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Opioids are the mainstay for cancer and noncancer pain management. However, their use is often associated with multiple adverse effects. Among them, the most common and persistent one is probably opioid-induced constipation (OIC). Periphery selective opioid antagonists may alleviate the symptoms of OIC without compromising the analgesic effects of opioids. Recently our laboratories have identified one novel lead compound, 17-cyclopropylmethyl-3,14β-dihydroxy-4,5α-epoxy-6β-[(4'-pyridyl)acetamido]morphinan (NAP), as a peripherally selective mu opioid receptor ligand carrying subnanomolar affinity to the mu opioid receptor and over 100-folds of selectivity over both the delta and kappa opioid receptors, with reasonable oral availability and half-life, and potential to treat OIC. Nanoparticle-based drug delivery systems are now widely considered due to their technological advantages such as good stability, high carrier capacity, low therapeutic side effects, etc. Herein we report nanoparticle supported NAP as a potential candidate for OIC treatment with improved peripheral selectivity over the original lead compound NAP.
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http://dx.doi.org/10.1021/acsmedchemlett.6b00382 | DOI Listing |
J Pain Res
September 2025
Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, People's Republic of China.
Purpose: Postoperative hyperalgesia (POH) is a common clinical phenomenon that will increase the experience of patients' pain. Previous studies have confirmed that surgical site, opioid analgesics, gender, and age were risk factors of POH. Limited research has been investigated to prove the association between obstructive sleep apnea (OSA) and POH.
View Article and Find Full Text PDFMedicine (Baltimore)
September 2025
Department of Anesthesiology, The First Affiliated Hospital of Traditional Chinese Medicine of Chengdu Medical College, XinDu Hospital of Traditional Chinese Medicine, Chengdu, China.
Background: With ultrasound-guided nerve block technology being increasingly used in hip surgery, the choice between fascia iliaca block (FIB) and lumbar plexus block (LPB) is still inconclusive. This study aims to evaluate the advantages and disadvantages of FIB and LPB in hip surgery.
Methods: PubMed, Web of Science, Cochrane Library, Embase, and CNKI were searched from inception to October 4, 2022.
Cochrane Database Syst Rev
September 2025
Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada.
Background: Opioid use disorder (OUD) is commonly treated in specialized care settings with long-acting opioid agonists, also known as opioid agonist therapy, or OAT. Despite the rise in opioid use globally and evidence for a 50% reduction in mortality when OAT is employed, the proportion of people with OUD receiving OAT remains small. One initiative to improve the access and uptake of OAT could be to offer OAT in a primary care setting; primary care clinics are more numerous, might reduce the visibility and potential stigma of receiving treatment for OUD, and may facilitate the care of other medical conditions that are unrelated to OUD.
View Article and Find Full Text PDFCureus
September 2025
General Surgery, Norfolk and Norwich University Hospital, Norwich, GBR.
Enhanced recovery after surgery (ERAS) protocols are increasingly used in total hip and knee arthroplasty to improve outcomes, reduce complications, and shorten hospital stays. This involves a multidisciplinary, evidence-based approach covering the preoperative to postoperative period. This review explores the current literature on ERAS implementation in elective total hip arthroplasty (THA) and total knee arthroplasty (TKA), focusing on clinical outcomes such as length of stay (LOS), opioid use, complications/readmissions, and other key components such as anesthetic standardization, use of opioid-sparing analgesia agents, early mobilization, and patient satisfaction.
View Article and Find Full Text PDFDrug Alcohol Depend Rep
September 2025
Center for Behavioral Emergency and Addiction Research, McWilliams School of Biomedical Informatics, The University of Texas Health Sciences Center at Houston (UTHealth), Houston, TX, United States.
Introduction: As the prevalence of opioid use disorder (OUD) continues to rise, early detection by medical professionals can often be the first step in linking individuals to treatment. This systematic review was designed to identify implemented OUD screening and assessment tools with studies published from January 2019 through June 2024, uncover common themes associated with implementation, and determine if these tools were recommended in clinical practice.
Methods: A systematic literature search was conducted within PubMed, EMBASE, and Web of Science using the keywords 'opioid use disorder,' 'documentation,' and 'screening assessment tool.