degree of stress evaluated. These included serum corticosterone level and the weight of body, spleen and thymus. Stress-induced analgesia, as measured by the tail-flick procedure, was monitored in these same dams as an additional non-invasive measure of stress. Both types of restraint induced greater and longer-lasting weight loss than food/water deprivation. Both also produced more fetal anomalies than observed in the offspring of caged controls or food/water deprived dams. Both forms of restraint equally elevated serum corticosterone levels above the increase exhibited by the food/water deprived dams. The most pronounced difference between the two types of restraint concerned the degree of analgesia. The type limiting mobility the most, caused much greater analgesia after 6 and 12 h of restraint although the dams subjected to the other form of restraint were significantly more analgesic than the food/water deprived dams by 12 h. Dams restrained in the supine position exhibited slightly greater weight loss, more analgesia and produced significantly more offspring with anomalies.
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PMID:Restraint-induced stress in pregnant mice--degree of immobilization affects maternal indices of stress and developmental outcome in offspring. 774 May 45

The doses of opioid analgesics required to control pain in patients with cancer may result in somnolence and reduced interaction with family members. Psychostimulants such as dextroamphetamine (DA, Dexedrine) or methylphenidate (MP, Ritalin) have been used in adults to counteract the sedation of opioid analgesia. We retrospectively reviewed our experience using these agents at Children's Hospital. Eleven patients (age 12-20 years) received DA or MP, and decreased somnolence or improved interaction was noted in five patients. Adverse effects potentially related to DA or MP were noted in two patients, none of which resulted in discontinuance of the stimulant. Further prospective, controlled studies are needed to assess the safety and efficacy of DA and MP in counteracting the sedation of opioid analgesia in children and adolescents.
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PMID:Dextroamphetamine or methylphenidate as adjuvants to opioid analgesia for adolescents with cancer. 791 10

Mucositis remains an important problem following BMT and may delay discharge from hospital. Patient-controlled analgesia (PCA) systems have been reported to be of benefit in controlling BMT-associated mucositis. The present study comprised 65 patients (age range 16-68 years; 19 allografts, 29 peripheral blood stem cell autografts and 17 autologous bone marrow). Subjects were prospectively randomised to receive intravenous diamorphine for pain relief either by conventional continuous infusion (CI) or by PCA, using a Medex Walkman 440 delivery system. Each patient assessed his/her pain control and nausea daily by a visual analogue scale. Twenty-two patients did not require any diamorphine. Four patients required diamorphine for pain other than mucositis, and four patients failed PCA control. Of 35 assessable cases, no difference in pain control was noted between CI and PCA. However, PCA-controlled patients required significantly less diamorphine than CI controlled patients (mean, 131 +/- 23 mg for PCA vs 296 +/- 40 mg for CI; P = 0.001), and PCA required fewer days of diamorphine than CI (mean, 7.17 +/- 0.66 days for PCA, 9.00 +/- 0.65 days for CI; P = 0.03). Side-effects were minimal and equivalent in the two arms. The findings suggest that PCA and CI offer equivalent control of the pain of BMT-associated mucositis, but PCA requires less total consumption and duration of diamorphine therapy.
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PMID:Comparison of a patient-controlled analgesia system with continuous infusion for administration of diamorphine for mucositis. 973 74

A novel dermorphin tetrapeptide N(alpha)-amidino-Tyr-D-Arg-Phe-MebetaAla-OH (ADAMB) was designed based on the structures of several dermorphin tetrapeptide analogues, including N(alpha)-amidino-Tyr-D-Arg-Phe-Gly-OH (ADA-DER), H-Tyr-D-Arg-Phe-betaAla-OH (TAPA), and H-Tyr-D-Arg-Phe-Sar-OH (DAS-DER). These parent compounds were known to show a weak oral analgesic activity in animals and/or to possess a different mechanism of analgesia from other mu-opioid peptides. Six analogues of ADAMB were also synthesized to investigate the effect on potency of N-terminal amidination and N-methyl-beta-alanine (MebetaAla) substitution at position 4. Compounds were assessed using the tail pressure test in mice after subcutaneous and oral administration. Among the peptides tested, ADAMB showed the strongest oral antinociceptive activity, with an ED(50) of 5.8 vs 22.2 mg/kg for morphine, as well as a 38-fold stronger activity after subcutaneous administration. ADAMB also showed long-lasting antinociceptive activity, with 50% of the maximum effect persisting in the tail pressure test at 10 h after oral administration (10 mg/kg). In contrast, orally administered morphine (80 mg/kg) showed a rapid decrease of activity in the same test and its antinociceptive effect disappeared within 4 h. When the antinociceptive effect of ADAMB was compared with that of analogues possessing betaAla(4) (1) or Sar(4) (2), as well as analogues with N-substitution (3-6), it was found that both the N(alpha)-amidino substitution and the MebetaAla(4) were synergistically involved in creating ADAMB's exceptionally high antinociceptive activity.
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PMID:Synthesis and structure-activity relationships of an orally available and long-acting analgesic peptide, N(alpha)-amidino-Tyr-D-Arg-Phe-MebetaAla-OH (ADAMB). 1240 19

In order to determine whether budesonide, which is believed to exert most of its anti-inflammatory effects in the intestinal tract, has a beneficial effect on disease activity in rheumatoid arthritis (RA), we treated 26 patients with active RA in double-blind fashion with either controlled ileal-release budesonide (9 mg by mouth) ( n=14) or placebo ( n=12). All patients remained on their existing disease-modifying antirheumatic drugs (DMARDs) and nonsteroidal anti-inflammatory drugs (NSAIDs). Paracetamol was used for escape analgesia. Evaluations were performed at 0, 2, and 4 weeks and included tender and swollen joint counts, duration of morning stiffness, visual analogue scale for pain (VAS) on a 100-mm horizontal scale, grip strength using a vigorimeter (lb/in(2)), haemoglobin, erythrocyte sedimentation rate (ESR) (Westergren method, mm/1st h), plasma viscosity (PV) in cP (normal range 1.5-1.72), C-reactive protein (CRP) (normal upper level 1 mg/dl), random plasma cortisol (nmol/l) drawn between 10 a.m. and 2 p.m., and blood pressure. Disease activity scores based on 28 joints (DAS 28) were also derived at all time points. Within-group comparisons revealed significant improvement in the budesonide-treated but not the placebo group with respect to numbers of tender and swollen joints, duration of morning stiffness, grip strength, pain, ESR, PV, and DAS 28. Between-group comparisons showed significant differences for ESR, PV, pain, and random plasma cortisol (drawn between 10 a.m. and 2 p.m.). There were no significant side effects in either group.
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PMID:Ileum-targeted steroid therapy in rheumatoid arthritis: double-blind, placebo-controlled trial of controlled-release budesonide. 1285 38

Opioids are widely used as analgesics to supplement general anaesthesia or as adjunct to anaesthetic agents and for long term analgesia and sedation in intensive care patients. Some clinical studies have suggested that opioids may have different and deleterious haemodynamic effects that remain incompletely examined. We compared the direct cardiac effects of fentanyl and remifentanil in isolated Wistar rat hearts. Twenty rats were randomly assigned to two groups. Hearts were perfused with modified Krebs Henseleit solution and were exposed to 1 x 10(-6) moles(M)/L fentanyl (n=10) in Group I and 1 x 10(-6) M/L remifentanil (n=10) in Group II. Heart rates, contractile force and coronary perfusion were recorded continuously during the study. There was a significant decrease in heart rate and increase in contractility and coronary perfusion in two groups (p<0.001). Fentanyl had less depressant effects on heart rate than remifentanil. We conclude that in isolated rat heart, fentanyl and remifentanil cause direct negative chronotropic and positive inotropic effect. Remifentanil had more depressant effects on heart rate than fentanyl in isolated rat heart.
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PMID:Direct cardiac effects in isolated perfused rat hearts of fentanyl and remifentanil. 1776 64