conclusions pain management in patients with liver dysfunction is always challenging to physicians because of the adverse reactions of drugs, especially opioids. opioids should be used cautiously since they can cause sedation, constipation and sudden encephalopathy effects. since the clearance of these drugs in patients with hepatic insufficiency is decreased, the initial dose must be decreased...

Opioids are a mainstay of treatment for pain worldwide. Pruritus, common side effect opioids, is patient dissatisfier that limits their use in many clinical settings. Both parenteral and neuraxial administration opioids frequently evoke pruritus. The ability to suppress while causing itch continues perplex clinicians researchers alike. Several mechanisms have been proposed explain how can give ...

BACKGROUND AND OBJECTIVES In addition to their major influence on human behavior, opium and opioids have been used for a long time as sedative and analgesic drugs. As from the 19th century, with the isolation of opium alkaloids and easy parenteral administration of these substances, there has been increased interest in the judicious medical use of opioids and in the analysis of social consequen...

Mu-opioids (i.e. morphine, oxycodone, hydrocodone) are considered to be the primary drugs for treatment of moderate to severe acute, chronic and cancer pain. Despite their analgesic effectiveness they have several clinically significant side-effects (cognitive, motor, respiratory, cardiovascular, gastrointestinal). They also have a limited spectrum of action, being more effective for nociceptiv...

CONTEXT Epidural labor analgesia, if selected by the patient, is associated with high cesarean delivery rates. Results of randomized trials comparing rates of cesarean delivery using epidural anesthesia vs parenteral opioids are inconsistent. OBJECTIVE To review the effects of epidural vs parenteral opioid analgesia on cesarean delivery rates. DATA SOURCES Studies were identified by searchi...

OBJECTIVE Standardization and systematization of data to provide quick access to compatibility of leading injectable drugs used in hospitals for parenteral nutrition. METHODS We selected 55 injectable drugs analyzed individually with two types of parenteral nutrition: 2-in-1 and 3-in-1. The following variables were considered: active ingredient, compatibility of drugs with the parenteral nutr...

Acute pain management in opioid dependent patients remains a challenging and complex problem and it is becoming more common (1). In the acute pain setting, in addition to their daily opioid maintenance these patients need a multimodal approach (1). Imani et al. in their study have shown that instead of simply increasing the dosage of morphine, using morphine in addition to chlorpromazine, prome...

A drug's plasma level, pharmacological effects or side effects, elimination, physicochemical properties or stability could be changed by interactions of drug-drug or drug-nutrition products in patients who receive enteral or parenteral nutritional support. As a result, patients might experience ineffective outcomes or unexpected effects of therapy (such as drug toxicity, embolism). Stability or...