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University of Arizona
1.
Ford, Jenna Corrine.
Opioid Misuse and Prescriber Accountability in an Urgent Care Setting
.
Degree: 2018, University of Arizona
URL: http://hdl.handle.net/10150/631313 
► The misuse of prescription opioids has become an epidemic, not only in the United States but across the globe. Implementation of The Controlled Substances Prescription…
(more)
▼ The misuse of prescription opioids has become an epidemic, not only in the United States but across the globe. Implementation of The Controlled Substances Prescription Monitoring Program (CSPMP) has been utilized to assist in combating the issue of the misuse of prescription
opioid pain medication. Evidence based practice guidelines have been recommended by various clinical practice and federal agencies such as the Center for Disease Control (CDC) with the overall goal of improving public health. The purpose of this doctoral project was to ensure that providers are utilizing these clinical programs and following the recommended guidelines on safe prescribing of
opioid pain medication in a FastMed Urgent Care setting. This project answered the following clinical question: When prescribing
opioid pain medication, to what extent are providers in the FastMed Urgent Care clinic accessing the Controlled Substances Prescription Monitoring Program (CSPMP) and following recommended prescribing guidelines?
This project was conducted using a retrospective chart review (RCR). A checklist was utilized to collect the data. The data was analyzed to find an average percentage of those prescribers who are following the recommendations highlighted in this project. All of the charts reviewed (N=37; 100%) had a documented history and physical (H&P) by the provider in the medical record. Past substance abuse was documented in 8 out of the 17 charts that were being prescribed an
opioid (N=17; 47%) (Table 1). Accessing the CSPMP before prescribing an
opioid medication was documented by providers 43.2% of the time (n=16). The prescribing of
opioid pain medication was documented 37.5% of the time (n=17), leaving only one chart which had documented prescribing of an
opioid pain medication but did not provide documentation of accessing the CSPMP prior to writing the prescription. The patient was referred to another discipline for treatment of pain 8.2% of the time (n=3) and education was documented on safety 100% of the time (n=37).
This project concluded that all providers are documenting a thorough history and physical, and the majority are utilizing evidence-based guidelines and accessing the Controlled Substance Prescription Monitoring Program when prescribing
opioid pain medication during the time frame of the review. After review, this project found that prescribers are not consistently documenting past history of substance abuse. However, prescribers in the FastMed setting are prescribing conservatively and the vast majority are taking the appropriate measures to ensure safe prescribing is taking place. An executive summary was drafted after the conclusion of this project and sent to the providers and administrators of the participating clinical setting with results and recommendations for future practice.
Advisors/Committee Members: Love, Rene (advisor), Allison, Theresa (committeemember), Kiviat, Joy (committeemember).
Subjects/Keywords: Opioid
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APA (6th Edition):
Ford, J. C. (2018). Opioid Misuse and Prescriber Accountability in an Urgent Care Setting
. (Doctoral Dissertation). University of Arizona. Retrieved from http://hdl.handle.net/10150/631313
Chicago Manual of Style (16th Edition):
Ford, Jenna Corrine. “Opioid Misuse and Prescriber Accountability in an Urgent Care Setting
.” 2018. Doctoral Dissertation, University of Arizona. Accessed February 28, 2021.
http://hdl.handle.net/10150/631313.
MLA Handbook (7th Edition):
Ford, Jenna Corrine. “Opioid Misuse and Prescriber Accountability in an Urgent Care Setting
.” 2018. Web. 28 Feb 2021.
Vancouver:
Ford JC. Opioid Misuse and Prescriber Accountability in an Urgent Care Setting
. [Internet] [Doctoral dissertation]. University of Arizona; 2018. [cited 2021 Feb 28].
Available from: http://hdl.handle.net/10150/631313.
Council of Science Editors:
Ford JC. Opioid Misuse and Prescriber Accountability in an Urgent Care Setting
. [Doctoral Dissertation]. University of Arizona; 2018. Available from: http://hdl.handle.net/10150/631313
Royal Roads University
2.
Ragan, Chrystal Marie.
Engaging people with lived experience of opioid use
.
Degree: 2020, Royal Roads University
URL: https://viurrspace.ca/handle/10613/23156
► This inquiry explored the research question: How can the Fort St John Community Action Team (CAT) create a safe environment to ensure peer input? The…
(more)
▼ This inquiry explored the research question: How can the Fort St John Community Action Team (CAT) create a safe environment to ensure peer input? The Northern Health Authority acted as a partner in this research. This inquiry was grounded in community-based action research and action research engagement methodology. Following Royal Roads University Research Ethics Board (REB) approval and the Northern Health Authority Research Ethics and Operational approval, eight people with lived experience (peers) over the age of nineteen, within the community of Fort St John, were recruited to participate in journey mapping sessions and semi-structured interviews. In addition, eight members of the Community Action Team (CAT) participated in a focus group. Findings in this inquiry include information related to the barriers peers experience accessing services within the community, the importance of supportive services within the community, the importance of foundational relationships between community professionals and peers, and the importance of using a variety of engagement methods to gather input from peers. This inquiry adhered to the Royal Roads University and Northern Health Research Ethics policies.
Subjects/Keywords: engagement;
opioid
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APA (6th Edition):
Ragan, C. M. (2020). Engaging people with lived experience of opioid use
. (Thesis). Royal Roads University. Retrieved from https://viurrspace.ca/handle/10613/23156
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Ragan, Chrystal Marie. “Engaging people with lived experience of opioid use
.” 2020. Thesis, Royal Roads University. Accessed February 28, 2021.
https://viurrspace.ca/handle/10613/23156.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Ragan, Chrystal Marie. “Engaging people with lived experience of opioid use
.” 2020. Web. 28 Feb 2021.
Vancouver:
Ragan CM. Engaging people with lived experience of opioid use
. [Internet] [Thesis]. Royal Roads University; 2020. [cited 2021 Feb 28].
Available from: https://viurrspace.ca/handle/10613/23156.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Ragan CM. Engaging people with lived experience of opioid use
. [Thesis]. Royal Roads University; 2020. Available from: https://viurrspace.ca/handle/10613/23156
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Harvard University
3.
Karmouta, Ryan.
The Opioid Epidemic and Dermatology: Prescribing Patterns and Complications in the Medicare Population.
Degree: Doctor of Medicine, 2018, Harvard University
URL: http://nrs.harvard.edu/urn-3:HUL.InstRepos:41973518
► Importance: The ongoing United States opioid epidemic has been fueled by prescription opioids. Increases in opioid-related deaths and complications mandates clinicians in all fields to…
(more)
▼ Importance: The ongoing United States opioid epidemic has been fueled by prescription opioids. Increases in opioid-related deaths and complications mandates clinicians in all fields to scrutinize their prescribing patterns.
Objective: To characterize the current status and potential complications of opioid prescribing practices among dermatologists for Medicare beneficiaries.
Design: Cross-sectional study using Medicare Part D prescriber data to evaluate opioid prescriptions by dermatologists in 2014. The number of prescribers, opioid claims, beneficiaries, and days supplied as well as the type of opioid and geographic location of prescribers were extracted and analyzed. The top 1% of dermatologists prescribing opioids were identified and evaluated for geographic location, type of practice, and time in practice. A systematic literature review was conducted to estimate the impact of opioid prescribing practices on the exposed population.
Setting: United States
Participants: Dermatologists included in the Medicare Part D prescriber database.
Main Outcome: Practice characteristics, epidemiology, and consequences of dermatology-prescribed opioids.
Results: Of 12,537 dermatologists, 5,305 (42.3%) prescribed 0 opioids claims, 5,408 (43.1%) prescribed 1-10 opioid claims, and 1,824 (14.5%) prescribed more than 10 opioid claims. Among dermatologists prescribing at least 10 opioid claims, a mean of 1.0 opioid claims was given to each beneficiary with a mean supply of 4.4 days. 111 (96.5%) of the dermatologists in the top 1% of opioid prescribers work in a surgical practice. Estimates suggest that dermatology-prescribed opioids will annually lead to 3,877-7,602 beneficiaries continuing to use opioids at 1 year and 1,825-4,209 at 3 years. 9,882-22,806 will experience gastrointestinal or CNS side effects and 588-999 will experience fractures.
Conclusions and Relevance: Opioid prescribing among dermatologists is limited and concentrated in the surgical setting, but may be associated with a substantial number of adverse events that serve as a reminder to emphasize non-opioid pain medications in the post-operative setting.
Scholarly Project
Subjects/Keywords: Opioid; Dermatology
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APA (6th Edition):
Karmouta, R. (2018). The Opioid Epidemic and Dermatology: Prescribing Patterns and Complications in the Medicare Population. (Doctoral Dissertation). Harvard University. Retrieved from http://nrs.harvard.edu/urn-3:HUL.InstRepos:41973518
Chicago Manual of Style (16th Edition):
Karmouta, Ryan. “The Opioid Epidemic and Dermatology: Prescribing Patterns and Complications in the Medicare Population.” 2018. Doctoral Dissertation, Harvard University. Accessed February 28, 2021.
http://nrs.harvard.edu/urn-3:HUL.InstRepos:41973518.
MLA Handbook (7th Edition):
Karmouta, Ryan. “The Opioid Epidemic and Dermatology: Prescribing Patterns and Complications in the Medicare Population.” 2018. Web. 28 Feb 2021.
Vancouver:
Karmouta R. The Opioid Epidemic and Dermatology: Prescribing Patterns and Complications in the Medicare Population. [Internet] [Doctoral dissertation]. Harvard University; 2018. [cited 2021 Feb 28].
Available from: http://nrs.harvard.edu/urn-3:HUL.InstRepos:41973518.
Council of Science Editors:
Karmouta R. The Opioid Epidemic and Dermatology: Prescribing Patterns and Complications in the Medicare Population. [Doctoral Dissertation]. Harvard University; 2018. Available from: http://nrs.harvard.edu/urn-3:HUL.InstRepos:41973518
University of Florida
4.
Serdarevic, Mirsada.
Risk Factors for Opioid Use Patterns Assessed through a Community Engagement Program in North Central Florida.
Degree: PhD, Epidemiology, 2019, University of Florida
URL: https://ufdc.ufl.edu/UFE0054009
► Prescription opioid use has reached epidemic levels in the United States with 130 individuals dying daily due to opioid overdose. Research investigating risk factors for…
(more)
▼ Prescription
opioid use has reached epidemic levels in the United States with 130 individuals dying daily due to
opioid overdose. Research investigating risk factors for prescription
opioid use among community members is important to identify areas where prevention strategies can be implemented, helping to reduce the significant burden of overdose in the US. While there have been some studies that focus on risk factors for prescription
opioid use, studies examining sex differences in prescription
opioid use in the community with large sample sizes have been limited. Specifically, there has been a lack of attention on women in addressing prescription
opioid use.
Advisors/Committee Members: Cottler,Linda B (committee chair), Striley,Catherine L (committee member), Leeman,Robert Francis (committee member).
Subjects/Keywords: community – florida – opioid
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APA (6th Edition):
Serdarevic, M. (2019). Risk Factors for Opioid Use Patterns Assessed through a Community Engagement Program in North Central Florida. (Doctoral Dissertation). University of Florida. Retrieved from https://ufdc.ufl.edu/UFE0054009
Chicago Manual of Style (16th Edition):
Serdarevic, Mirsada. “Risk Factors for Opioid Use Patterns Assessed through a Community Engagement Program in North Central Florida.” 2019. Doctoral Dissertation, University of Florida. Accessed February 28, 2021.
https://ufdc.ufl.edu/UFE0054009.
MLA Handbook (7th Edition):
Serdarevic, Mirsada. “Risk Factors for Opioid Use Patterns Assessed through a Community Engagement Program in North Central Florida.” 2019. Web. 28 Feb 2021.
Vancouver:
Serdarevic M. Risk Factors for Opioid Use Patterns Assessed through a Community Engagement Program in North Central Florida. [Internet] [Doctoral dissertation]. University of Florida; 2019. [cited 2021 Feb 28].
Available from: https://ufdc.ufl.edu/UFE0054009.
Council of Science Editors:
Serdarevic M. Risk Factors for Opioid Use Patterns Assessed through a Community Engagement Program in North Central Florida. [Doctoral Dissertation]. University of Florida; 2019. Available from: https://ufdc.ufl.edu/UFE0054009
Eastern Michigan University
5.
Pellerin, James.
Opioid use and abuse in the United States.
Degree: MA, Sociology, Anthropology, and Criminology, 2018, Eastern Michigan University
URL: https://commons.emich.edu/theses/990
► Opioids have quadrupled the number of unintentional drug overdose deaths since 1999 and are now among the leading causes of death in the United…
(more)
▼ Opioids have quadrupled the number of unintentional drug overdose deaths since 1999 and are now among the leading causes of death in the United States. Though some reform has recently occurred, the United States continues to operate largely under a punitive criminal justice model despite unsuccessful legislative schemes and voluminous research stemming from a previous war on drugs. This thesis serves to explore the history and extent of opioids in the United States and to analyze salient catalysts responsible for creating an epidemic of abuse. While private and governmental coalitions have formed to develop successful interventions and treatments, they are drastically underfunded. Beginning in the early 2000s, there have been a number of civil and criminal lawsuits against manufacturers, distributors, and prescribers of opioids, with the hope of curbing overdose deaths and disrupt the illicit
opioid market.
Advisors/Committee Members: Peter Wood, Ph.D, Brian Sellers, Ph.D, Grigoris Argeros, Ph.D.
Subjects/Keywords: opioid; epidemic; Sackler family; Perdue Pharma; OxyContin®; pain scale; opioid intervention; opioid treatment; opioid legislation; opioid litigation; Criminology; Sociology
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APA (6th Edition):
Pellerin, J. (2018). Opioid use and abuse in the United States. (Masters Thesis). Eastern Michigan University. Retrieved from https://commons.emich.edu/theses/990
Chicago Manual of Style (16th Edition):
Pellerin, James. “Opioid use and abuse in the United States.” 2018. Masters Thesis, Eastern Michigan University. Accessed February 28, 2021.
https://commons.emich.edu/theses/990.
MLA Handbook (7th Edition):
Pellerin, James. “Opioid use and abuse in the United States.” 2018. Web. 28 Feb 2021.
Vancouver:
Pellerin J. Opioid use and abuse in the United States. [Internet] [Masters thesis]. Eastern Michigan University; 2018. [cited 2021 Feb 28].
Available from: https://commons.emich.edu/theses/990.
Council of Science Editors:
Pellerin J. Opioid use and abuse in the United States. [Masters Thesis]. Eastern Michigan University; 2018. Available from: https://commons.emich.edu/theses/990
Virginia Commonwealth University
6.
Fisher, Deborah.
Opioid Withdrawal Signs and Symptoms in the Pediatric Patient during Opioid Tapering.
Degree: PhD, Nursing, 2012, Virginia Commonwealth University
URL: https://doi.org/10.25772/8CSY-VF88
;
https://scholarscompass.vcu.edu/etd/2719
► Opioids are used routinely in the pediatric intensive care population for analgesia, sedation, blunting of physiologic responses to stress, and safety. In children, physical dependence…
(more)
▼ Opioids are used routinely in the pediatric intensive care population for analgesia, sedation, blunting of physiologic responses to stress, and safety. In children, physical dependence may occur in as little as two to three days of continuous
opioid therapy. Once the child no longer needs the
opioid, the medications are reduced over time. A review of the literature revealed that the majority of the published studies used either a neonatal
opioid assessment tool or no assessment tool. A subsequent international survey of pediatric providers found a wide range of
opioid tapering practices and sporadic use of
opioid withdrawal instruments to guide practice. Since tapering routines vary among practitioners, it is not uncommon to see signs and symptoms of
opioid withdrawal. A prospective, descriptive study was conducted to describe the frequency of
opioid withdrawal signs and symptoms and to identify factors associated with these
opioid withdrawal signs and symptoms. The sample of 25 was drawn from all patients, ages 2 weeks to 21 years admitted to the Children’s Hospital of Richmond Pediatric Intensive Care Unit (PICU) and who have received continuous infusion or scheduled opioids for at least 5 days. Data collected included:
opioid withdrawal score (WAT-1),
opioid taper rate (total dose of
opioid per day in morphine equivalents per kilogram [MEK]), pretaper peak MEK, pretaper cumulative MEK, number of days of
opioid exposure prior to taper, and age. Out of 26 enrolled participants, only 9 (45%) had
opioid withdrawal on any given day. In addition, there was limited variability in WAT-1 scores. The most common symptoms notes were diarrhea, vomit, sweat, and fever. For optimal
opioid withdrawal assessments, clinicians should use a validated instrument such as the WAT-1 to measure for signs and symptoms of
opioid withdrawal. Further research is indicated to examine risk factors for
opioid withdrawal in children.
Advisors/Committee Members: Mary Jo Grap, Janet B. Younger, Suzanne W. Ameringer, R.K. Elswick Jr.
Subjects/Keywords: opioid analgesia; opioid withdrawal; opioid tapering; critical care; child; Medicine and Health Sciences; Nursing
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APA (6th Edition):
Fisher, D. (2012). Opioid Withdrawal Signs and Symptoms in the Pediatric Patient during Opioid Tapering. (Doctoral Dissertation). Virginia Commonwealth University. Retrieved from https://doi.org/10.25772/8CSY-VF88 ; https://scholarscompass.vcu.edu/etd/2719
Chicago Manual of Style (16th Edition):
Fisher, Deborah. “Opioid Withdrawal Signs and Symptoms in the Pediatric Patient during Opioid Tapering.” 2012. Doctoral Dissertation, Virginia Commonwealth University. Accessed February 28, 2021.
https://doi.org/10.25772/8CSY-VF88 ; https://scholarscompass.vcu.edu/etd/2719.
MLA Handbook (7th Edition):
Fisher, Deborah. “Opioid Withdrawal Signs and Symptoms in the Pediatric Patient during Opioid Tapering.” 2012. Web. 28 Feb 2021.
Vancouver:
Fisher D. Opioid Withdrawal Signs and Symptoms in the Pediatric Patient during Opioid Tapering. [Internet] [Doctoral dissertation]. Virginia Commonwealth University; 2012. [cited 2021 Feb 28].
Available from: https://doi.org/10.25772/8CSY-VF88 ; https://scholarscompass.vcu.edu/etd/2719.
Council of Science Editors:
Fisher D. Opioid Withdrawal Signs and Symptoms in the Pediatric Patient during Opioid Tapering. [Doctoral Dissertation]. Virginia Commonwealth University; 2012. Available from: https://doi.org/10.25772/8CSY-VF88 ; https://scholarscompass.vcu.edu/etd/2719
University of Arizona
7.
Olson, Keith Mathew.
Atypical Opioid Interactions – Development of Selective Mu-Delta Heterodimer Antagonists, Clinical Opioids at Non-Mu Pain Targets and Endogenous Biased Signaling
.
Degree: 2017, University of Arizona
URL: http://hdl.handle.net/10150/626669
► Most clinical opioids produce analgesia through the Mu Opioid Receptor (MOR) providing the only effective treatment for chronic pain patients. These studies explore three pre-clinical…
(more)
▼ Most clinical opioids produce analgesia through the Mu
Opioid Receptor (MOR) providing the only effective treatment for chronic pain patients. These studies explore three pre-clinical strategies to improve MOR analgesia and minimize side effects: 1) compounds that target G-protein Coupled Receptors (GPCRs) heterodimers, such as heterodimerization between the Delta
Opioid Receptor (DOR) and MOR (MDOR); 2) multi-functional compounds that target multiple receptor systems for synergistic effects, such as a MOR agonist and a the serotonin reuptake transporter (SERT) inhibitor; or 3) biased agonists that preferentially activate one signaling pathway associated with analgesia over another associated with side effects at the same receptor. First, several indirect lines of evidence indicate the MOR-DOR heterodimer (MDOR) can regulate MOR
opioid tolerance and withdrawal. However, studying MDOR remains difficult because no selective MDOR antagonists are available. To address this need, we created a novel series of bivalent MDOR antagonists by connecting a low affinity MOR antagonist (H-Tyr-Pro-Phe-D1Nal-NH2) to a moderate affinity DOR (H- Tyr-Tic-OH) antagonist with variable length polyamide spacers (15-41 atoms). In vitro radioligand binding and [35S]-GTPγS coupling assays in MOR, DOR, and MDOR expressing cell lines show bivalent ligands produce a clear length dependence in MDOR but not MOR or DOR cell lines. The lead compound – D24M with a 24-atom spacer – displayed high potency (IC50MDOR = 0.84 nM) with 91-fold selectivity for MDOR:DOR and 1,000-fold MDOR:MOR selectivity. Second, clinicians have long appreciated subtle but distinct differences in analgesia and side effects of MOR opioids. A variety of non-MOR targets including DOR, Kappa
Opioid Receptor (KOR), the Cannabinoid Receptor-1 (CB1), the Sigma-1 Receptor (σ1R), the Dopamine- (DAT), Serotonin- (SERT) and Norepinephrine- Reuptake Transporters (NET) induce analgesia and/or modulate MOR mediated side effects. To determine if different
opioid profiles arise from non-MOR interactions, we evaluated the binding and function of nine clinical analgesics at the nine aforementioned targets revealing several clinical opioids contain previously unidentified affinity’s or activity’s. Hydrocodone displayed low affinity at the MOR (KI = 1800 nM) and only ~2 fold less affinity at the σ1R (KI = 4000 nM). Second buprenorphine promoted monoamine influx at DAT, SERT and NET with EC50 > 1,000 nM. These novel interactions suggest the nuanced differences of clinical opioids may arise from previously unappreciated off-target effects. Future studies will assess whether these in vitro results predict hydrocodone and buprenorphine activity in vivo. Finally, the unique function of the numerous endogenous
opioid peptides at a given receptor remains unclear. How endogenous ligands interact with ORs produces obvious drug design consequences. These studies show two endogenous Dynorphin analogues – Dynorphin A and Dynorphin B – differentially regulate two ubiquitous signaling modules – βarrestin2…
Advisors/Committee Members: Hruby, Victor J (advisor), Streicher, John M (advisor), Hruby, Victor J. (committeemember), Streicher, John M. (committeemember), Ghosh, Indraneel (committeemember), Montfort, William (committeemember), Porreca, Frank (committeemember).
Subjects/Keywords: Bivalent;
Delta Opioid Receptor;
Functional Selectivity;
MDOR Heterodimer;
Mu Opioid Receptor;
Opioid Signaling
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APA ·
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MLA ·
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Manager
APA (6th Edition):
Olson, K. M. (2017). Atypical Opioid Interactions – Development of Selective Mu-Delta Heterodimer Antagonists, Clinical Opioids at Non-Mu Pain Targets and Endogenous Biased Signaling
. (Doctoral Dissertation). University of Arizona. Retrieved from http://hdl.handle.net/10150/626669
Chicago Manual of Style (16th Edition):
Olson, Keith Mathew. “Atypical Opioid Interactions – Development of Selective Mu-Delta Heterodimer Antagonists, Clinical Opioids at Non-Mu Pain Targets and Endogenous Biased Signaling
.” 2017. Doctoral Dissertation, University of Arizona. Accessed February 28, 2021.
http://hdl.handle.net/10150/626669.
MLA Handbook (7th Edition):
Olson, Keith Mathew. “Atypical Opioid Interactions – Development of Selective Mu-Delta Heterodimer Antagonists, Clinical Opioids at Non-Mu Pain Targets and Endogenous Biased Signaling
.” 2017. Web. 28 Feb 2021.
Vancouver:
Olson KM. Atypical Opioid Interactions – Development of Selective Mu-Delta Heterodimer Antagonists, Clinical Opioids at Non-Mu Pain Targets and Endogenous Biased Signaling
. [Internet] [Doctoral dissertation]. University of Arizona; 2017. [cited 2021 Feb 28].
Available from: http://hdl.handle.net/10150/626669.
Council of Science Editors:
Olson KM. Atypical Opioid Interactions – Development of Selective Mu-Delta Heterodimer Antagonists, Clinical Opioids at Non-Mu Pain Targets and Endogenous Biased Signaling
. [Doctoral Dissertation]. University of Arizona; 2017. Available from: http://hdl.handle.net/10150/626669
Oregon State University
8.
Choi, Heekyung.
Synthesis and biological evaluation of dynorphin a analogues as pharmacological probed of opioid receptors.
Degree: PhD, Pharmacy, 1995, Oregon State University
URL: http://hdl.handle.net/1957/34934
Subjects/Keywords: Opioid peptides
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Manager
APA (6th Edition):
Choi, H. (1995). Synthesis and biological evaluation of dynorphin a analogues as pharmacological probed of opioid receptors. (Doctoral Dissertation). Oregon State University. Retrieved from http://hdl.handle.net/1957/34934
Chicago Manual of Style (16th Edition):
Choi, Heekyung. “Synthesis and biological evaluation of dynorphin a analogues as pharmacological probed of opioid receptors.” 1995. Doctoral Dissertation, Oregon State University. Accessed February 28, 2021.
http://hdl.handle.net/1957/34934.
MLA Handbook (7th Edition):
Choi, Heekyung. “Synthesis and biological evaluation of dynorphin a analogues as pharmacological probed of opioid receptors.” 1995. Web. 28 Feb 2021.
Vancouver:
Choi H. Synthesis and biological evaluation of dynorphin a analogues as pharmacological probed of opioid receptors. [Internet] [Doctoral dissertation]. Oregon State University; 1995. [cited 2021 Feb 28].
Available from: http://hdl.handle.net/1957/34934.
Council of Science Editors:
Choi H. Synthesis and biological evaluation of dynorphin a analogues as pharmacological probed of opioid receptors. [Doctoral Dissertation]. Oregon State University; 1995. Available from: http://hdl.handle.net/1957/34934
University of Michigan
9.
Bender, Aaron M.
Synthesis and Evaluation of Mixed Efficacy Mu Opioid Receptor (MOR), Delta Opioid Receptor (DOR) Peptidomimetic Ligands.
Degree: PhD, Medicinal Chemistry, 2016, University of Michigan
URL: http://hdl.handle.net/2027.42/120867
► Reported here is a structure activity relationship (SAR) study on a series of mixed efficacy mu opioid receptor (MOR) agonist/delta opioid receptor (DOR) antagonist ligands…
(more)
▼ Reported here is a structure activity relationship (SAR) study on a series of mixed efficacy mu
opioid receptor (MOR) agonist/delta
opioid receptor (DOR) antagonist ligands featuring a tetrahydroquinoline (THQ) scaffold. A diverse set of substitutions at the 6-position of the THQ core has revealed a number of important trends. Attachment of this pendant at a basic nitrogen resulted in a number of analogues that showed superior binding affinity and potency at MOR, with improved binding affinity at the kappa
opioid receptor (KOR). In particular, N-acetylated, tetrahydroisoquinoline analogue 102 showed equal, subnanomolar binding affinity for MOR, DOR and KOR, with a low nanomolar EC50 at MOR and no stimulation at DOR. 102, in addition to isoindoline analogue 86, were also shown to produce dose dependent antinociception in the mouse warm water tail withdrawal (WWTW) assay, with both compounds having a total duration of action comparable to morphine, an improvement on lead peptidomimetic 1.
Substitution of the THQ aniline with a variety of heteroatoms was found to maintain subnanomolar MOR binding affinity and high efficacy, although only thiochroman analogue 214 was found to produce a dose dependent antinociceptive effect in the WWTW assay, with a duration of action comparable to 86 and 102. Expansion or contraction of the THQ ring system was detrimental to the overall desired MOR agonist/DOR antagonist profile, with MOR potency being particularly affected.
A 3-step synthesis of Boc-2’,6’-dimethyl-L-tyrosine featuring a microwave-assisted Negishi coupling is also described, which led to the expedient synthesis of novel tyrosine analogues that were incorporated into the peptidomimetic scaffold. Of particular interest is 2’,6’-dichloro-L-tyrosine intermediate 243, which may be useful for the development of peptidomimetics with reduced liability for oxidative metabolism on the aryl methyl groups, and carboxamido peptidomimetic 251, which shows a total duration of action in vivo that is comparable to lead compound 1.
An alternative series of peptidomimetics featuring a piperidine or piperazine core is also discussed. In this series, it was found that an increase in the length of the hydrophobic chain at position 4 corresponds to an improved efficacy at MOR.
Advisors/Committee Members: Mosberg, Henry I (committee member), Traynor John R, (committee member), Soellner, Matthew Bryan (committee member), Larsen, Scott D (committee member).
Subjects/Keywords: Opioid; Peptidomimetic; Chemistry; Science
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APA (6th Edition):
Bender, A. M. (2016). Synthesis and Evaluation of Mixed Efficacy Mu Opioid Receptor (MOR), Delta Opioid Receptor (DOR) Peptidomimetic Ligands. (Doctoral Dissertation). University of Michigan. Retrieved from http://hdl.handle.net/2027.42/120867
Chicago Manual of Style (16th Edition):
Bender, Aaron M. “Synthesis and Evaluation of Mixed Efficacy Mu Opioid Receptor (MOR), Delta Opioid Receptor (DOR) Peptidomimetic Ligands.” 2016. Doctoral Dissertation, University of Michigan. Accessed February 28, 2021.
http://hdl.handle.net/2027.42/120867.
MLA Handbook (7th Edition):
Bender, Aaron M. “Synthesis and Evaluation of Mixed Efficacy Mu Opioid Receptor (MOR), Delta Opioid Receptor (DOR) Peptidomimetic Ligands.” 2016. Web. 28 Feb 2021.
Vancouver:
Bender AM. Synthesis and Evaluation of Mixed Efficacy Mu Opioid Receptor (MOR), Delta Opioid Receptor (DOR) Peptidomimetic Ligands. [Internet] [Doctoral dissertation]. University of Michigan; 2016. [cited 2021 Feb 28].
Available from: http://hdl.handle.net/2027.42/120867.
Council of Science Editors:
Bender AM. Synthesis and Evaluation of Mixed Efficacy Mu Opioid Receptor (MOR), Delta Opioid Receptor (DOR) Peptidomimetic Ligands. [Doctoral Dissertation]. University of Michigan; 2016. Available from: http://hdl.handle.net/2027.42/120867
10.
Dennis, Brittany Burns.
Chronic Pain: A Red Herring or Risk Factor in the Management of Patients Receiving Opioid Substitution Therapy.
Degree: PhD, 2015, McMaster University
URL: http://hdl.handle.net/11375/18470
► Background: The consequences of continued opioid abuse among patients treated with opioid substitution therapy (OST) are serious and can result in abnormal cardiovascular function, overdose,…
(more)
▼ Background: The consequences of continued
opioid abuse among patients treated with
opioid substitution therapy (OST) are serious and can result in abnormal cardiovascular function, overdose, and mortality. Conflicting evidence exists that both implicates and refutes the role of chronic non-cancer pain (CNCP) as a major risk factor for continued
opioid abuse within the addiction treatment setting. This thesis aims to 1) evaluate the impact of chronic pain on the treatment outcomes of patients with
opioid addiction receiving OST, 2) determine whether a clinical or inflammatory profile exists to distinguish pain in this population, 3) explore the sources of heterogeneity in previous studies examining this question, 4) determine the best therapy for patients with chronic pain, and 5) evaluate the most effective treatment for
opioid addiction. We anticipate chronic pain to be an important predictor of continued
opioid abuse such that patients with comorbid pain will require careful consideration when managed on OST.
Methods: We systematically reviewed the literature to determine the impact of pain in
opioid addiction patients receiving methadone maintenance treatment (MMT). We determined the clinical and inflammatory profile of MMT patients using data from the Genetics of
Opioid Addiction (GENOA) research collaborative between the Canadian Addiction Treatment Centres (CATC) and the Population Genomic Program. GENOA is a prospective cohort study aimed to determine the genetic, biological, and psychosocial determinants of treatment prognosis for
opioid addiction patients receiving MMT. GENOA recruits patients ≥ 18 years of age meeting the DSM-IV criteria for
opioid dependence. All GENOA participants are receiving MMT for the management of
opioid addiction. Baseline data from the GENOA pilot study (n=235) were used to evaluate the impact of pain on illict
opioid use behaviour and determine the clinical and inflammatory profile of patients with comorbid pain. We explored sources of heterogeneity in previous studies using data from the full-phase GENOA study (n=444), examining the prognostic value of different pain measures for predicting illicit
opioid use. We then performed a multiple treatment comparison of all
opioid substitution and antagonist therapies in efforts to determine the best intervention for improving treatment outcomes for patients with comorbid pain. We lastly determined the most effective treatment for
opioid addiction by performing a network meta-analysis using data from a systematic review of
opioid maintenance therapy trials.
Results: Our initial systematic review confirmed a lack of consensus in the literature, whereby some studies suggest pain increases risk for illicit
opioid use and other studies suggest pain has no effect on substance use behaviour. Findings from the analysis of GENOA pilot data confirmed chronic pain to be an important predictor of sustained
opioid abuse and also showed patients with pain to have elevated Interferon-Gamma. Using data from the GENOA prospective cohort study we…
Advisors/Committee Members: Samaan, Zainab, Clinical Epidemiology/Clinical Epidemiology & Biostatistics.
Subjects/Keywords: chronic pain; methadone; opioid substitution therapy; opioid agonist treatment; methadone maintenance treatment; opioid addiction; addiction; opioid induced hyperalgesia
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APA (6th Edition):
Dennis, B. B. (2015). Chronic Pain: A Red Herring or Risk Factor in the Management of Patients Receiving Opioid Substitution Therapy. (Doctoral Dissertation). McMaster University. Retrieved from http://hdl.handle.net/11375/18470
Chicago Manual of Style (16th Edition):
Dennis, Brittany Burns. “Chronic Pain: A Red Herring or Risk Factor in the Management of Patients Receiving Opioid Substitution Therapy.” 2015. Doctoral Dissertation, McMaster University. Accessed February 28, 2021.
http://hdl.handle.net/11375/18470.
MLA Handbook (7th Edition):
Dennis, Brittany Burns. “Chronic Pain: A Red Herring or Risk Factor in the Management of Patients Receiving Opioid Substitution Therapy.” 2015. Web. 28 Feb 2021.
Vancouver:
Dennis BB. Chronic Pain: A Red Herring or Risk Factor in the Management of Patients Receiving Opioid Substitution Therapy. [Internet] [Doctoral dissertation]. McMaster University; 2015. [cited 2021 Feb 28].
Available from: http://hdl.handle.net/11375/18470.
Council of Science Editors:
Dennis BB. Chronic Pain: A Red Herring or Risk Factor in the Management of Patients Receiving Opioid Substitution Therapy. [Doctoral Dissertation]. McMaster University; 2015. Available from: http://hdl.handle.net/11375/18470
Penn State University
11.
Morse, Megan.
Ligand-directed Functional Selectivity at the Opioid Receptor Family: An Epic Approach to Understanding Opioid Receptor Signaling.
Degree: 2012, Penn State University
URL: https://submit-etda.libraries.psu.edu/catalog/12691
► Opioid receptors are G-protein coupled receptors (GPCRs) that are activated by opioid ligands. These ligands offer powerful medical benefits due to their analgesic properties, but…
(more)
▼ Opioid receptors are G-protein coupled receptors (GPCRs) that are activated by
opioid ligands. These ligands offer powerful medical benefits due to their analgesic properties, but activation of
opioid receptors can also lead to many negative side effects, including tolerance and dependence. Conventional theory ascribes most of the analgesic and addictive effects of opioids to the activation of the mu
opioid receptor subtype (MOR). However, it has recently been suggested that the other classic
opioid receptors, the delta
opioid receptor (DOR) and the kappa
opioid receptor (KOR), may also contribute important functionality. We hypothesize that all of the classic
opioid receptors play a vital role in understanding the full functionality of the
opioid signaling system. Directed drug design is the future of therapeutic development, and in order to be capable of creating targeted
opioid analgesics, we must be able to break down the signaling pathway.
Using dynamic mass redistribution (DMR) assays and biosensor technology, we characterized all three classic
opioid receptors using a library of known
opioid ligands. We also studied the roles of cellular context in
opioid receptor signaling by characterizing the endogenous population of
opioid receptors found in SH-SY5Y neuroblastoma cells. Utilizing 13 different assay formats, this technology allowed us to examine receptor specificity, G-protein coupling, and downstream pathway selectivity. It has been suggested in the literature that ligand-directed functional selectivity provides a sufficient basis for understanding GPCR activity and molding the future of drug design. We hypothesize that the use of biosensor high throughput technology presents a viable opportunity to fully decipher the complexities of the
opioid signaling cascade.
Advisors/Committee Members: Robert G Levenson, Dissertation Advisor/Co-Advisor, Kevin Douglas Alloway, Committee Member, Patricia Grigson, Committee Member, Victor J Ruiz Velasco, Committee Member.
Subjects/Keywords: GPCR; Opioid; Receptor SIgnaling; DMR
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APA (6th Edition):
Morse, M. (2012). Ligand-directed Functional Selectivity at the Opioid Receptor Family: An Epic Approach to Understanding Opioid Receptor Signaling. (Thesis). Penn State University. Retrieved from https://submit-etda.libraries.psu.edu/catalog/12691
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Morse, Megan. “Ligand-directed Functional Selectivity at the Opioid Receptor Family: An Epic Approach to Understanding Opioid Receptor Signaling.” 2012. Thesis, Penn State University. Accessed February 28, 2021.
https://submit-etda.libraries.psu.edu/catalog/12691.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Morse, Megan. “Ligand-directed Functional Selectivity at the Opioid Receptor Family: An Epic Approach to Understanding Opioid Receptor Signaling.” 2012. Web. 28 Feb 2021.
Vancouver:
Morse M. Ligand-directed Functional Selectivity at the Opioid Receptor Family: An Epic Approach to Understanding Opioid Receptor Signaling. [Internet] [Thesis]. Penn State University; 2012. [cited 2021 Feb 28].
Available from: https://submit-etda.libraries.psu.edu/catalog/12691.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Morse M. Ligand-directed Functional Selectivity at the Opioid Receptor Family: An Epic Approach to Understanding Opioid Receptor Signaling. [Thesis]. Penn State University; 2012. Available from: https://submit-etda.libraries.psu.edu/catalog/12691
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Boston University
12.
Culp, Jenna L.
Cocaine use, treatment retention and opioid abstinence at six months in a coordinated primary care and substance abuse treatment clinic among opioid-dependent patients treated with buprenorphine.
Degree: MA, Medical Sciences, 2012, Boston University
URL: http://hdl.handle.net/2144/12336
► Cocaine use among opioid dependent persons is common, with an estimated 40 to 70% of those seeking treatment for opioid dependence, also using cocaine (Sullivan…
(more)
▼ Cocaine use among opioid dependent persons is common, with an estimated 40 to 70% of those seeking treatment for opioid dependence, also using cocaine (Sullivan et al., 2011 ). The effects of cocaine use on treatment outcomes for those seeking medication assisted treatment (MAT) for opioid
dependence are not well understood. Buprenorphine, prescribed under the brand name Suboxone, has recently emerged as a convenient, effective method of MAT. The Facilitated Access to Substance Abuse Treatment with Prevention And Treatment of HIV (FAST PATH) program at Boston Medical Center, is a research study to provide substance abuse treatment along with primary care and HIV risk-reduction counseling to those afflicted with these epidemics. The objective of this study was to determine the association of cocaine use with treatment retention and opioid abstinence at six months for patients receiving
buprenorphine in the FAST PATH program.
A prospective cohort study was conducted on 116 patients enrolled in the FAST PATH program through 02/01/2012. Assessments were conducted at baseline and six months to evaluate the association between baseline cocaine use and treatment retention as well as opioid abstinence at six months. Baseline cocaine use was measured by either any urine toxicology screen positive for cocaine prior to study enrollment or 30 day self-reported cocaine use on the initial assessment.
Of the 116 participants, 39% were positive for cocaine use at baseline and 52% were HIV positive. Baseline cocaine use had no effect significant on treatment retention or opioid abstinence at six months. Among all the participant characteristics measured, there were no significant differences between the cocaine positive (n=45) and cocaine negative (n=71) groups. In adjusted analysis, age was the only covariate which was significant at predicting the odds of treatment retention or opioid abstinence with a 1.11 (p-value = 0.0003) and 1.08 (p-value = 0.02) greater odds of each, respectively. Although cocaine use
did not affect the dependent variables, integrated substance abuse and primary care clinics utilizing buprenorphine are a rich area of future research. Specifically, subsequent studies should determine how varied groups of opioid dependent persons perform within this framework, and the underlying characteristics moderating their outcomes.
Subjects/Keywords: Opioid dependence; Cocaine; FAST PATH
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Manager
APA (6th Edition):
Culp, J. L. (2012). Cocaine use, treatment retention and opioid abstinence at six months in a coordinated primary care and substance abuse treatment clinic among opioid-dependent patients treated with buprenorphine. (Masters Thesis). Boston University. Retrieved from http://hdl.handle.net/2144/12336
Chicago Manual of Style (16th Edition):
Culp, Jenna L. “Cocaine use, treatment retention and opioid abstinence at six months in a coordinated primary care and substance abuse treatment clinic among opioid-dependent patients treated with buprenorphine.” 2012. Masters Thesis, Boston University. Accessed February 28, 2021.
http://hdl.handle.net/2144/12336.
MLA Handbook (7th Edition):
Culp, Jenna L. “Cocaine use, treatment retention and opioid abstinence at six months in a coordinated primary care and substance abuse treatment clinic among opioid-dependent patients treated with buprenorphine.” 2012. Web. 28 Feb 2021.
Vancouver:
Culp JL. Cocaine use, treatment retention and opioid abstinence at six months in a coordinated primary care and substance abuse treatment clinic among opioid-dependent patients treated with buprenorphine. [Internet] [Masters thesis]. Boston University; 2012. [cited 2021 Feb 28].
Available from: http://hdl.handle.net/2144/12336.
Council of Science Editors:
Culp JL. Cocaine use, treatment retention and opioid abstinence at six months in a coordinated primary care and substance abuse treatment clinic among opioid-dependent patients treated with buprenorphine. [Masters Thesis]. Boston University; 2012. Available from: http://hdl.handle.net/2144/12336
Harvard University
13.
Wood, Rachel Perron.
Group Visits for Chronic Pain.
Degree: Doctor of Medicine, 2017, Harvard University
URL: http://nrs.harvard.edu/urn-3:HUL.InstRepos:40621396
► Purpose: To evaluate the efficacy of group visits for chronic pain patients on opioids. Methods: Nineteen chronic pain patients participated in a year-long program consisting…
(more)
▼ Purpose: To evaluate the efficacy of group visits for chronic pain patients on opioids.
Methods: Nineteen chronic pain patients participated in a year-long program consisting of monthly visits. Visits consisted of a check-in with a healthcare provider, urine sampling, assessment of mood and pain by surveys, an educational component, and group support discussion. Mindfulness meditation, music therapy, education on use of pain medications, and other topics were taught. Five patients also participated in a focus group to evaluate their experiences with healthcare as a chronic pain patient and to elicit thoughts on the group visit program. Fourteen primary care providers of the same clinic were surveyed to assess thoughts on treatment of pain patients on an individual and clinic-wide level.
Results: Baseline assessment with the Opioid Risk Tool showed >50% of patients had a moderate to high risk for opioid abuse. There was no significant difference in opioid usage at 6 months. Due to the increased frequency of urine sampling with the program, several patients were noted to have cocaine in the urine and were able to be counseled appropriately. Most (89%) of subjects had a substance use contract established when one did not exist previously. Patients in the focus group felt they had been subject to bias in the healthcare system as pain patients, but were comfortable with their current primary care provider and not concerned that the group visit program would force them to stop taking opiates that they might need. Providers surveyed at the clinic felt that there needed to be clear, clinic-wide guidelines for how to treat pain patients to allow for better individual practice and improved cross-coverage of patients. Results of PHQ-9 (depression), PEG (pain), GAD-7 (anxiety), and SF-20 (physical functioning) are pending completion of the study in the fall of 2017.
Conclusions: Interim results of a group visit program for chronic pain patients suggest that this format is a low-cost, effective way to improve management of this population.
Scholarly Project
Subjects/Keywords: opioid; group visits; chronic pain
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APA ·
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Export
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Manager
APA (6th Edition):
Wood, R. P. (2017). Group Visits for Chronic Pain. (Doctoral Dissertation). Harvard University. Retrieved from http://nrs.harvard.edu/urn-3:HUL.InstRepos:40621396
Chicago Manual of Style (16th Edition):
Wood, Rachel Perron. “Group Visits for Chronic Pain.” 2017. Doctoral Dissertation, Harvard University. Accessed February 28, 2021.
http://nrs.harvard.edu/urn-3:HUL.InstRepos:40621396.
MLA Handbook (7th Edition):
Wood, Rachel Perron. “Group Visits for Chronic Pain.” 2017. Web. 28 Feb 2021.
Vancouver:
Wood RP. Group Visits for Chronic Pain. [Internet] [Doctoral dissertation]. Harvard University; 2017. [cited 2021 Feb 28].
Available from: http://nrs.harvard.edu/urn-3:HUL.InstRepos:40621396.
Council of Science Editors:
Wood RP. Group Visits for Chronic Pain. [Doctoral Dissertation]. Harvard University; 2017. Available from: http://nrs.harvard.edu/urn-3:HUL.InstRepos:40621396
Oregon State University
14.
Hikoi, Hirotaka.
The effects of opioid receptor antagonism on plasma catecholamines and fat metabolism during prolonged exercise above or below lactate threshold in males.
Degree: PhD, Human Performance, 1999, Oregon State University
URL: http://hdl.handle.net/1957/33383
Subjects/Keywords: Opioid peptides
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APA ·
Chicago ·
MLA ·
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CSE |
Export
to Zotero / EndNote / Reference
Manager
APA (6th Edition):
Hikoi, H. (1999). The effects of opioid receptor antagonism on plasma catecholamines and fat metabolism during prolonged exercise above or below lactate threshold in males. (Doctoral Dissertation). Oregon State University. Retrieved from http://hdl.handle.net/1957/33383
Chicago Manual of Style (16th Edition):
Hikoi, Hirotaka. “The effects of opioid receptor antagonism on plasma catecholamines and fat metabolism during prolonged exercise above or below lactate threshold in males.” 1999. Doctoral Dissertation, Oregon State University. Accessed February 28, 2021.
http://hdl.handle.net/1957/33383.
MLA Handbook (7th Edition):
Hikoi, Hirotaka. “The effects of opioid receptor antagonism on plasma catecholamines and fat metabolism during prolonged exercise above or below lactate threshold in males.” 1999. Web. 28 Feb 2021.
Vancouver:
Hikoi H. The effects of opioid receptor antagonism on plasma catecholamines and fat metabolism during prolonged exercise above or below lactate threshold in males. [Internet] [Doctoral dissertation]. Oregon State University; 1999. [cited 2021 Feb 28].
Available from: http://hdl.handle.net/1957/33383.
Council of Science Editors:
Hikoi H. The effects of opioid receptor antagonism on plasma catecholamines and fat metabolism during prolonged exercise above or below lactate threshold in males. [Doctoral Dissertation]. Oregon State University; 1999. Available from: http://hdl.handle.net/1957/33383
15.
조, 한범.
Comparison of the Incidence and Severity of Cough after Alfentanil and Remifentanil Injection.
Degree: 2011, Ajou University
URL: http://repository.ajou.ac.kr/handle/201003/4364
;
http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000011484
► Introduction: Intravenous administration of fentanyl derivatives can induce cough paradoxically. This study examined the incidence and severity of cough after a bolus of alfentanil and…
(more)
▼ Introduction: Intravenous administration of fentanyl derivatives can induce cough paradoxically. This study examined the incidence and severity of cough after a bolus of alfentanil and remifentanil.
Methods: Four-hundred sixty five patients, aged 18-70 years, were allocated randomly to three groups to receive alfentanil 10 μg/kg, remifentanil 1 μg/kg, or an equal volume of 0.9% saline intravenously over 10 s. Any episode of cough was classified as coughing and graded as mild (1-2), moderate (3-4) or severe (5 or more).
Results: The overall incidence of cough was higher in the opioid groups than the saline group. The remifentanil group [39/150 patients; 26.0%, (95% CI, 19.6-33.6%)] showed a higher incidence than the alfentanil group [11/152 patients; 7.2%, (95% CI, 0.4-12.6%)] (P < 0.001). There was no significant difference in the severity of cough between alfentanil and remifentanil group.
Conclusion: This study demonstrated that the equipotent boluses of alfentanil and remifentanil induced coughing, even though the incidence of cough after alfentanil administration was lower than that after remifentanil administration.
ABSTRACT i
TABLE OF CONTENTS ii
LIST OF TABLES iii
LIST OF FIGURE iv
ABBREVIATIONS v
I. INTRODUCTION 1
II. PATIENTS AND METHODS 3
III. RESULTS 5
IV. DISCUSSION 12
REFERENCES 17
국문요약 21
Doctor
Advisors/Committee Members: 대학원 의학과, 200924410, 조, 한범.
Subjects/Keywords: alfentanil; remifentanil; opioid induced cough
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APA (6th Edition):
조, . (2011). Comparison of the Incidence and Severity of Cough after Alfentanil and Remifentanil Injection. (Thesis). Ajou University. Retrieved from http://repository.ajou.ac.kr/handle/201003/4364 ; http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000011484
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
조, 한범. “Comparison of the Incidence and Severity of Cough after Alfentanil and Remifentanil Injection.” 2011. Thesis, Ajou University. Accessed February 28, 2021.
http://repository.ajou.ac.kr/handle/201003/4364 ; http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000011484.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
조, 한범. “Comparison of the Incidence and Severity of Cough after Alfentanil and Remifentanil Injection.” 2011. Web. 28 Feb 2021.
Vancouver:
조 . Comparison of the Incidence and Severity of Cough after Alfentanil and Remifentanil Injection. [Internet] [Thesis]. Ajou University; 2011. [cited 2021 Feb 28].
Available from: http://repository.ajou.ac.kr/handle/201003/4364 ; http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000011484.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
조 . Comparison of the Incidence and Severity of Cough after Alfentanil and Remifentanil Injection. [Thesis]. Ajou University; 2011. Available from: http://repository.ajou.ac.kr/handle/201003/4364 ; http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000011484
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
University of Iowa
16.
Hartung, Alyssa Michelle.
Potential opioid receptor modulators derived from novel stilbenes.
Degree: PhD, Chemistry, 2014, University of Iowa
URL: https://ir.uiowa.edu/etd/3093
► The stilbene structure is part of many biologically active natural products, and these compounds can be attractive targets for chemical synthesis. A convergent synthetic…
(more)
▼ The stilbene structure is part of many biologically active natural products, and these compounds can be attractive targets for chemical synthesis. A convergent synthetic design can be utilized in order to install the central olefinic moiety by way of organophosphorus compounds. This design has been employed to prepare a number of natural products, including the potent anti-cancer compounds known as the schweinfurthins and many analogues thereof. Not only do all these structures consist of a stilbenoid scaffold, but all are partially terpenoid in nature as well. Striking similarities to the schweinfurthins would become apparent following the isolation of a new group of compounds, which would later become known as the pawhuskins. In 2004, Belofsky and co-workers reported a small set of prenylated stilbenes that they named pawhuskins. Pawhuskins A-C were isolated from the common North American purple prairie clover
(Dalea purpurea) collected near Pawhuska, Oklahoma. Belofsky's findings support an ethnomedical use, because the pawhuskins were shown to modulate
opioid receptors through displacement of a nonselective radioactive antagonist (
3[H]-naloxone) striatal tissue taken from rat brain. Pawhuskin A was the most potent member of the family, making it one of a small group of compounds that does not contain a basic nitrogen atom but that still exhibits effects on the opiate receptor system. This activity is surprising given the absence of the traditional pharmacophore, a 6-membered piperidine ring containing a basic nitrogen. In these studies, we will report the
opioid receptor binding affinity and selectivity of pawhuskin A using a functional assay based on [
35S]GTP-γ-S binding. Because of our well-established history of synthesizing prenylated stilbenes, and the unique biological activity of the pawhuskins, we embarked on a synthetic effort targeted at pawhuskin analogues. The preparation of sixteen analogues will be presented. The structure-activity relationship studies of twenty compounds correlated to illuminate more information on the novel pawhuskin pharmacophore will also be reported. Efforts toward preparation of more water-soluble structures similar to the pawhuskins will also be described. The interrelated studies involving pawhuskin analogue synthesis and elucidation of the novel pharmacophore, as well as interesting chemical findings, will be discussed in detail.
Advisors/Committee Members: Wiemer, David F. (supervisor).
Subjects/Keywords: opioid; pawhuskin; stilbene; Chemistry
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APA (6th Edition):
Hartung, A. M. (2014). Potential opioid receptor modulators derived from novel stilbenes. (Doctoral Dissertation). University of Iowa. Retrieved from https://ir.uiowa.edu/etd/3093
Chicago Manual of Style (16th Edition):
Hartung, Alyssa Michelle. “Potential opioid receptor modulators derived from novel stilbenes.” 2014. Doctoral Dissertation, University of Iowa. Accessed February 28, 2021.
https://ir.uiowa.edu/etd/3093.
MLA Handbook (7th Edition):
Hartung, Alyssa Michelle. “Potential opioid receptor modulators derived from novel stilbenes.” 2014. Web. 28 Feb 2021.
Vancouver:
Hartung AM. Potential opioid receptor modulators derived from novel stilbenes. [Internet] [Doctoral dissertation]. University of Iowa; 2014. [cited 2021 Feb 28].
Available from: https://ir.uiowa.edu/etd/3093.
Council of Science Editors:
Hartung AM. Potential opioid receptor modulators derived from novel stilbenes. [Doctoral Dissertation]. University of Iowa; 2014. Available from: https://ir.uiowa.edu/etd/3093
17.
Pennock, Reagan L.
Differential desensitization of pre- and postsynaptic mu opioid receptors regulating proopiomelanocortin neurons of the arcuate nucleus.
Degree: PhD, Biomedical Sciences, 2017, Colorado State University
URL: http://hdl.handle.net/10217/181406
► The mu opioid receptor (MOR) is the primary target of powerful opiate analgesics such as morphine and codeine. Repeated use of opiates, as may occur…
(more)
▼ The mu
opioid receptor (MOR) is the primary target of powerful opiate analgesics such as morphine and codeine. Repeated use of opiates, as may occur in patients with chronic pain, leads to the development of tolerance to the drugs' analgesic effects and may result in the development of dependence. This reduces the effectiveness of opiate-based treatments over extended periods of time, and can result in withdrawal when such a treatment is terminated. Many years of study have been dedicated to understanding the processes that lead to the development of tolerance, as an understanding of the mechanisms underlying tolerance could lead the development of novel therapeutic strategies that prolong the efficacy of
opioid-based pain treatments. One particular area of focus has been on acute desensitization of the MOR. Studies of acute desensitization, defined as the loss of receptor function that occurs in the seconds to minutes following activation with an agonist, largely focus on the attenuation of desensitization of desensitization-susceptible MORs found on the somato-dendritic region of neurons in various parts of the nervous system. In these studies, we will focus on characterizing desensitization-resistant MORs located on the axon terminal region of GABAergic neurons that form synapses with hypothalamic proopiomelanocortin (POMC) neurons. Activation of presynaptic MORs, as well as other Gαi/o-coupled GPCRs located on presynaptic terminals, results in an inhibition of GABA release, which causes a subsequent inhibition of the amplitude or frequency of inhibitory postsynaptic currents (IPSCs). Our findings demonstrate that apparent resistance to desensitization by presynaptic MORs, measured as a sustained inhibition of IPSC amplitude or frequency, cannot be explained by a large receptor reserve, nor can desensitization become detectable after chronic treatment with the opiate morphine. It was also found that resistance to desensitization is a common, but not universal, property of Gαi/o-coupled G-protein coupled receptors located on presynaptic terminals. Comparison of desensitization-resistant MORs with desensitization-susceptible GABAB receptors revealed that both populations of receptors have similar receptor-effector coupling, and that resistance or susceptibility to desensitization is unaffected by experimental conditions that isolate either Ca2+-independent spontaneous release or Ca2+-dependent synchronous release. These findings provide evidence that resistance or susceptibility to desensitization is not dependent on particular receptor-effector coupling, and is likely receptor delimited. The previous findings suggest that resistance to desensitization by the MOR may be conferred by altered physical properties of presynaptic receptors relative to their postsynaptic counterparts. A likely way that these physical differences could manifest would be through differential mobility of pre- and postsynaptic receptors. To provide proof of principle that such measurements can be made, single-particle tracking of MORs…
Advisors/Committee Members: Hentges, Shane (advisor), Tamkun, Michael (committee member), Vigh, Jozsef (committee member), Krapf, Diego (committee member).
Subjects/Keywords: electrophysiology; neurotransmission; diffusion; opioid; GPCR
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APA (6th Edition):
Pennock, R. L. (2017). Differential desensitization of pre- and postsynaptic mu opioid receptors regulating proopiomelanocortin neurons of the arcuate nucleus. (Doctoral Dissertation). Colorado State University. Retrieved from http://hdl.handle.net/10217/181406
Chicago Manual of Style (16th Edition):
Pennock, Reagan L. “Differential desensitization of pre- and postsynaptic mu opioid receptors regulating proopiomelanocortin neurons of the arcuate nucleus.” 2017. Doctoral Dissertation, Colorado State University. Accessed February 28, 2021.
http://hdl.handle.net/10217/181406.
MLA Handbook (7th Edition):
Pennock, Reagan L. “Differential desensitization of pre- and postsynaptic mu opioid receptors regulating proopiomelanocortin neurons of the arcuate nucleus.” 2017. Web. 28 Feb 2021.
Vancouver:
Pennock RL. Differential desensitization of pre- and postsynaptic mu opioid receptors regulating proopiomelanocortin neurons of the arcuate nucleus. [Internet] [Doctoral dissertation]. Colorado State University; 2017. [cited 2021 Feb 28].
Available from: http://hdl.handle.net/10217/181406.
Council of Science Editors:
Pennock RL. Differential desensitization of pre- and postsynaptic mu opioid receptors regulating proopiomelanocortin neurons of the arcuate nucleus. [Doctoral Dissertation]. Colorado State University; 2017. Available from: http://hdl.handle.net/10217/181406
University of Debrecen
18.
Balla, Bálint.
Opioid analgetikumok a klasszikus fájdalomcsillapításban
.
Degree: DE – TEK – Természettudományi és Technológiai Kar – Biológiai és Ökológiai Intézet, 2010, University of Debrecen
URL: http://hdl.handle.net/2437/95993
Opioid analgetikumok és azok hatásmechanizmusa
Advisors/Committee Members: Pórszász, Róbert (advisor).Subjects/Keywords: opioid;
fájdalom
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APA (6th Edition):
Balla, B. (2010). Opioid analgetikumok a klasszikus fájdalomcsillapításban
. (Thesis). University of Debrecen. Retrieved from http://hdl.handle.net/2437/95993
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Balla, Bálint. “Opioid analgetikumok a klasszikus fájdalomcsillapításban
.” 2010. Thesis, University of Debrecen. Accessed February 28, 2021.
http://hdl.handle.net/2437/95993.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Balla, Bálint. “Opioid analgetikumok a klasszikus fájdalomcsillapításban
.” 2010. Web. 28 Feb 2021.
Vancouver:
Balla B. Opioid analgetikumok a klasszikus fájdalomcsillapításban
. [Internet] [Thesis]. University of Debrecen; 2010. [cited 2021 Feb 28].
Available from: http://hdl.handle.net/2437/95993.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Balla B. Opioid analgetikumok a klasszikus fájdalomcsillapításban
. [Thesis]. University of Debrecen; 2010. Available from: http://hdl.handle.net/2437/95993
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
University of Dundee
19.
Higgins, Cassandra.
Comorbid opioid dependence and chronic pain : clinical implications.
Degree: PhD, 2018, University of Dundee
URL: https://discovery.dundee.ac.uk/en/studentTheses/bbc038cc-562c-4e01-a617-147de73b1312
;
https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.738563
► Context Chronic pain and opioid dependence confer substantial individual and societal burdens and are notoriously difficult to treat effectively. Their comorbid presentation further complicates effective…
(more)
▼ Context Chronic pain and opioid dependence confer substantial individual and societal burdens and are notoriously difficult to treat effectively. Their comorbid presentation further complicates effective treatment through complex physiological and environmental interactions. Objectives (1) What are the clinical characteristics and treatment outcomes associated with comorbid chronic pain in ORT patients? (2) Does the patient-attributed direction of the causal relationship in the development of opioid dependence and chronic pain identify two clinically-distinct treatment populations? (3) What is the incidence of iatrogenic opioid dependence or abuse following opioid analgesic treatment? (4) Is there evidence of opioid-induced hyperalgesia in humans? Methods Primary data Participants were 467 treatment-seeking, opioid-dependent patients. Materials comprised standardised instruments – focusing on illicit substance use and mental health characteristics – completed by medical staff at study inception, and extracts of routinely-collected clinical datasets spanning the follow-up period. Procedures involved the use of a health informatics approach. Electronic linkage of data collected at study inception with routinely-collected clinical datasets spanning the 5-year follow-up period. Secondary data Systematic searches were undertaken using six electronic research databases, supplemented by manual searches. Study quality was assessed using instruments developed by NIH. Data synthesis using random effects models (DerSimonian-Laird method) generated: (1) a pooled incidence of iatrogenic dependence or abuse following opioid analgesic treatment; and (2) a pooled effect of opioid exposure on the development of opioid-induced hyperalgesia. Additional analyses included assessment of heterogeneity in study effects, within- and between-study risk of bias and sensitivity analyses. Results A total of 246 (53%) patients reported comorbid chronic pain. This ‘comorbid’ group was associated with increased mortality, physical and mental health problems, service utilisation and illicit drug use, specifically benzodiazepines and cannabinoids. Within the ‘comorbid’ group, patients who reported a causal impact of opioid dependence on the development of pain were associated with increased illicit drug use and psychiatric morbidity. Secondary data analyses revealed a 4.7% incidence estimate of iatrogenic dependence or abuse following opioid analgesic treatment, and evidence of the development of opioid-induced hyperalgesia following therapeutic opioid exposure. Conclusions Elevated mortality, morbidity and illicit drug use in opioid-dependent patients with comorbid chronic pain reflects a patient population with substantial health burdens. The dynamic relationship between these severe and chronic conditions necessitates complex, multimodal treatment strategies and multiagency collaboration, including general psychiatric intervention. Whilst a substantial proportion reported that opioid dependence developed as a consequence of pain problems, there is…
Subjects/Keywords: Pain; Opioid; Dependency; Addiction
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APA ·
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Manager
APA (6th Edition):
Higgins, C. (2018). Comorbid opioid dependence and chronic pain : clinical implications. (Doctoral Dissertation). University of Dundee. Retrieved from https://discovery.dundee.ac.uk/en/studentTheses/bbc038cc-562c-4e01-a617-147de73b1312 ; https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.738563
Chicago Manual of Style (16th Edition):
Higgins, Cassandra. “Comorbid opioid dependence and chronic pain : clinical implications.” 2018. Doctoral Dissertation, University of Dundee. Accessed February 28, 2021.
https://discovery.dundee.ac.uk/en/studentTheses/bbc038cc-562c-4e01-a617-147de73b1312 ; https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.738563.
MLA Handbook (7th Edition):
Higgins, Cassandra. “Comorbid opioid dependence and chronic pain : clinical implications.” 2018. Web. 28 Feb 2021.
Vancouver:
Higgins C. Comorbid opioid dependence and chronic pain : clinical implications. [Internet] [Doctoral dissertation]. University of Dundee; 2018. [cited 2021 Feb 28].
Available from: https://discovery.dundee.ac.uk/en/studentTheses/bbc038cc-562c-4e01-a617-147de73b1312 ; https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.738563.
Council of Science Editors:
Higgins C. Comorbid opioid dependence and chronic pain : clinical implications. [Doctoral Dissertation]. University of Dundee; 2018. Available from: https://discovery.dundee.ac.uk/en/studentTheses/bbc038cc-562c-4e01-a617-147de73b1312 ; https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.738563
Universitat Pompeu Fabra
20.
Zejcirovic, Dijana.
Essays in applied microeconomics.
Degree: Departament d'Economia i Empresa, 2018, Universitat Pompeu Fabra
URL: http://hdl.handle.net/10803/663097
► Esta tesis está compuesta de tres capítulos. En los primeros dos capítulos se estudia el impacto de la promoción farmacéutica de los analgésicos opiáceos en…
(more)
▼ Esta tesis está compuesta de tres capítulos. En los primeros dos capítulos se estudia el impacto de la promoción farmacéutica de los analgésicos opiáceos en Estados Unidos. En el primer capítulo se encuentra que los lugares donde los agentes de ventas farmacéuticas visitaron a un mayor número de doctores, tienen mayores tasas de muertes por sobredosis de opiáceos. Se muestra que los doctores que son visitados por los agentes de ventas escriben más recetas médicas incluyendo opiáceos. El segundo capítulo estudia el rol de la promoción y disponibilidad de opiáceos en suicidios no causados por envenenamiento. Los resultados indican que la promoción de opiáceos puede aumentar la tasa de suicidios pero que este efecto es mitigado en lugares con fuertes redes de apoyo para la adicción. En el tercer capítulo, se analiza el efecto de estar expuesto a violencia causada por un conflicto civil sobre el comportamiento electoral. Usando datos de elecciones en Bosnia y Herzegovina entre 1990 y 2014, y aprovechando diferencias en la intensidad de la guerra entre municipalidades, se estima que la violencia en contra de personas civiles tiene un efecto negativo en la participación electoral.
Advisors/Committee Members: [email protected] (authoremail), true (authoremailshow), Tarozzi, Alessandro, 1971- (director), true (authorsendemail).
Subjects/Keywords: Pharmaceutical promotion; Opiáceos; Opioid; 33
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APA (6th Edition):
Zejcirovic, D. (2018). Essays in applied microeconomics. (Thesis). Universitat Pompeu Fabra. Retrieved from http://hdl.handle.net/10803/663097
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Zejcirovic, Dijana. “Essays in applied microeconomics.” 2018. Thesis, Universitat Pompeu Fabra. Accessed February 28, 2021.
http://hdl.handle.net/10803/663097.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Zejcirovic, Dijana. “Essays in applied microeconomics.” 2018. Web. 28 Feb 2021.
Vancouver:
Zejcirovic D. Essays in applied microeconomics. [Internet] [Thesis]. Universitat Pompeu Fabra; 2018. [cited 2021 Feb 28].
Available from: http://hdl.handle.net/10803/663097.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Zejcirovic D. Essays in applied microeconomics. [Thesis]. Universitat Pompeu Fabra; 2018. Available from: http://hdl.handle.net/10803/663097
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Victoria University of Wellington
21.
Young, David.
Pre-clinical Anti-Addictive and Side-Effect profiles of Novel Kappa-opioid Agonists.
Degree: 2015, Victoria University of Wellington
URL: http://hdl.handle.net/10063/5020
► Background: Drug addiction is a chronic, relapsing disorder with great socioeconomic and morbidity costs. An estimated 27 million people worldwide suffer from drug dependence, with…
(more)
▼ Background: Drug addiction is a chronic, relapsing disorder with great socioeconomic and morbidity costs. An estimated 27 million people worldwide suffer from drug dependence, with over 180,000 drug abuse-related deaths reported annually (UNODC, 2015). Currently, there are no FDA-approved pharmacotherapies for psychostimulant addiction, limiting the efficacy of treatment for cocaine and amphetamine abuse. Kappa-
opioid receptor (KOPr) agonists can act as inhibitors of reward, and have been investigated in pre-clinical models of drug abuse for potential anti-addictive properties, but display undesirable side-effects such as dysphoria and sedation. A naturally-occurring KOPr agonist, Salvinorin A (SalA), has been explored as a lead for new KOPr-based anti-addictive medications. SalA is a short-acting but potent non-nitrogenous KOPr agonist with known anti-cocaine effects, and chemical alterations to this structure have produced novel agonists with comparable or greater potency at the KOPr. This thesis compares two novel SalA analogues, 16-ethynyl Salvinorin A (Ethy-SalA) and 16-methyl Salvinorin A (Me-SalA), in pre-clinical models of addiction and side-effect tests.
Methods: Sprague-Dawley rats were used to model the behavioural effects of acute KOPr treatment upon cocaine self-administration and drug-seeking behaviour, natural reward-seeking, cocaine-induced and spontaneous locomotion, and pro-depressive forced-swim testing. Transiently co-transfected HEK-293 cells were used to model the influence of KOPr activation upon dopamine transporter (DAT) function in an in vitro model of dopamine uptake, using confocal microscopy to detect internalisation of the fluorescent DAT substrate ASP+.
Results: Acute pre-treatments of Ethy-SalA significantly attenuated cocaine-reinstatement of drug-seeking behaviour (at 0.1 and 0.3 mg/kg) and progressive ratio (PR) self-administration of cocaine (at 2.0 mg/kg). The less potent agonist Me-SalA did not attenuate cocaine-reinstatement or PR self-administration at the doses tested (0.3-2.0 mg/kg). Despite apparent anti-cocaine effects, Ethy-SalA (0.3 mg/kg) was not found to effectively reduce cocaine-induced locomotor hyperactivity or sensitisation in rats. Side-effect screens were carried out on the novel compounds using the doses tested in cocaine-primed reinstatement. Ethy-SalA (0.3 mg/kg) and Me-SalA (1.0 mg/kg) did not significantly affect spontaneous locomotor behaviour 0.3 mg/kg, or reduce self-administration of the natural reward sucrose at a dose of 0.3 mg/kg in rats. Depression-like effects caused by acute Ethy-SalA treatment (0.3 mg/kg) were also not detected in the Forced Swim Test. Treatment with Ethy-SalA (10 µM) significantly increased uptake of the fluorescent ASP+ in co-transfected DAT/KOPr HEK-293 cells.
Conclusions: A single treatment of the novel KOPr agonist Ethy-SalA, but not the novel agonist Me-SalA, was found to attenuate drug-seeking behaviours in models of cocaine administration with greater potency than SalA, and without detectable sedative or…
Advisors/Committee Members: Kivell, Bronwyn.
Subjects/Keywords: Kappa-opioid; Addiction; Pre-clinical
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APA (6th Edition):
Young, D. (2015). Pre-clinical Anti-Addictive and Side-Effect profiles of Novel Kappa-opioid Agonists. (Masters Thesis). Victoria University of Wellington. Retrieved from http://hdl.handle.net/10063/5020
Chicago Manual of Style (16th Edition):
Young, David. “Pre-clinical Anti-Addictive and Side-Effect profiles of Novel Kappa-opioid Agonists.” 2015. Masters Thesis, Victoria University of Wellington. Accessed February 28, 2021.
http://hdl.handle.net/10063/5020.
MLA Handbook (7th Edition):
Young, David. “Pre-clinical Anti-Addictive and Side-Effect profiles of Novel Kappa-opioid Agonists.” 2015. Web. 28 Feb 2021.
Vancouver:
Young D. Pre-clinical Anti-Addictive and Side-Effect profiles of Novel Kappa-opioid Agonists. [Internet] [Masters thesis]. Victoria University of Wellington; 2015. [cited 2021 Feb 28].
Available from: http://hdl.handle.net/10063/5020.
Council of Science Editors:
Young D. Pre-clinical Anti-Addictive and Side-Effect profiles of Novel Kappa-opioid Agonists. [Masters Thesis]. Victoria University of Wellington; 2015. Available from: http://hdl.handle.net/10063/5020
University of Victoria
22.
Malhotra, Madhav.
Peer alerting lifeline: a study of backend infrastructure for a crowdsourced emergency response system.
Degree: Department of Computer Science, 2019, University of Victoria
URL: https://dspace.library.uvic.ca//handle/1828/10495
► Opioid users are an at-risk community. Risk of opioid overdose among substance users has increased tremendously in the last decade. Many factors, including adulterated drugs…
(more)
▼ Opioid users are an at-risk community. Risk of
opioid overdose among substance users has increased tremendously in the last decade. Many factors, including adulterated drugs and hesitation in calling emergency response services, have led to many individuals not receiving the required harm reduction treatment, during an overdose incident. The problem is further compounded by the fact that many users are using alone in private residences and hence, no support mechanisms are available for them to assist them in case of an overdose situation. To circumvent this scenario, citizen training in Naloxone, an overdose harm reduction drug, has been promoted. However, there lies an essential communication gap between the citizens who have the training and the Naloxone kit and an active overdose event. Many at-risk communities may face the same challenge, especially if they are at risk of social isolation and voluntary/involuntary self-harm.
Through our work, we wish to mobilize change in such at-risk communities, by studying the backend infrastructure of a crowdsourced emergency response system, called as a Peer Alerting Lifeline. The system would be responsible, for connecting peer responders, to an actual emergency event. Specifically, in the case of substance overdose, this would allow Naloxone kit holders to be informed of an overdose event in their vicinity and respond to the same. We aim to study the design infrastructure of such a system.
Advisors/Committee Members: Coady, Yvonne (supervisor).
Subjects/Keywords: opioid; emergency; naloxone; crowdsourcing
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APA (6th Edition):
Malhotra, M. (2019). Peer alerting lifeline: a study of backend infrastructure for a crowdsourced emergency response system. (Masters Thesis). University of Victoria. Retrieved from https://dspace.library.uvic.ca//handle/1828/10495
Chicago Manual of Style (16th Edition):
Malhotra, Madhav. “Peer alerting lifeline: a study of backend infrastructure for a crowdsourced emergency response system.” 2019. Masters Thesis, University of Victoria. Accessed February 28, 2021.
https://dspace.library.uvic.ca//handle/1828/10495.
MLA Handbook (7th Edition):
Malhotra, Madhav. “Peer alerting lifeline: a study of backend infrastructure for a crowdsourced emergency response system.” 2019. Web. 28 Feb 2021.
Vancouver:
Malhotra M. Peer alerting lifeline: a study of backend infrastructure for a crowdsourced emergency response system. [Internet] [Masters thesis]. University of Victoria; 2019. [cited 2021 Feb 28].
Available from: https://dspace.library.uvic.ca//handle/1828/10495.
Council of Science Editors:
Malhotra M. Peer alerting lifeline: a study of backend infrastructure for a crowdsourced emergency response system. [Masters Thesis]. University of Victoria; 2019. Available from: https://dspace.library.uvic.ca//handle/1828/10495
University of Minnesota
23.
Yekkirala, Ajay S.
Elucidating the role of opioid receptor heteromers as targets for analgesic drug design.
Degree: PhD, Pharmacology, 2011, University of Minnesota
URL: http://purl.umn.edu/161209
► Opioid receptors are class A members of the G protein coupled-receptor (GPCR) superfamily. There is high amino acid homology (~60%) within the opioid receptor family…
(more)
▼ Opioid receptors are class A members of the G protein coupled-receptor (GPCR) superfamily. There is high amino acid homology (~60%) within the opioid receptor family that constitutes a group of four receptor types: MOP (mu), DOP (delta), KOP (kappa), and NOP (nociceptin, orphanin FQ, ORL1). Opioid receptors are present in the central nervous system and peripherally, including immune cells, and are believed to function as neuromodulators or immunomodulators. Morphine is among the best known clinically employed analgesics that activate opioid receptors. Although the concept of opioid receptor dimers was proposed nearly 30 years ago, classical models of GPCRs, including opioid receptors, were generally based on the assumption that they are organized and function as monomers. However, in view of burgeoning evidence for the existence of heteromeric GPCRs, that includes at least twelve different heteromeric opioid receptors in cultured cells, it seems likely that constitutive oligomerization of GPCRs may be the general rule rather than the exception. Among the many heteromers reported in the opioid receptor family are mu/kappa, kappa/delta and mu/delta. However, the in vivo physiological and behavioral relevance for the proposed heteromers have not yet been rigorously established. The greatest drawback in studying the signaling and trafficking properties of heteromers pertains to the lack of selective ligands targeting opioid heteromers. It is, therefore, necessary to first develop tools that can be used as probes to address the shortcomings. Hence, we evaluated standard opioids agonists and antagonists, novel ligands synthesized in our lab, and clinically used opioid analgesics to establish a ligand selectivity profile that takes into account the existence of heteromers. Utilizing mu-delta agonist/antagonist bivalent ligands we have provided direct evidence for bridging of opioid receptor heteromers using immunofluorescent methods. Moreover, we performed studies to elucidate how the individual protomers constituting a heteromer modulate the trafficking and functional properties of each other. The results have painted an intriguing picture suggesting that the effects are dependent on both protomer composition and the ligands used. Those studies have given us valuable information on the role of opioid heteromers in physiology, and as unique targets in drug discovery.
Subjects/Keywords: Analgesics; GPCRs; Heterodimers; Opioid
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APA (6th Edition):
Yekkirala, A. S. (2011). Elucidating the role of opioid receptor heteromers as targets for analgesic drug design. (Doctoral Dissertation). University of Minnesota. Retrieved from http://purl.umn.edu/161209
Chicago Manual of Style (16th Edition):
Yekkirala, Ajay S. “Elucidating the role of opioid receptor heteromers as targets for analgesic drug design.” 2011. Doctoral Dissertation, University of Minnesota. Accessed February 28, 2021.
http://purl.umn.edu/161209.
MLA Handbook (7th Edition):
Yekkirala, Ajay S. “Elucidating the role of opioid receptor heteromers as targets for analgesic drug design.” 2011. Web. 28 Feb 2021.
Vancouver:
Yekkirala AS. Elucidating the role of opioid receptor heteromers as targets for analgesic drug design. [Internet] [Doctoral dissertation]. University of Minnesota; 2011. [cited 2021 Feb 28].
Available from: http://purl.umn.edu/161209.
Council of Science Editors:
Yekkirala AS. Elucidating the role of opioid receptor heteromers as targets for analgesic drug design. [Doctoral Dissertation]. University of Minnesota; 2011. Available from: http://purl.umn.edu/161209
University of New Mexico
24.
Shrestha, Shikhar.
Assessment of nutritional status in pregnant women on opioid maintenance therapy.
Degree: College of Pharmacy, 2015, University of New Mexico
URL: http://hdl.handle.net/1928/30361
► Objectives: Patients who use substances or those who are on opioid maintenance therapy could be at risk of inadequate nutrition. These inadequacies could translate to…
(more)
▼ Objectives: Patients who use substances or those who are on
opioid maintenance therapy could be at risk of inadequate nutrition. These inadequacies could translate to adverse outcomes during pregnancy. The objective of this study was to determine differences in dietary macro and micronutrient intake in pregnant women on OMT compared to healthy controls. Methods: Participants from a parent prospective cohort study ENRICH' were classified into two groups: OMT users and healthy controls. Inclusion into the nutritional analysis was based on eligibility criteria of completion of food frequency questionnaire administered during hospital stay after delivery, absence of heavy drinking and adequate energy intake. Crude differences in energy, macro (carbohydrate, protein and total fat) and micronutrient (vitamin A, B1, B2, B6, B12, C, D, E, beta-carotenes, folate, iron and choline) intake between the study groups were compared using student's t-test which was repeated after adjustment by total energy intake. To control for multiple comparisons MANOVA was used. Multivariate regression was used to control for confounders. Results: A total of 54 subjects (34 OMT and 20 controls) were included in the nutritional analyses. No significant effect of OMT status on energy intake was observed. It was observed that OMT group had lower energy adjusted protein intake (p=0.03). Analysis of the dietary micronutrient intake showed that the subjects on OMT had significantly lower Vitamin E (-0.9a-TE/1000Kcal/day, 95%CI:-1.8, 0.1, p=0.03) and folate (-45.9 DFE/1000Kcal/day, 95%CI:-87.1,-4.6, p=0.03) intake compared to controls after controlling for marital status, insurance type, age and BMI. There was a significant effect of ethnicity on energy-adjusted carbohydrate intake (p=0.02) and employment (p<0.01) on energy-adjusted protein intake after controlling covariates. It was observed that diet alone was not able to meet the requirements of several micronutrients in both the OMT and control group. Conclusion: It was observed that pregnant women on OMT had lower intake of several micronutrients compared to healthy controls which could lead to adverse pregnancy outcomes. The results of this study reinforces the requirement of micronutrient supplementation during pregnancy. Future studies should focus on investigating the effect of these differences in pregnancy outcomes and implement policies to promote healthy diet.
Advisors/Committee Members: Bakhireva, Ludmila N., Raisch, Dennis W., Pribis, Peter.
Subjects/Keywords: Pregnancy; Opioid Maintenance Therapy; Nutrition
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APA (6th Edition):
Shrestha, S. (2015). Assessment of nutritional status in pregnant women on opioid maintenance therapy. (Masters Thesis). University of New Mexico. Retrieved from http://hdl.handle.net/1928/30361
Chicago Manual of Style (16th Edition):
Shrestha, Shikhar. “Assessment of nutritional status in pregnant women on opioid maintenance therapy.” 2015. Masters Thesis, University of New Mexico. Accessed February 28, 2021.
http://hdl.handle.net/1928/30361.
MLA Handbook (7th Edition):
Shrestha, Shikhar. “Assessment of nutritional status in pregnant women on opioid maintenance therapy.” 2015. Web. 28 Feb 2021.
Vancouver:
Shrestha S. Assessment of nutritional status in pregnant women on opioid maintenance therapy. [Internet] [Masters thesis]. University of New Mexico; 2015. [cited 2021 Feb 28].
Available from: http://hdl.handle.net/1928/30361.
Council of Science Editors:
Shrestha S. Assessment of nutritional status in pregnant women on opioid maintenance therapy. [Masters Thesis]. University of New Mexico; 2015. Available from: http://hdl.handle.net/1928/30361
University of Minnesota
25.
Meng, Jingjing.
Mechanisms Underlying Opioid Modulation of Gut Immunity.
Degree: PhD, Pharmacology, 2014, University of Minnesota
URL: http://hdl.handle.net/11299/174874
► Opioids are used widely by clinicians due to their potent analgesic activities and sedative properties. However, opioid use or abuse is associated with multiple adverse…
(more)
▼ Opioids are used widely by clinicians due to their potent analgesic activities and sedative properties. However, opioid use or abuse is associated with multiple adverse gastrointestinal (GI) symptoms and higher susceptibility to infection caused by pathogens with gut origin. Both clinical and laboratory studies implied that opioids showed suppressive effects on gut immunity and predisposed critically sick patients to infections while the mechanism underlying this defect is still unknown. In the present study we investigated how opioids modulate gut epithelial barrier function and immune responses of gut associated lymphoid tissue (GALT). We demonstrated significant bacterial translocation from gut lumen to mesenteric lymph node (MLN) and liver following morphine treatment in wild-type (WT) animals that was significantly attenuated in Toll-like receptor (TLR2 and 4) knockout mice. We further observed significant disruption of tight junction protein organization only in the ileum but not in the colon of morphine treated WT animals. Inhibition of myosin light chain kinase (MLCK) blocked the effects of both morphine and TLR ligands, suggesting the role of MLCK in tight junction modulation by TLR. Additionally we determined the immune responses of GALT to polymicrobial sepsis in the presence and absence of opioids by using a murine cecal ligation and puncture model. The results showed that opioids accelerated the mortality rate of polymicrobial sepsis. During sepsis progression, morphine treatment altered gut microbiome and subsequently promoted gram-positive bacterial dissemination, which induced excess IL-17A production in a TLR2-dependent manner, resulting in increased gut permeability, sustained inflammation and higher mortality. This study improved our understanding of the role of morphine in modulating gut barrier functions and the roles of GALT in infection susceptibility, which may provide the potential therapeutic targets for novel drug development and lead to more powerful strategy to control or prevent severe infectious diseases like sepsis especially in the opioid using and abusing population.
Subjects/Keywords: epithelium; gut; immunology; opioid; sepsis
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APA (6th Edition):
Meng, J. (2014). Mechanisms Underlying Opioid Modulation of Gut Immunity. (Doctoral Dissertation). University of Minnesota. Retrieved from http://hdl.handle.net/11299/174874
Chicago Manual of Style (16th Edition):
Meng, Jingjing. “Mechanisms Underlying Opioid Modulation of Gut Immunity.” 2014. Doctoral Dissertation, University of Minnesota. Accessed February 28, 2021.
http://hdl.handle.net/11299/174874.
MLA Handbook (7th Edition):
Meng, Jingjing. “Mechanisms Underlying Opioid Modulation of Gut Immunity.” 2014. Web. 28 Feb 2021.
Vancouver:
Meng J. Mechanisms Underlying Opioid Modulation of Gut Immunity. [Internet] [Doctoral dissertation]. University of Minnesota; 2014. [cited 2021 Feb 28].
Available from: http://hdl.handle.net/11299/174874.
Council of Science Editors:
Meng J. Mechanisms Underlying Opioid Modulation of Gut Immunity. [Doctoral Dissertation]. University of Minnesota; 2014. Available from: http://hdl.handle.net/11299/174874
University of Minnesota
26.
Kotecki, Lydia.
Inhibitory signaling and reward: the role of GIRK channels in the mesocorticolimbic dopamine system.
Degree: PhD, Pharmacology, 2015, University of Minnesota
URL: http://hdl.handle.net/11299/177149
► Drug abuse is a critical global problem and given the current lack of efficacious pharmacotherapies to treat addiction, it is vital that we gain a…
(more)
▼ Drug abuse is a critical global problem and given the current lack of efficacious pharmacotherapies to treat addiction, it is vital that we gain a better understanding of the cellular and molecular targets of drugs of abuse, and how modulation of these targets leads to addiction. Although different abused drugs work through different mechanisms of action, addiction is thought to have a common pathway, the mesocorticolimbic system, which consists of the ventral tegmental area (VTA) and reciprocal connections with downstream targets. G protein-coupled receptors (GPCRs) and downstream effectors represent a major target for drug-induced changes in mesocorticolimbic signaling. G protein-gated inwardly rectifying K+ (GIRK) channels are a key downstream target of inhibitory GPCRs and have been shown to mediate the inhibitory effects of many neurotransmitters in the CNS. Dysregulation of GPCR-GIRK signaling has been identified in a number of disorders, including addiction. This dissertation focuses on the role of GIRK-dependent inhibitory signaling throughout the mesocorticolimbic system, and how this form of signaling contributes to the cellular and reward-related behavioral effect of drugs of abuse. The importance of GIRK-dependent signaling to drug addiction is supported by the fact that several drugs of abuse can produce adaptations to the GPCR-GIRK signaling cascade. GIRK-dependent signaling was also believed to be a key regulatory of opioid effects within the mesocorticolimbic system, thought to ultimately contribute to opioid reward. Here, we challenged the opioid signaling “dogma” and show that GIRK-dependent signaling in midbrain GABA neurons is not required for disinhibition of VTA DA neurons and subsequent opioid-induced motor-stimulation. Interestingly, it appears the unique GIRK2/GIRK3 channel found in VTA DA neurons can modulate the behavioral sensitivity to opioids. In addition, we found that this GIRK2/GIRK3 channel can also modulate cocaine locomotor sensitivity, suggesting it could be a shared mechanism of other drugs of abuse. Taken together, these findings demonstrate that GPCR-GIRK inhibitory signaling in VTA DA neurons is critical to the molecular and behavioral effects of drugs of abuse. These findings also suggest that the discovery of novel compounds that modulate GIRK channel function in a subunit-dependent manner could help us prevent and/or treat addiction.
Subjects/Keywords: GIRK; mesocorticolimbic; opioid; VTA
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CSE |
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APA (6th Edition):
Kotecki, L. (2015). Inhibitory signaling and reward: the role of GIRK channels in the mesocorticolimbic dopamine system. (Doctoral Dissertation). University of Minnesota. Retrieved from http://hdl.handle.net/11299/177149
Chicago Manual of Style (16th Edition):
Kotecki, Lydia. “Inhibitory signaling and reward: the role of GIRK channels in the mesocorticolimbic dopamine system.” 2015. Doctoral Dissertation, University of Minnesota. Accessed February 28, 2021.
http://hdl.handle.net/11299/177149.
MLA Handbook (7th Edition):
Kotecki, Lydia. “Inhibitory signaling and reward: the role of GIRK channels in the mesocorticolimbic dopamine system.” 2015. Web. 28 Feb 2021.
Vancouver:
Kotecki L. Inhibitory signaling and reward: the role of GIRK channels in the mesocorticolimbic dopamine system. [Internet] [Doctoral dissertation]. University of Minnesota; 2015. [cited 2021 Feb 28].
Available from: http://hdl.handle.net/11299/177149.
Council of Science Editors:
Kotecki L. Inhibitory signaling and reward: the role of GIRK channels in the mesocorticolimbic dopamine system. [Doctoral Dissertation]. University of Minnesota; 2015. Available from: http://hdl.handle.net/11299/177149
University of Tennessee – Knoxville
27.
Skadberg, Rebecca M.
A Longitudinal Study of Anxious and Depressive Symptomology and Pain Medication Usage.
Degree: MA, Psychology, 2017, University of Tennessee – Knoxville
URL: https://trace.tennessee.edu/utk_gradthes/4984
► Evidence suggests that depression and anxiety may be related to pain medication use in a bidirectional manner. Understanding the relationship of these factors is of…
(more)
▼ Evidence suggests that depression and anxiety may be related to pain medication use in a bidirectional manner. Understanding the relationship of these factors is of heightened importance due to the extensive use of long-term
opioid pain medication therapy for treatment of adults suffering from chronic pain. The present study, utilizing a large longitudinal sample from the National Survey of Midlife Development in the United States (MIDUS), examined the relationship between depression, anxiety, gender, and pain medication usage in individuals with chronic pain over an almost 20-year span. Structural equation modeling found stability of depression and anxiety in individuals with chronic pain. It also appears that both anxiety and depression may have a bidirectional positive relationship in this population. As expected, pain medication use predicted later use at 10 years. Surprisingly, pain medication use was not strongly related to later negative affect in this sample. However, heightened anxiety was associated with later pain medication use. Gender effects were nonsignificant. Implications for those who are prescribed pain medications over a long term are discussed.
Advisors/Committee Members: Todd M. Moore, L. Christian Elledge, Kristina C. Gordon.
Subjects/Keywords: Chronic Pain; Opioid Pain Medication
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APA (6th Edition):
Skadberg, R. M. (2017). A Longitudinal Study of Anxious and Depressive Symptomology and Pain Medication Usage. (Thesis). University of Tennessee – Knoxville. Retrieved from https://trace.tennessee.edu/utk_gradthes/4984
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Chicago Manual of Style (16th Edition):
Skadberg, Rebecca M. “A Longitudinal Study of Anxious and Depressive Symptomology and Pain Medication Usage.” 2017. Thesis, University of Tennessee – Knoxville. Accessed February 28, 2021.
https://trace.tennessee.edu/utk_gradthes/4984.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
MLA Handbook (7th Edition):
Skadberg, Rebecca M. “A Longitudinal Study of Anxious and Depressive Symptomology and Pain Medication Usage.” 2017. Web. 28 Feb 2021.
Vancouver:
Skadberg RM. A Longitudinal Study of Anxious and Depressive Symptomology and Pain Medication Usage. [Internet] [Thesis]. University of Tennessee – Knoxville; 2017. [cited 2021 Feb 28].
Available from: https://trace.tennessee.edu/utk_gradthes/4984.
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
Council of Science Editors:
Skadberg RM. A Longitudinal Study of Anxious and Depressive Symptomology and Pain Medication Usage. [Thesis]. University of Tennessee – Knoxville; 2017. Available from: https://trace.tennessee.edu/utk_gradthes/4984
Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation
McGill University
28.
Lucido, Anna Lisa.
Identification and characterization of factors binding to the CS3 Element of the mouse Foxa2 node enhancer.
Degree: MS, Department of Neurology and Neurosurgery, 2005, McGill University
URL: https://escholarship.mcgill.ca/downloads/dz010s39f.pdf
;
https://escholarship.mcgill.ca/concern/theses/7d278w574
► Dans notre laboratoire, nous avons démontré que les récepteurs delta opioïde (δORs), ayant une localisation principalement intracellulaire, peuvent être recrutes à la membrane plasmique suite…
(more)
▼ Dans notre laboratoire, nous avons démontré que les récepteurs delta opioïde (δORs), ayant une localisation principalement intracellulaire, peuvent être recrutes à la membrane plasmique suite à une stimulation prolongée a la morphine. Le premier objectif de ce travail était d'établir un système in vitro pour L’étude des mécanismes de régulation du trafic de δOR induit par la morphine. Dans les cellules hypophysaires GH3, nous avons trouvé que l'application prolongée de morphine diminue la densité deδORs a la membrane, alors qu'elle induit plutôt leur recrutement vers la membrane plasmique dans les neurones de ganglions spinaux en culture. Ces observations suggèrent donc que les niveaux de localisation intracellulaire ainsi que la régulation du trafic des δORs induit par la morphine est un phénomène spécifique aux cellules de type neuronal. […]
Studies from our laboratory have demonstrated that delta opioid receptors (δORs) are primarily localized intracellularly and may be recruited to the plasma membrane upon prolonged treatment with morphine. Our first objective was to establish a model in vitro system to study the mechanism of morphine-induced δOR trafficking. We discovered that while prolonged morphine treatment decreased the density of δORs at the plasma membrane in GH3 pituitary cells, the same treatment induced a translocation of δORs from intracellular to plasma membrane-bound compartments in cultured dorsal root ganglion cells, suggesting that the baseline intracellular localization and morphine-induced trafficking of SORs is a phenomenon specific to neurons. […]
Advisors/Committee Members: Beaudet, Alain (Supervisor).
Subjects/Keywords: Opioid receptors
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APA (6th Edition):
Lucido, A. L. (2005). Identification and characterization of factors binding to the CS3 Element of the mouse Foxa2 node enhancer. (Masters Thesis). McGill University. Retrieved from https://escholarship.mcgill.ca/downloads/dz010s39f.pdf ; https://escholarship.mcgill.ca/concern/theses/7d278w574
Chicago Manual of Style (16th Edition):
Lucido, Anna Lisa. “Identification and characterization of factors binding to the CS3 Element of the mouse Foxa2 node enhancer.” 2005. Masters Thesis, McGill University. Accessed February 28, 2021.
https://escholarship.mcgill.ca/downloads/dz010s39f.pdf ; https://escholarship.mcgill.ca/concern/theses/7d278w574.
MLA Handbook (7th Edition):
Lucido, Anna Lisa. “Identification and characterization of factors binding to the CS3 Element of the mouse Foxa2 node enhancer.” 2005. Web. 28 Feb 2021.
Vancouver:
Lucido AL. Identification and characterization of factors binding to the CS3 Element of the mouse Foxa2 node enhancer. [Internet] [Masters thesis]. McGill University; 2005. [cited 2021 Feb 28].
Available from: https://escholarship.mcgill.ca/downloads/dz010s39f.pdf ; https://escholarship.mcgill.ca/concern/theses/7d278w574.
Council of Science Editors:
Lucido AL. Identification and characterization of factors binding to the CS3 Element of the mouse Foxa2 node enhancer. [Masters Thesis]. McGill University; 2005. Available from: https://escholarship.mcgill.ca/downloads/dz010s39f.pdf ; https://escholarship.mcgill.ca/concern/theses/7d278w574
University of Canterbury
29.
Kelly, Helana Ellen.
The effect of titrated fentanyl on cough response in healthy participants.
Degree: MS, Speech and Language Sciences, 2014, University of Canterbury
URL: http://dx.doi.org/10.26021/8890
► Background: One population prone to aspiration pneumonia and impaired cough is the postoperative patient. Postoperative pneumonia is the third most common complication among surgical patients…
(more)
▼ Background: One population prone to aspiration pneumonia and impaired cough is the postoperative patient. Postoperative pneumonia is the third most common complication among surgical patients after urinary tract and wound infections (Wren, Martin, Yoon, & Bech, 2010). A patient who has their surgical course complicated by aspiration pneumonia has increased morbidity, increased length of hospital stay and places greater demands on the health system. Mortality rates are cited as high as 70% (Wren, et al., 2010). Despite the prevalence of postoperative pneumonia and the high morbidity and mortality rates, little is known about the effect of anaesthesia on swallowing and airway protection. This study investigated the effect of clinical doses of fentanyl on suppressed cough reflex in healthy participants.
Materials and Methods: After receiving ethical approval, 14 young, healthy participants gave informed written consent and completed the study protocol. Each participant received a total of 2 mcg/kg of fentanyl in four doses administered at five-minute intervals. Fentanyl effect site concentrations (ESC) were estimated using a standard pharmacokinetic model. During the administration period, suppressed cough response testing (SCR) with nebulised citric acid was performed after each fentanyl dose. Citric acid was presented in increments of 0.2M from each participant’s baseline cough response until a present-strong response was achieved. During the post-administration period, SCR was compared with reducing effect site concentrations to determine the time course for resolution of cough suppression.
Results: Suppressed cough threshold increased and decreased in parallel with modeled fentanyl effect site concentrations. Mean citric acid concentration increased from 0.5M at baseline to 0.6M after 0.5 mcg/kg of fentanyl, 0.7 M after 1 mcg/kg of fentanyl, 0.9M after 1.5 mcg/kg of fentanyl and 1.2M after 2 mcg/kg of fentanyl. Predicted effect site concentrations after final doses of fentanyl (2 mcg/kg) were 1.89 ng/mL (1.81-1.96), well within the range seen clinically in the postoperative period. After the final dose of fentanyl, participants had on average 3.4 increments of change in their cough response (at increments of 0.2M).
Conclusion: SCR testing with citric acid is sensitive enough to mirror changes in fentanyl ESC in healthy, young participants. The degree of reflex suppression seen has been associated with an 8-fold increase in aspiration risk in the general medical patient with dysphagia (Miles, Moore, McFarlane, Lee, Allen, Huckabee, 2013). Further research into the application of SCR in the postoperative period may help clinical decisions regarding safety to commence oral intake.
Subjects/Keywords: fentanyl; opioid; cough; cough reflex
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APA ·
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Export
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APA (6th Edition):
Kelly, H. E. (2014). The effect of titrated fentanyl on cough response in healthy participants. (Masters Thesis). University of Canterbury. Retrieved from http://dx.doi.org/10.26021/8890
Chicago Manual of Style (16th Edition):
Kelly, Helana Ellen. “The effect of titrated fentanyl on cough response in healthy participants.” 2014. Masters Thesis, University of Canterbury. Accessed February 28, 2021.
http://dx.doi.org/10.26021/8890.
MLA Handbook (7th Edition):
Kelly, Helana Ellen. “The effect of titrated fentanyl on cough response in healthy participants.” 2014. Web. 28 Feb 2021.
Vancouver:
Kelly HE. The effect of titrated fentanyl on cough response in healthy participants. [Internet] [Masters thesis]. University of Canterbury; 2014. [cited 2021 Feb 28].
Available from: http://dx.doi.org/10.26021/8890.
Council of Science Editors:
Kelly HE. The effect of titrated fentanyl on cough response in healthy participants. [Masters Thesis]. University of Canterbury; 2014. Available from: http://dx.doi.org/10.26021/8890
Macquarie University
30.
Junqueira Santiago, Marina.
Regulation of the μ-opioid receptor signalling in naturally occurring variants and phosphorylation site mutants.
Degree: 2015, Macquarie University
URL: http://hdl.handle.net/1959.14/1068731
► Empirical thesis.
Bibliography: pages 263-303.
1. General introduction and outline – 2. Introduction – 3. Experimental methodology – 4. Desensitisation and kinase modulators – 5.…
(more)
▼ Empirical thesis.
Bibliography: pages 263-303.
1. General introduction and outline – 2. Introduction – 3. Experimental methodology – 4. Desensitisation and kinase modulators – 5. Regulation of N-terminal SNPs of hMOPr – 6. Regulation of TM1 and ICL2 SNPs of hMOPr – 7. The ICL3 : hMOPr SNPs and phosphosite mutants – 8. Regulation of C-terminal phosphosite mutant of hMOPr – 9. Summary and prospects.
Opioid drugs are highly effective for the treatment of moderate to severe nociceptive pain. They exert their analgesic and rewarding effects primarily by signalling through the μ-opioid receptor (MOPr). The focus of this project was to better understand MOPr signalling regulation by investigating natural variants of MOPr and MOPr phosphosite mutants.
Isogenic, stably transfected mouse pituitary adenoma (AtT20) cell lines expressing eight naturally occurring human MOPr variants and four phosphomutants were created. Opioid-stimulated changes in membrane potential were measured using a membrane potential-sensitive dye, while receptor phosphorylation of Ser 377 residue was determined by Western Blot and whole-cell ELISA was used to obtain the receptor surface loss dynamics.
The N-terminal MOPr variants, A6V and N40D, are the most common single-nucleotide polymorphisms found worldwide. Their signalling regulation was quite similar to the wild-type MOPr in each assay, where buprenorphine was the opiod with the most variance observed. In AtT20-hMOPr-L85I cells morphine mediated internalisation was not as substantial as previously reported, while the second intracellular loop (ICL2) polymorphism R181C dramatically impacted receptor ability to signal by affecting opioid affinity and probably G protein binding. The majority of the third intracellular loop (ICL3) variants had detrimental effect in receptor signalling and regulation which indicates the important role this region plays in G protein activation. In addition the multiple phosphorylation mutants also affected membrane expression which was related to endoplasmic reticulum sequestration and possible changes in receptor stability. Finally, deleting all the putative phosphorylation sites in the human MOPr C-terminal domain did not greatly influence homologous desensitisation of the membrane potential signal, yet completely abolished internalisation as expected. In contrast heterologous desensitisation was deeply compromised in some mutants of the ICL3 while total phosphorylation deletion of the C-terminal was the only variant to increase desensitisation of somatostatin signalling. Interestingly buprenorphine induced signalling had a quite different profile across the variants, and morphine and methodone signalling were more affected by the ICL3 changes when compared to opioid peptides and buprenorphine.
Overall, these results support the hypothesis of multiple mechanisms involved in regulation of MOPr, where ICL2 and ICL3 are crucial for G protein signalling, and receptor phosphorylation is not necessary for receptor desensitisation. In addition,…
Advisors/Committee Members: Macquarie University. Department of Biomedical Sciences.
Subjects/Keywords: Opioids – Receptors; opioid; polymorphism; desensitization
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APA (6th Edition):
Junqueira Santiago, M. (2015). Regulation of the μ-opioid receptor signalling in naturally occurring variants and phosphorylation site mutants. (Doctoral Dissertation). Macquarie University. Retrieved from http://hdl.handle.net/1959.14/1068731
Chicago Manual of Style (16th Edition):
Junqueira Santiago, Marina. “Regulation of the μ-opioid receptor signalling in naturally occurring variants and phosphorylation site mutants.” 2015. Doctoral Dissertation, Macquarie University. Accessed February 28, 2021.
http://hdl.handle.net/1959.14/1068731.
MLA Handbook (7th Edition):
Junqueira Santiago, Marina. “Regulation of the μ-opioid receptor signalling in naturally occurring variants and phosphorylation site mutants.” 2015. Web. 28 Feb 2021.
Vancouver:
Junqueira Santiago M. Regulation of the μ-opioid receptor signalling in naturally occurring variants and phosphorylation site mutants. [Internet] [Doctoral dissertation]. Macquarie University; 2015. [cited 2021 Feb 28].
Available from: http://hdl.handle.net/1959.14/1068731.
Council of Science Editors:
Junqueira Santiago M. Regulation of the μ-opioid receptor signalling in naturally occurring variants and phosphorylation site mutants. [Doctoral Dissertation]. Macquarie University; 2015. Available from: http://hdl.handle.net/1959.14/1068731
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Open Access Theses and Dissertations
