A G6P2032 female, prior cesarean x3 with history of opioid addiction maintained on buprenorphine presented for scheduled repeat cesarean section. Pre-operatively, her maintenance dose of medication was held secondary ...A G6P2032 female, prior cesarean x3 with history of opioid addiction maintained on buprenorphine presented for scheduled repeat cesarean section. Pre-operatively, her maintenance dose of medication was held secondary to concerns for partial agonist effect. Post-operative pain control was suboptimal with the patient ultimately proceeding to withdrawal. Doses of hydromorphone were titrated to 10 mg every 3 hours to avoid further withdrawal. Review of expert opinion after discharge recommended against holding buprenorphine therapy in the post-operative period. Pain management options include maintenance therapy with additional doses of opioid and non-opioid pain relieving medications.展开更多
Oral methadone or sublingual buprenorphine are first-line medications for pharmacotherapy of opioid use disorders(OUDs).Three long-acting buprenorphine depot or implant formulations are currently available for the tre...Oral methadone or sublingual buprenorphine are first-line medications for pharmacotherapy of opioid use disorders(OUDs).Three long-acting buprenorphine depot or implant formulations are currently available for the treatment of OUDs:(1)CAM 2038(Buvidal)for subcutaneous weekly and monthly application;(2)RBP-6000(Sublocade^(TM))as a monthly depot formulation;and(3)A six-month buprenorphine implant[Probuphine^(TM)].The pharmacology,clinical efficacy and prospects of these medications are discussed.展开更多
Background:Extended-release buprenorphine(XR)is indicated for pain management in rodents,but little is known about its use in mice.This study aimed to investigate whether high dose XR effectively attenuates post-opera...Background:Extended-release buprenorphine(XR)is indicated for pain management in rodents,but little is known about its use in mice.This study aimed to investigate whether high dose XR effectively attenuates post-operative hypersensitivity better than low dose XR in a mouse model of incisional pain.Methods:Mice(n 44)were randomly assigned to 1 of 4 treatment groups:(a)saline(1 ml/kg SC,once);(b)sustained release buprenorphine(Bup-SR,1 mg/kg SC,once);(c)low dose extended-release buprenorphine(XR-lo,3.25 mg/kg SC,once);(d)high dose extended-release buprenorphine(XR-hi,6.5 mg/kg SC,once).On days1,0(4 hours),1,2,and 3,mechanical and thermal hypersensitivities were evaluated,and plasma buprenorphine concentrations were measured.Results:Mechanical(days 0-2)and thermal(days 0-1)hypersensitivities were ob-served in the saline group.Bup-SR,XR-lo,and XR-hi attenuated mechanical hyper-sensitivity on days 0,1,and 2.None of the treatment groups,except XR-Lo on day 0,attenuated thermal hypersensitivity on days 0 or 1.Plasma buprenorphine concen-tration peaked at 4 hours(day 0)in all treatment groups and remained greater than 1 ng/mL on days 0-2.No abnormal clinical observations or gross pathologic findings were seen in any groups.Conclusion:The results indicate XR-hi did not effectively attenuate post-operative hypersensitivity better than XR-lo.Thus both 3.25 and 6.5 mg/kg XR are recom-mended for attenuating post-operative hypersensitivity for at least up to 48 hours in mice.展开更多
A sensitive, simple and rapid high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method was developed and fully validated for the simultaneous quantification of buprenorphine (BUP) and it...A sensitive, simple and rapid high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method was developed and fully validated for the simultaneous quantification of buprenorphine (BUP) and its N-dealkylated metabolite norbuprenorphine (NBUP) in 200 μL human plasma. Human plasma samples were prepared using liquid-liquid extraction, and then separated on a Shiseido MG C18 (5 μm, 2.0 mm × 50 mm) via 4.1 min gradient elution. Following electrospray ionization, the analytes were quantified on a triple-quadrupole mass spectrometer in multiple-reaction-monitoring (MRM) positive ion mode. Linearity was achieved from 25.0 to 10000 pg/mL for buprenorphine, from 20.0 to 8000 pg/mL for norbupre- norphine with r2〉0.99. The method was demonstrated with acceptable accuracy, precision and specificity for the detection of buprenorphine and norbuprenorphine. Recovery was 81.8-88.8 % for buprenorphine and 77.0-84.6% for norbuprenorphine, and the matrix effect was 95.6-97.4% for buprenorphine and 94.0-96.9% for norbuprenorphine; all were not concentration dependent. With validated matrix and autosampler stability data, this method was successfully applied in a bioequivalence study to support abbreviated new drug application.展开更多
Objective:To study the effect of buprenorphine transdermal patch combined with patient-controlled intravenous analgesia on the serum pain-related biochemical indexes in elderly patients with intertrochanteric fracture...Objective:To study the effect of buprenorphine transdermal patch combined with patient-controlled intravenous analgesia on the serum pain-related biochemical indexes in elderly patients with intertrochanteric fracture.Methods: A total of 92 elderly patients with intertrochanteric fracture who received surgical treatment in the hospital between August 2014 and January 2017 were collected and divided into control group (n=46) and observation group (n=46) according to the random number table method. The control group received patient-controlled intravenous analgesia, and the observation group received buprenorphine transdermal patch combined with patient-controlled intravenous analgesia. Differences in serum levels of inflammatory factors, oxidative stress indexes and pain mediators of two groups of patients were measured before and 24h after surgery.Results: Differences in serum levels of inflammatory factors, oxidative stress indexes and pain mediators were not statistically significant between the two groups before surgery;24 h after surgery, serum IL-1β, IL-6, IL-8, TNF-α, MDA, SP, PGE2, 5-HT, HA and NPY levels of both groups of patients increased significantly while SOD, TAC and CAT levels decreased significantly, and serum IL-1β, IL-6, IL-8, TNF-α, MDA, SP, PGE2, 5-HT, HA and NPY levels of observation group were lower than those of control group while SOD, TAC and CAT levels were higher than those of control group.Conclusion: Buprenorphine transdermal patch combined with patient-controlled intravenous analgesia can effectively inhibit the expression of pain-related indexes and relieve early postoperative pain intensity in elderly patients with intertrochanteric fracture.展开更多
文摘A G6P2032 female, prior cesarean x3 with history of opioid addiction maintained on buprenorphine presented for scheduled repeat cesarean section. Pre-operatively, her maintenance dose of medication was held secondary to concerns for partial agonist effect. Post-operative pain control was suboptimal with the patient ultimately proceeding to withdrawal. Doses of hydromorphone were titrated to 10 mg every 3 hours to avoid further withdrawal. Review of expert opinion after discharge recommended against holding buprenorphine therapy in the post-operative period. Pain management options include maintenance therapy with additional doses of opioid and non-opioid pain relieving medications.
文摘Oral methadone or sublingual buprenorphine are first-line medications for pharmacotherapy of opioid use disorders(OUDs).Three long-acting buprenorphine depot or implant formulations are currently available for the treatment of OUDs:(1)CAM 2038(Buvidal)for subcutaneous weekly and monthly application;(2)RBP-6000(Sublocade^(TM))as a monthly depot formulation;and(3)A six-month buprenorphine implant[Probuphine^(TM)].The pharmacology,clinical efficacy and prospects of these medications are discussed.
文摘星基广播式自动相关监视(ADS-B,automatic dependent surveillance-broadcast)系统是一种新型的航空器监视技术,在未来空中交通管理系统中具有广阔的应用前景。为了深入研究星基ADS-B系统中航空器到卫星的空天链路通信性能,将专业软件Matlab和STK(system tool kit)有效联合,构建符合国际标准的星基ADS-B空天链路完整模型;通过离散事件动态交互模拟ADS-B消息的发送与接收全过程,最后统计得出体现星基ADS-B空天链路通信性能的消息识别概率(POI,possibility of identify)、消息检测概率(POD,possibility of detective)、信号接收功率、信号冲突概率、卫星覆盖范围等指标。仿真结果表明,随着区域内航空器数量上升,POI、POD下降,消息冲突概率上升。
文摘Background:Extended-release buprenorphine(XR)is indicated for pain management in rodents,but little is known about its use in mice.This study aimed to investigate whether high dose XR effectively attenuates post-operative hypersensitivity better than low dose XR in a mouse model of incisional pain.Methods:Mice(n 44)were randomly assigned to 1 of 4 treatment groups:(a)saline(1 ml/kg SC,once);(b)sustained release buprenorphine(Bup-SR,1 mg/kg SC,once);(c)low dose extended-release buprenorphine(XR-lo,3.25 mg/kg SC,once);(d)high dose extended-release buprenorphine(XR-hi,6.5 mg/kg SC,once).On days1,0(4 hours),1,2,and 3,mechanical and thermal hypersensitivities were evaluated,and plasma buprenorphine concentrations were measured.Results:Mechanical(days 0-2)and thermal(days 0-1)hypersensitivities were ob-served in the saline group.Bup-SR,XR-lo,and XR-hi attenuated mechanical hyper-sensitivity on days 0,1,and 2.None of the treatment groups,except XR-Lo on day 0,attenuated thermal hypersensitivity on days 0 or 1.Plasma buprenorphine concen-tration peaked at 4 hours(day 0)in all treatment groups and remained greater than 1 ng/mL on days 0-2.No abnormal clinical observations or gross pathologic findings were seen in any groups.Conclusion:The results indicate XR-hi did not effectively attenuate post-operative hypersensitivity better than XR-lo.Thus both 3.25 and 6.5 mg/kg XR are recom-mended for attenuating post-operative hypersensitivity for at least up to 48 hours in mice.
文摘A sensitive, simple and rapid high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method was developed and fully validated for the simultaneous quantification of buprenorphine (BUP) and its N-dealkylated metabolite norbuprenorphine (NBUP) in 200 μL human plasma. Human plasma samples were prepared using liquid-liquid extraction, and then separated on a Shiseido MG C18 (5 μm, 2.0 mm × 50 mm) via 4.1 min gradient elution. Following electrospray ionization, the analytes were quantified on a triple-quadrupole mass spectrometer in multiple-reaction-monitoring (MRM) positive ion mode. Linearity was achieved from 25.0 to 10000 pg/mL for buprenorphine, from 20.0 to 8000 pg/mL for norbupre- norphine with r2〉0.99. The method was demonstrated with acceptable accuracy, precision and specificity for the detection of buprenorphine and norbuprenorphine. Recovery was 81.8-88.8 % for buprenorphine and 77.0-84.6% for norbuprenorphine, and the matrix effect was 95.6-97.4% for buprenorphine and 94.0-96.9% for norbuprenorphine; all were not concentration dependent. With validated matrix and autosampler stability data, this method was successfully applied in a bioequivalence study to support abbreviated new drug application.
文摘Objective:To study the effect of buprenorphine transdermal patch combined with patient-controlled intravenous analgesia on the serum pain-related biochemical indexes in elderly patients with intertrochanteric fracture.Methods: A total of 92 elderly patients with intertrochanteric fracture who received surgical treatment in the hospital between August 2014 and January 2017 were collected and divided into control group (n=46) and observation group (n=46) according to the random number table method. The control group received patient-controlled intravenous analgesia, and the observation group received buprenorphine transdermal patch combined with patient-controlled intravenous analgesia. Differences in serum levels of inflammatory factors, oxidative stress indexes and pain mediators of two groups of patients were measured before and 24h after surgery.Results: Differences in serum levels of inflammatory factors, oxidative stress indexes and pain mediators were not statistically significant between the two groups before surgery;24 h after surgery, serum IL-1β, IL-6, IL-8, TNF-α, MDA, SP, PGE2, 5-HT, HA and NPY levels of both groups of patients increased significantly while SOD, TAC and CAT levels decreased significantly, and serum IL-1β, IL-6, IL-8, TNF-α, MDA, SP, PGE2, 5-HT, HA and NPY levels of observation group were lower than those of control group while SOD, TAC and CAT levels were higher than those of control group.Conclusion: Buprenorphine transdermal patch combined with patient-controlled intravenous analgesia can effectively inhibit the expression of pain-related indexes and relieve early postoperative pain intensity in elderly patients with intertrochanteric fracture.