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Medicine Aug 2022This study aimed to evaluate the application of oxycodone in anesthesia induction and overall management of Da Vinci robot-assisted nephrectomy. (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
This study aimed to evaluate the application of oxycodone in anesthesia induction and overall management of Da Vinci robot-assisted nephrectomy.
METHODS
A total of 42 patients undergoing Da Vinci robot-assisted nephrectomy with general anesthesia were selected. They were randomly divided into 2 groups: patients were induced with oxycodone (oxycodone group) and were induced with sufentanil (sufentanil group). The vital signs at the following time points were recorded: after injection of induced drugs (T1), during glottis exposure (T2), immediately after intubation (T3), 1 minute (T4), 2 minute (T5), 3 minute (T6), 5 minute (T7), 10 minute (T8) after intubation, during skin incision (T9), at the end of suturing skin (T10), during extubation (T11), and during hemodynamic fluctuations intraoperatively (T`). Numerical rating scale, facial affective scale and monitoring of adverse events (visual analogue scale, NVAS) were evaluated postoperatively at 1 hour (T'"1), 3 hours (T""2), 6 hours (T""3), 12 hours (T""4), 24 hours (T""5), and 48 hours (T"'6).
RESULTS
The systolic blood pressure, the diastolic blood pressure and the mean arterial blood pressure showed no statistically different changes between the 2 groups. There were no statistical differences in heart rate and respiratory rate among various timepoints intraoperatively. There were statistical differences in Bispectral index (BIS) scores in T6 between the 2 groups. The numerical rating scale and facial affective scale scores were significantly lower in oxycodone group. Anesthetized with oxycodone, the pain did not affect the sleep of patients after operation. Also, the postoperative QoR-40 scores were lower in oxycodone group.
CONCLUSION
Compared with sufentanil, anesthesia induction with 0.3 mg/kg oxycodone in Da Vinci robot-assisted nephrectomy can achieve mild pain and mild adverse responses in patients postoperatively.
Topics: Anesthesia, General; Humans; Nephrectomy; Oxycodone; Pain; Robotics; Sufentanil
PubMed: 35960116
DOI: 10.1097/MD.0000000000029893 -
Drug and Alcohol Dependence Dec 2023Despite the thousands of lives lost during the ongoing opioid crisis, a scarcity of new and effective clinical treatments for opioid use disorder (OUD) remains. To...
Despite the thousands of lives lost during the ongoing opioid crisis, a scarcity of new and effective clinical treatments for opioid use disorder (OUD) remains. To address this unmet need, some researchers have turned to dissociative and psychedelic drugs to treat multiple psychiatric conditions. In particular, low doses of ketamine have been shown to attenuate opioid withdrawal and drug use in clinical and preclinical studies. However, ketamine has misuse liability and dissociative side effects that may limit its widespread application as a treatment for OUD. More recently, (2R,6R)-hydroxynorketamine (HNK), a ketamine metabolite that lacks misuse potential, has gained attention for its effectiveness in depression and stress models. To uncover its role in OUD, we tested the time-dependent effects of (2R,6R)-HNK on oxycodone withdrawal and reinstatement of oxycodone conditioned place preference (CPP). In male and female oxycodone-dependent mice, we found that 24h pretreatment with (2R,6R)-HNK (10 or 30mg/kg, s.c.) reduced the frequency of withdrawal-like behaviors and global withdrawal scores during naloxone-precipitated withdrawal, whereas 1h pretreatment with (2R,6R)-HNK only reduced paw tremors and the sum of global withdrawal scores but not GWS Z-scores. In other experiments, both 1h and 24h pretreatment with (2R,6R)-HNK (30mg/kg, s.c.) blocked drug-induced reinstatement of oxycodone CPP. Finally, we found (2R,6R)-HNK (30mg/kg, sc) had no effect on locomotor activity and thigmotaxis. Together, these results indicate that acute (2R,6R)-HNK has efficacy in some preclinical models of OUD without producing locomotor or anxiety-like side effects.
Topics: Humans; Mice; Male; Female; Animals; Ketamine; Antidepressive Agents; Oxycodone; Hallucinogens
PubMed: 37864957
DOI: 10.1016/j.drugalcdep.2023.110987 -
Expert Opinion on Investigational Drugs Aug 2007Oxytrex (Pain Therapeutics, Inc.) is an oral opioid that combines a therapeutic amount of oxycodone with an ultra-low dose of the antagonist naltrexone. Animal data... (Review)
Review
Oxytrex (Pain Therapeutics, Inc.) is an oral opioid that combines a therapeutic amount of oxycodone with an ultra-low dose of the antagonist naltrexone. Animal data indicate that this combination minimizes the development of physical dependence and analgesic tolerance while prolonging analgesia. Oxytrex is in late-stage clinical development by Pain Therapeutics for the treatment of moderate-to-severe chronic pain. To evaluate the safety and efficacy of the oxycodone/naltrexone combination, three clinical studies have been conducted, one in healthy volunteers and the other two in patients with chronic pain. The putative mechanism of ultra-low-dose naltrexone is to prevent an alteration in G-protein coupling by opioid receptors that is associated with opioid tolerance and dependence. Opioid agonists are initially inhibitory but become excitatory through constant opioid receptor activity. The agonist/antagonist combination of Oxytrex may reduce the conversion from an inhibitory to an excitatory receptor, thereby decreasing the development of tolerance and physical dependence.
Topics: Animals; Chemistry, Pharmaceutical; Dose-Response Relationship, Drug; Drug Administration Schedule; Humans; Naltrexone; Oxycodone
PubMed: 17685875
DOI: 10.1517/13543784.16.8.1277 -
Pharmacotherapy Jul 2002Prescriptions for controlled-release oxycodone, a narcotic analgesic, recently contributed to a dramatic increase in pharmacy costs for a large private insurance... (Review)
Review
Prescriptions for controlled-release oxycodone, a narcotic analgesic, recently contributed to a dramatic increase in pharmacy costs for a large private insurance company. To determine whether this agent offered clinical benefits over other available drugs that would justify its significantly greater cost, a systematic review of 16 clinical trials was undertaken. The review suggested that immediate-release and controlled-release preparations of oxycodone have similar efficacy and comparable side effect profiles. Controlled-release oxycodone has the advantage of less frequent dosing than immediate-release oxycodone; however, other agents may be dosed infrequently at much lower costs. For patients requiring a controlled-release opioid treatment, controlled-release morphine and methadone should be considered because they appear to be as effective as oxycodone and cost considerably less. Controlled-release oxycodone may be appropriate for some patients, particularly if they cannot tolerate other controlled-release or long-acting opioid analgesics.
Topics: Clinical Trials as Topic; Delayed-Action Preparations; Humans; Oxycodone; Pain
PubMed: 12126222
DOI: 10.1592/phco.22.11.898.33628 -
Molecules (Basel, Switzerland) Sep 2019The total synthesis of (+)-10-keto-oxycodone was attained from phenethyl acetate in a stereoselective manner. Absolute stereochemistry was established via enzymatic...
The total synthesis of (+)-10-keto-oxycodone was attained from phenethyl acetate in a stereoselective manner. Absolute stereochemistry was established via enzymatic dihydroxylation of phenethyl acetate with the recombinant strain JM109 (pDTG601A) that furnished the corresponding -cyclohexadienediol whose configuration corresponds to the absolute stereochemistry of the ring C of (+)-10-keto-oxycodone. Intramolecular Heck reaction was utilized to establish the quaternary carbon at C-13, along with the dibenzodihydrofuran functionality. The C-14 hydroxyl and C-10 ketone were installed via SmI-mediated radical cyclization, and oxidation of a benzylic alcohol (obtained from an intermediate nitrate azide), respectively. The synthesis of (+)-10-keto-oxycodone was completed in a total of 14 operations (21 steps) and an overall yield of ~2%. Experimental and spectral data are provided for key intermediates and new compounds.
Topics: Acetates; Catalysis; Chemistry Techniques, Synthetic; Molecular Structure; Oxycodone; Stereoisomerism
PubMed: 31557873
DOI: 10.3390/molecules24193477 -
Zhongguo Yi Xue Ke Xue Yuan Xue Bao.... Feb 2020To evaluate the value of oxycodone hydrochloride for postoperative pain management in patients undergoing patient-controlled intravenous analgesia(PCIA). The medical...
To evaluate the value of oxycodone hydrochloride for postoperative pain management in patients undergoing patient-controlled intravenous analgesia(PCIA). The medical records on postoperative pain management in our department from January 1 to June 30,2018,were retrospectively analyzed.Totally 136 patients were assigned into oxycodone,sufentanil,or morphine groups according to the opioid used in the PCIA.Patients were assessed for postoperative pain severity(scored with NRS)and adverse reactions 24,36,and 48 hours after surgery.The area under curve(AUC)was calculated. The score of pain at exercise was significantly lower in the oxycodone group(2.2±2.4)than in the sufentanil group(3.4±2.1)(=0.305,=0.0126)or the morphine group(3.4±1.7)(=0.104,=0.0277)36 hours after surgery.AUC at rest was significantly lower in the oxycodone and morphine groups than in the sufentanil group(29.00,27.00,and 40.01,respectively);in contrast,AUC at exercise was significantly lower in the oxycodone group(63.17)than in the sufentanil and morphine groups(82.00 and 80.93,respectively).The consumption of opioids was significantly higher in the sufentanil group[(37.2±16.1),(46.1±24.3),(64.4±33.4)mg]than in the oxycodone group[(20.4±14.8)(=3.571,=0.001),(24.2±16.1)(=4.63,<0.0001),(34.4±25.1)mg(=6.409,<0.0001)]or the morphine group[(16.6±11.7)(=4.233,<0.0001),(20.5±14.1)(=5.250,<0.0001),(28.8±19.0)mg(=7.354,<0.0001)]24,36,48 hours after surgery.The oxycodone group experienced less vomiting(=11.360,=0.003)and early termination of PCIA(=7.914,=0.019)compared with the other two groups. Oxycodone can be used for postoperative PCIA.It can alleviate a variety of postoperative pain,with superior analgesic efficiency and safety to sufentanil and morphine.
Topics: Analgesia, Patient-Controlled; Humans; Morphine; Oxycodone; Pain, Postoperative; Retrospective Studies; Sufentanil; Surgical Procedures, Operative
PubMed: 32131946
DOI: 10.3881/j.issn.1000-503X.11141 -
Journal of Clinical Pharmacology Apr 2017Oxycodone DETERx (Collegium Pharmaceutical Inc, Canton, Massachusetts) is an extended-release, microsphere-in-capsule, abuse-deterrent formulation designed to retain its... (Randomized Controlled Trial)
Randomized Controlled Trial
Oxycodone DETERx (Collegium Pharmaceutical Inc, Canton, Massachusetts) is an extended-release, microsphere-in-capsule, abuse-deterrent formulation designed to retain its extended-release properties after tampering (eg, chewing/crushing). This randomized, double-blind, placebo-controlled, triple-dummy study evaluated the oral abuse potential of intact and chewed oxycodone DETERx capsules compared with crushed immediate-release oxycodone. Subjects with a history of recreational opioid use who were nondependent/nontolerant to opioids were enrolled. Treatments included intact oxycodone DETERx (high-fat, high-calorie meal and fasted), chewed oxycodone DETERx (high-fat, high-calorie meal and fasted), crushed immediate-release oxycodone (fasted), and placebo (high-fat, high-calorie meal). Plasma samples were collected to determine pharmacokinetic parameters. The primary endpoint was drug liking at the moment; other endpoints included drug effects questionnaire scores, Addiction Research Center Inventory/Morphine Benzedrine Group score, pupillometry measurements, and safety. Thirty-eight subjects completed the study. Chewed and intact oxycodone DETERx were bioequivalent, unlike crushed immediate-release oxycodone, which yielded higher peak oxycodone plasma concentrations compared with all methods of oxycodone DETERx administration. The mean maximum (peak) effect (E ) for drug liking was significantly lower for chewed and intact oxycodone DETERx than for crushed immediate-release oxycodone (P < .01). The time to E was significantly longer for chewed and intact oxycodone DETERx than for crushed immediate-release oxycodone (P < .0001). Scores for feeling high and Addiction Research Center Inventory/Morphine Benzedrine Group scores demonstrated lower abuse potential for chewed and intact oxycodone DETERx compared with crushed immediate-release oxycodone. Study treatments were well tolerated; no subjects experienced serious adverse events. These results demonstrate the lower oral abuse potential of chewed and intact oxycodone DETERx than crushed immediate-release oxycodone.
Topics: Administration, Oral; Adolescent; Adult; Cross-Over Studies; Delayed-Action Preparations; Double-Blind Method; Drug Compounding; Female; Humans; Male; Mastication; Middle Aged; Opioid-Related Disorders; Oxycodone; Young Adult
PubMed: 27669664
DOI: 10.1002/jcph.833 -
Pharmacogenomics Mar 2023Variability in the pharmacokinetics and pharmacodynamics of oxycodone in children undergoing surgery could be due to genetic polymorphisms. The authors studied the...
Variability in the pharmacokinetics and pharmacodynamics of oxycodone in children undergoing surgery could be due to genetic polymorphisms. The authors studied the association between clinical outcomes and pharmacogenes in children undergoing major surgery. A total of 89 children (35 undergoing pectus excavatum repair and 54 undergoing spinal fusion) were recruited. SNP rs6902403 showed an association with maximum pain score and total morphine equivalent dose (p < 0.05). Other polymorphisms in SNP, , and were also shown to be associated with average morphine equivalent dose, length of hospital stay and maximum surgical pain (p < 0.05). This study demonstrates novel associations between the above pharmacogenes and oxycodone's pharmacokinetics as well as postoperative outcomes in children. : NCT03495388 (ClinicalTrials.gov).
Topics: Humans; Child; Oxycodone; Pharmacogenetics; Prospective Studies; Analgesics, Opioid; Pain, Postoperative; Morphine; Analgesia
PubMed: 36946298
DOI: 10.2217/pgs-2022-0149 -
Neuropharmacology Dec 2019Repeated exposure to the opioid agonist, oxycodone, can lead to addiction. Accumulating evidence has shown that oxytocin (OT), a neurohypophyseal neuropeptide, could...
Repeated exposure to the opioid agonist, oxycodone, can lead to addiction. Accumulating evidence has shown that oxytocin (OT), a neurohypophyseal neuropeptide, could reduce the abuse potential of drugs. Recent studies suggest that epigenetic regulation through DNA methylation are involved in neuroadaptations. The current study was conducted to investigate the effects of OT on oxycodone conditioned place preference (CPP) and the epigenetic mechanism of OT in the hippocampus. For induction of CPP, oxycodone (3.0 mg/kg, i. p.) was administrated to male Sprague-Dawley rats once every other day during an eight-day conditioning phase. Global 5-methylcytosine (5-mC) level was determined based on CPP procedure, including acquisition, expression, extinction and reinstatement. We also measured mRNA levels of DNA methyltransferases (Dnmts), ten-eleven translocations (Tets) and synaptic genes (Psd95, Shank2, Gap43, etc.), and determined synaptic density after restraint stress-induced reinstatement of oxycodone CPP. The results showed that OT (2.5 μg, i. c.v.) pretreatment specifically inhibited the CPP acquisition and expression, facilitated the CPP extinction, and abolished restraint stress-induced reinstatement of oxycodone CPP. OT markedly inhibited global 5-mC changes induced by oxycodone CPP in the four phases. Following restraint stress-induced reinstatement of oxycodone CPP, OT significantly increased mRNA levels of Dnmt1, decreased Tet1 mRNA, synaptic proteins and synaptic density in the hippocampus. Our study indicated that reversal of global DNA hypomethylation through OT could significantly attenuate the rewarding effects induced by oxycodone. Our results suggested that OT could be specific manipulation on oxycodone addiction.
Topics: Animals; Conditioning, Psychological; DNA Methylation; Epigenesis, Genetic; Extinction, Psychological; Hippocampus; Learning; Male; Memory; Narcotic Antagonists; Opioid-Related Disorders; Oxycodone; Oxytocin; Rats; Rats, Sprague-Dawley
PubMed: 31526808
DOI: 10.1016/j.neuropharm.2019.107778 -
The Medical Letter on Drugs and... Mar 2012
Review
Topics: Animals; Chemistry, Pharmaceutical; Humans; Oxycodone; Pain
PubMed: 22382582
DOI: No ID Found