Optimal Timing of Endoscopic Intervention After Extracorporeal Shock-Wave Lithotripsy in the Treatment of Chronic Pancreatitis with Pancreatic Stones.

This study aims to determine the optimal timing of endoscopic intervention after extracorporeal shock wave lithotripsy(ESWL) of chronic pancreatitis with pancreatic stones.

Start Date01 Nov 2024

Sponsor / Collaborator

Changhai Hospital of Shanghai

NCT05905367 / RecruitingPhase 4IIT

Rapid IV Symptom-inhibited Fentanyl Induction (SIFI) to Facilitate Rotation Onto Oral Opioid Agonist Therapy (OAT)

The goal of this clinical trial is to test a treatment strategy for individuals with opioid use disorder (OUD) who use fentanyl. Participants will receive medically-administered doses of intravenous (IV) fentanyl at intervals until they are comfortable and do not have withdrawal symptoms. They then will be given opioid agonist therapy (OAT) once daily by mouth, which is the current standard treatment for OUD. In this trial, each participant's starting dose of OAT will be tailored to meet their opioid needs, based on the amount of IV fentanyl they received.
The main questions this trial aims to answer are:
* Is the IV fentanyl protocol feasible and safe for use in a community clinic setting?
* Will the protocol result in higher-than-standard starting doses of OAT? Are these doses safe, and will they enable participants to stay on OAT for a longer time?

Start Date29 Jan 2024

Sponsor / Collaborator

University of British Columbia

IRCT20210415050976N13 / RecruitingPhase 1/2IIT

comparison of post-operative pain during 2 weeks after rotator cuff repair surgery between patients received interscalene block alone and patients received interscalene block and intravenous morphin

Start Date08 Jan 2024

Sponsor / Collaborator

Jahrom University

100 Clinical Results associated with Morphine Hydrochloride Hydrate

100 Translational Medicine associated with Morphine Hydrochloride Hydrate

100 Patents (Medical) associated with Morphine Hydrochloride Hydrate

398

Literatures (Medical) associated with Morphine Hydrochloride Hydrate

01 Aug 2024·The Journal of arthroplasty

Efficacy of Oral Nefopam on Multimodal Analgesia in Total Knee Arthroplasty: A Prospective, Double-Blind, Placebo-Controlled, Randomized Trial

Article

Author: Ye, Shuwei ; Kang, Pengde ; Wang, Qiuru ; Hu, Jian ; Yang, Jing

BACKGROUND:

Multimodal analgesia is central to pain management after total knee arthroplasty (TKA). This study aimed to evaluate the efficacy of adding oral nefopam to multimodal analgesia for post-TKA pain management.

METHODS:

In this prospective, double-blind, placebo-controlled, randomized trial, 100 patients who underwent TKA at our hospital were randomized to either the nefopam or the control group. After surgery, patients in the nefopam group received 200 mg of celecoxib, 150 mg of pregabalin, and 40 mg of nefopam twice daily to control postoperative pain. Patients in the control group received 200 mg of celecoxib, 150 mg of pregabalin, and a placebo. Oxycodone hydrochloride (10 mg) was used as the rescue analgesic. If the pain remained poorly controlled, 10 mg of morphine hydrochloride was injected subcutaneously as a secondary rescue analgesic. The primary outcome was the postoperative consumption of oxycodone and morphine as rescue analgesics. Secondary outcomes were postoperative pain assessed using the visual analogue scale (VAS), functional recovery assessed by the range of knee motion and ambulation distance, time until hospital discharge, indicators of liver function, and complication rates.

RESULTS:

Patients in the nefopam group had significantly lower postoperative oxycodone and morphine consumption within 24 hours after surgery and during hospitalization, lower VAS pain scores at rest and during motion within 24 h after surgery, better functional recovery on postoperative days 1 and 2, and a shorter hospital stay. However, the absolute reduction in 0 to 24 h opioid consumption, VAS pain scores, and knee range of motion did not exceed the reported minimal clinically important difference. Both groups had similar indicators of liver function and complication rates.

CONCLUSIONS:

Adding oral nefopam to multimodal analgesia resulted in statistically significant improvements in opioid consumption, VAS pain scores, and functional recovery. However, the amount of improvement may not be clinically important.

01 Jun 2024·Heliyon

20- Deoxyingenol attenuate morphine-induced hippocampus neurotoxicity and memory impairments in rats

Article

Author: Zou, Linfang ; Ma, Jianfeng ; Qi, Dansi ; Zhou, Jiansong ; Ju, Nanbin ; Pan, Jun ; Zhang, Xutong ; Lou, Yani ; Lin, Yuanqu

Objective:

The present study aimed to see if 20-Deoxyingenol(20-DOI) could protect hippocampus neurons from the neurotoxic effects of morphine and reduce memory loss in rats.

Method:

Male Wistar rats were given morphine hydrochloride (45 mg/kg, sc, four weeks) and 20-DOI (10, 20 mg/kg, ip., coadministered with morphine) for the Morris Water Maze (MWM) test to investigate the effects of 20-DOI on spatial learning and memory. Western blotting was used to evaluate the expression of the hippocampal CA1 region of the cleaved caspase-3, Bax, and Bcl2 proteins and so on. Moreover, these assays were used to evaluate the expression of superoxide dismutase (SOD)2, heme oxygenase 1(HO1) protein, and glutathione peroxidase (GPx) activity within the hippocampus CA1 area.

Results:

The administration of 20-DOI (10 and 20 mg/kg) to morphine-treated mice enhanced spatial learning and reduced memory deficits. Additionally, 20-DOI treatment reduced apoptosis and oxidative stress in the hippocampal CA1 region of morphine-treated rats. Moreover, 20-DOI improved the autophagy level of the hippocampal CA1 area of morphine-treated rats using Transcription factor EB (TFEB), and 20-DOI prevented spatial learning and memory impairment in morphine-treated rats. The current observation could be partially due to the inhibition of neuronal apoptosis and oxidative stress in the hippocampal CA1 region of rats treated with morphine and the improved autophagy in this region.

Conclusions:

20-DOI attenuated morphine administration in rats with chronic disease caused spatial learning and memory dysfunction. These mechanistic effects could be partially related to 20-DOI protecting the CA1 region of rat hippocampal neurons from the morphine-induced oxidative stress, apoptosis, and autophagy through TFEB.

01 May 2024·Journal of Orthopaedic Surgery

Efficacy of adding infiltration between the popliteal artery and the capsule of the posterior knee (IPACK) to adductor canal block and local infiltration analgesia in total knee arthroplasty: A retrospective cohort study

Article

Author: Zhao, Dongmei ; Li, Pengcheng

Objective:

Local infiltration analgesia (LIA), adductor canal block (ACB), and infiltration between the popliteal artery and the capsule of the posterior knee (IPACK) are popular multimodal analgesia techniques used during total knee arthroplasty (TKA). This study aimed to explore the efficacy of adding the IPACK technique to ACB and LIA in patients undergoing TKA.

Methods:

In this retrospective cohort study, patients who underwent primary unilateral TKA were divided into two groups based on their date of admission. Sixty-three patients underwent IPACK, ACB and LIA (IPACK group) during surgery, while 60 patients underwent ACB and LIA (control group). The primary outcome was the postoperative administration of morphine hydrochloride as a rescue analgesic. Secondary outcomes included time to first rescue analgesia, postoperative pain assessed using the visual analog scale (VAS), functional recovery assessed by knee range of motion and ambulation distance, time until hospital discharge, and complication rates.

Results:

The two groups were similar in average postoperative 0-to-24-h morphine consumption (11.8 mg for the control group vs 12.7 mg for the IPACK group, p = .428) and average total morphine consumption (18.2 mg vs 18.0 mg, p = .983) during hospitalization. There were also no significant differences in the secondary outcomes.

Conclusions:

The addition of IPACK to ACB and LIA did not provide any clinical analgesic benefits. Orthopedic surgeons and anesthesiologists are justified in using ACB and LIA without IPACK for TKA.

News (Medical) associated with Morphine Hydrochloride Hydrate

03 Jan 2023

·www.biospace.com

Wex Pharmaceuticals Inc. Enrolls the First Patient in The Phase 2b Clinical Trial Evaluating the Efficacy and Safety of Halneuron(R) In the Treatment of Chemotherapy-Induced Neuropathic Pain

VANCOUVER, BC / ACCESSWIRE / January 3, 2023 / WEX Pharmaceuticals Inc. ("WEX" or the "Company"), a biotechnology company developing Halneuron® (Tetrodotoxin or TTX) for pain, announced that the first patient has been dosed in its Phase 2B clinical trial evaluating the efficacy and safety of Tetrodotoxin in the treatment of Chemotherapy-Induced Neuropathic Pain (the "Clinical Trial"). The Clinical Trial is a randomized, double-blind, placebo-controlled, multinational, multicenter study evaluating the efficacy and safety of Halneuron® in 222 patients with moderate-to-severe Chemotherapy-Induced Neuropathic Pain ("CINP"). Patients will be randomized to receive either Halneuron or a placebo in addition to any concomitant medication they are taking for their CINP. The primary objective will be to determine the duration of pain relief experienced with Halneuron as measured by a Numeric Pain Response Scale (NPRS). Secondary objectives include determining the efficacy of TTX compared to placebo in the improvement of quality of life for subjects and determining the safety of TTX compared to placebo in subjects with CINP. WEX recently announced it had received authorizations from the regulatory authorities of China, Singapore, Taiwan, Korea, USA, and Canada to conduct the Clinical Trial in these countries. Mr. Walter Korz, Chief Operating Officer of WEX stated, "We continually receive feedback from key pain opinion leaders and physicians that new non-opioid pain therapies are needed and dosing the first patient in the Clinical Trial is a vital step towards the evaluation of TTX for the treatment of CINP. We look forward to the Clinical Trial's continued advancement." This is the first time Halneuron® will be evaluated in an Asian patient population outside China, and WEX expects the Clinical Trial will provide additional information towards the conduct of the Phase 3 CINP clinical trial being planned. About Halneuron® Halneuron® (TTX, Tetrodotoxin), a selective sodium channel blocker, produces analgesia either by decreasing the propagation of action potentials by sodium channels and/or by blocking ectopic discharges associated with chronic pain. Halneuron® is an injectable formulation of Tetrodotoxin, a novel small molecule with action exclusively on the peripheral nervous system. Halneuron does not cross the blood-brain barrier and therefore is without the common side effects of euphoria, addiction, tolerance, sedation, and confusion experienced by opioids and other analgesics. Pharmacology studies revealed that TTX is a more potent analgesic than standard analgesic agents such as aspirin, morphine, or meperidine, with potential applications in many moderate to severe neuropathic pain conditions. About WEX Pharmaceuticals Inc. WEX Pharmaceuticals Inc. is a late-stage drug development company dedicated to the development, manufacture, and commercialization of innovative drug products to treat pain. WEX is a leader in research in the field of sodium channel blockers and has programs in various stages of development based on the Halneuron® platform. WEX has conducted late-stage multinational clinical trials in cancer pain and chemotherapy-induced neuropathic pain. WEX is a wholly owned subsidiary of CK Life Sciences Int'l., (Holdings) Inc. ("CKLS"). CKLS is engaged in the business of research and development, manufacturing, commercialization, marketing, sale of, and investment in products and assets which fall into three core categories - nutraceuticals, pharmaceuticals and agriculture-related. CKLS is a member of the CK Hutchison Group. For additional information, please visit . This news release contains forward-looking statements within the meaning of the U.S. Private Securities Litigation Reform Act of 1995 and applicable Canadian securities laws, including statements regarding the objectives and potential results of the Clinical Trial, the planned Phase 3 CINP clinical trial and the safety and therapeutic utility of Halneuron® as a peripheral-acting, non-opioid analgesic. Statements in this document regarding future expectations, beliefs, goals, plans, or prospects constitute forward-looking statements that involve risks and uncertainties, which may cause actual results to differ materially from the statements made. For this purpose, any statements that are contained herein that are not statements of historical fact may be deemed to be forward-looking statements. Without limiting the foregoing, the words "believes", "anticipates", "plans", "intends", "will", "should", "expects", "projects", "reduces," "affirms", "acceptable", "accepts", "establishes", "continued advancement", and similar expressions are intended to identify forward-looking statements. You are cautioned that such statements are subject to a multitude of risks and uncertainties that could cause actual results, future circumstances, or events to differ materially from those projected in the forward-looking statements. These risks include, but are not limited to: those associated with the success of research and development programs, the Company's ability to raise additional funding and the potential dilutive effects thereof, the regulatory approval process, competition, securing and maintaining corporate alliances, market acceptance of the Company's products, the availability of government and insurance reimbursements for the Company's products, the strength of intellectual property, reliance on subcontractors and key personnel and other risks detailed from time-to-time in the Company's public disclosure documents and other filings with the U.S. Securities and Exchange Commission and Canadian securities regulatory authorities. Forward-looking statements are developed based on assumptions about such risks, uncertainties and other factors, including, but not limited to: obtaining positive results of clinical trials, obtaining regulatory approvals, TTX is a more potent analgesic than standard analgesics, safety of product, effectiveness of drug, general business and economic conditions, the Company's ability to successfully develop and commercialize new products, the assumption that the Company's current good relationships with third parties will be maintained, the availability of financing on reasonable terms, the Company's ability to attract and retain skilled staff, market competition, the products and technology offered by the Company's competitors, no known competing drugs specifically for CINP, and the Company's ability to protect patents and proprietary rights. Forward-looking statements are made as of the date hereof, and the Company disclaims any intention and has no obligation or responsibility, except as required by law, to update or revise any forward-looking statements, whether as a result of new information, future events, or otherwise. For further information contact: WEX Pharmaceuticals Inc. Mr. Walter Korz Chief Operating Officer Phone: (604) 683-8880 Fax: (604) 683-8868 E-mail: wex@wexpharma.com Internet: SOURCE: WEX Pharmaceuticals Inc. View source version on accesswire.com:

Phase 2Phase 3

22 Dec 2022

·www.sciencedaily.com

Treating gut pain via a Nobel prize-winning receptor

Targeting a receptor responsible for our sense of touch and temperature, which researchers have now found to be present in our colon, could provide a new avenue for treating chronic pain associated with gastrointestinal disorders such as irritable bowel syndrome. A team examining the colon identified the presence of Piezo2, the subject of the 2021 Nobel Prize in Physiology or Medicine, now known to be responsible for sensing light touch on our skin. Targeting a receptor responsible for our sense of touch and temperature, which researchers have now found to be present in our colon, could provide a new avenue for treating chronic pain associated with gastrointestinal disorders such as irritable bowel syndrome. A team examining the colon, led by Professor Hongzhen Hu at Washington University and Professor Nick Spencer at Flinders University, identified the presence of Piezo2, the subject of the 2021 Nobel Prize in Physiology or Medicine, now known to be responsible for sensing light touch on our skin. "In discovering that this receptor is also in our gut, there's the potential that selectively targeting these channels could be used for long-term silencing of pain sensations from internal organs, without the need for frequent consumption of opiate pain medications," says Professor Spencer, a Matthew Flinders Professor in the College of Medicine and Public Health. Professor Nick Spencer said, "Chronic pain from internal organs, such as the gut or bladder, is notoriously difficult to treat. Opiates, including morphine and their derivates have been commonly used to treat a variety of types of pain but visceral pain doesn't respond well to the treatment and the drugs are highly addictive with a multitude of side effects." The authors say the availability of selective pain medications for the gut has been hindered by a lack of understanding about how sensory nerves communicate pain sensations from the gut to the brain. "It was previously known that many different ion channels are located on the 'pain-sensing' neurons that communicate from the gut to the brain, but our study, published in the journal Neuron, has now identified the major ion channel in the colon that responds to mechanical stimulation leading to the sensation of pain," says Professor Spencer. "Furthermore, we have discovered that the major ion channel that responds to this mechanical pain is a member of the Piezo ion channel, specifically Piezo2. "From this knowledge we can focus on targeting these channels to silence the pain sensations and hopefully produce a treatment for visceral pain, common in conditions such as irritable bowel syndrome, endometriosis or abdominal cancers, while avoiding the devastating side effects of opioids." The research was funded by grants from the US National Institutes of Health and the National Health and Medical Research Foundation.

21 Dec 2022

·medcitynews.com

ISO: What You Need To Know About The Deadly New Drug

One of the most dangerous and deadly drugs to ever hit the market could be hiding in plain sight, and if we don’t take swift action, we could be facing another devasting wave of overdose deaths among unsuspecting users. It’s called ISO, short for isotonitazine, a deadly synthetic opioid that is 100X to 1000X stronger than morphine and 20X more potent than fentanyl. As of this writing, it’s been detected in at least 180 deceased individuals who likely died from ISO overdose in 18 states around the country. However, it’s widely assumed this number is grossly underestimated because most standard toxicology screenings don’t yet include ISO detection. There could be countless more deaths miscategorized as non-opioid related, simply because the coroner didn’t know or have the means to test for ISO. ISO: The facts What makes ISO so dangerous, aside from its extreme potency? ISO can be present in powder, tablet or solution form and can be snorted, injected and inhaled by smoking or vaporizing. Like fentanyl, ISO is often mixed into other drugs like heroin or even counterfeit Xanax pills, so users have absolutely no idea they’re ingesting it. That means a casual or experimental user might show up at a party, take a Xanax that’s offered to them just to relax and have a good time, and end up in the ER fighting for their life. Because no one is aware the ISO was present, bystanders may be ill-equipped to respond. Narcan can counteract the effects of ISO, but because ISO is still so new, there is no currently established protocol for dosing. Even first responders may not know exactly how to treat ISO overdose, or worse, may not be able to respond quickly enough or have enough Narcan on hand to reverse ISO’s immediate and deadly effects. A deadly concoction For those unfamiliar with the drug trade, you might be wondering why illicit drug manufacturers would lace their product with something so deadly? Wouldn’t they want to keep their customers alive? The answer is poor or careless compounding. ISO belongs to a family of synthetic opioids investigated as potential analgesics in the 1950s, but ISO was determined to have no clinical value. Authorities believe this most recent formulation was produced by a Chinese vendor in anticipation of a fentanyl production ban. So, while ISO itself is created by highly skilled chemists, those who are mixing it into the end product aren’t likely as sophisticated. The goal of blending ISO (or fentanyl, for that matter) is to increase the effect of the primary drug and to deliver a better high or to enhance its addictive properties to keep users coming back for more. But because dealers are more concerned with profits than quality, their products get cut and blended with other substances. And because it takes such a miniscule amount of ISO to have devastating effects, imperfect blending can lead to deadly results. This is compounded by the fact that the user may have never ingested ISO before, so they have zero tolerance, making an overdose even more likely. Tighter controls led to unintended consequences But how do drugs like ISO even become desirable? Simply put, through the law of supply and demand. Few would argue that clamping down on opioid prescriptions was a necessary step toward reducing the plague of opioid addiction. But tighter opioid controls have actually had devastating unintended consequences, as opioid-addicted individuals turned to other drugs. This shift paved the way for more dangerous drugs like heroin, fentanyl and ISO to fill the void, driving an unprecedented overdose death rate that, tragically, shows no signs of slowing down. The path forward It is impossible to avoid what can’t be seen. There is no identifiable way to determine whether or not a drug has been adulterated with ISO, or any other substance for that matter. As a result, counterfeit Adderall, Xanax, oxycodone and others are becoming less and less likely to be the particular substance that is advertised. Taking a pill of any kind that was given and not prescribed is a lethal gamble. Unfortunately, these stories are becoming more and more commonplace. The best way to reduce the adverse effects of a substance many may not know about, let alone be able to detect, would be to stay away from it completely. In our haste to save lives, we may have oversimplified the issue by trying to solve a very complex problem with a single-point solution: cutting off access to the drug. In hindsight—and in real-time—there’s much more that needs to be done to curb the epidemic of addiction in our country.

100 Deals associated with Morphine Hydrochloride Hydrate

External Link

KEGG	Wiki	ATC	Drug Bank
D02271	Morphine Hydrochloride Hydrate	N02AA01	DB00295

R&D Status

Approved

10 top approved records.

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Indication	Country/Location	Organization	Date
Anesthesia	JP	Sumitomo Pharma Co., Ltd.	01 Dec 1991
Cough	JP	Sumitomo Pharma Co., Ltd.	01 Dec 1991
Diarrhea	JP	Sumitomo Pharma Co., Ltd.	01 Dec 1991
Cancer Pain	JP	Sumitomo Pharma Co., Ltd.	01 Dec 1991

Developing

10 top R&D records.

to view more data

Indication	Highest Phase	Country/Location	Organization	Date
Chronic Pain	Phase 1	CN	Southwest Pharmaceutical Group Co. Ltd.	09 Aug 2022

Clinical Result

Indication

Phase

Evaluation

View All Results

Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT02990910 (CTgov)	Not Applicable	Analgesia	280	Individualized opioid analgesia (Individualized Opioid Analgesia)	nerjakczke(sfiphpkwdw) = tcsttmtmlf bqnhpjqfhu (gfzqzxqcvl, ntbkdulvra - rjnsdqxqmp) View more	-	09 Aug 2017
				conventional opioid analgesia (Conventional Opioid Analgesia)	nerjakczke(sfiphpkwdw) = tpqsljaxju bqnhpjqfhu (gfzqzxqcvl, hqehxcyavu - qfrxposyxk) View more
NCT02046772 (CTgov)	Phase 4	Hemorrhoids	63	Morphine Chloride+Bupivacaine low dose (Bupivacaine + Morphine Chloride)	grfylkfjyg(khqidtfxuf) = gihtebdvqp ojkmmzhvbg (fekfrwbdbc, eynmcuecaw - wzfuhuznys) View more	-	01 Sep 2014
				Bupivacaine standard dose (Bupivacaine Standard Dose)	grfylkfjyg(khqidtfxuf) = qwllbkmniy ojkmmzhvbg (fekfrwbdbc, kenjpokves - zhucjeuaod) View more
Pubmed \| Clinics (Sao Paulo)	Not Applicable	-	-	Intrathecal Morphine	xvmczcryas(xjltjicpdo) = roimnrcynk eemquszgan (tvzooslfiy )	Positive	01 Apr 2009
NCT00803114 (CTgov)	Phase 4	Pain	228	Preservative-free epidural morphine (Epidural Morphine)	qjquffdrbc(orfrwzgddf) = wqumxgahzy hqarlsuauf (mebaoejklk, nnbmyxkxpt - ubiobcfzsi) View more	-	05 Dec 2008
				Placebo (Placebo)	qjquffdrbc(orfrwzgddf) = eqonvhbhkn hqarlsuauf (mebaoejklk, dxhpxzxcys - oszijedvdb) View more
Pubmed \| Anesth Analg	Not Applicable	Pain, Postoperative	-	Epidural analgesia group	ofeugumnfj(ievdbikkqh) = sakrqsfpht asbymrvkqt (aiboabayfv ) View more	Positive	01 Apr 2006
				Intrathecal analgesia group	ofeugumnfj(ievdbikkqh) = curypaudqn asbymrvkqt (aiboabayfv ) View more

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