|
|
Co-use of opioid analgesics with alcohol and/or benzodiazepines in patients with chronic non-cancer pain
Nováková, Daniela ; Mravčík, Viktor (advisor) ; Koutská, Kateřina Olga (referee)
Background: The problem of the simultaneous use (co-use) of benzodiazepines (BZD) and/or alcohol in patients with a diagnosis of chronic non-cancer pain (CHNCP) using strong opioid analgesics (OA) is still poorly mapped in the Czech Republic. Aims: To map the prevalence of co-use of BZDs and alcohol among patients with CHNNB taking long-term prescription OA. To determine differences between co-using groups and not-co-using patients and to determine predictors of co-use. Design and setting: The research is based on a secondary analysis of data collected in the period from March 2019 to December 2019 in the form of an anonymous questionnaire survey among patients of nine pain treatment centers in the Czech Republic. For research purposes, clinical and sociodemographic data related to co-use obtained from a semi-structured (anamnestic) questionnaire and data from the standardized questionnaires Screener and Opioid Assessment for Patients with Pain (SOAPP-R), Opioid Risk Tool (ORT) and Emotional Thermometers (ET) were analyzed. Particpants: The sample consisted of 305 respondents older than 18 years with diagnosed chronic pain and treated with strong OA for at least three moths. Measurements: Descriptive analysis was performed using descriptive statistics methods. Mann- Whitney test, chi-square test,...
|
|
|
Molecular mechanisms of morphine action on the immune system
Zeťková, Anna ; Hejnová, Lucie (advisor) ; Vašek, Daniel (referee)
This paper focuses on the molecular effect of morphine, which is widely used for its analgesic and sedative properties. This makes it an important drug for the treatment of chronic and severe pain. In addition to its positive effects, the long-term administration of morphine in particular has its drawbacks, such as the rapid development of tolerance and dependence on it. Other negative effects include constipation, respiratory stagnation or vomiting. These effects are caused not only by the influence of morphine on nerve cells, but also on other cells of the body. This thesis is primarily concerned with the effect of morphine on microglia, which are not only involved in the immune response in the central nervous system, but also have an effect on pain perception or the development of tolerance. This is one of the main areas of research in the field of opioids, therefore, the aim of this thesis is to summarize the findings on the effect of morphine on microglia, which happens mainly through opioid receptors, toll-like receptors and purinoceptors.
|
|
|
Toxicology of opioid analgesics and their impact on traffic accidents in the Moravian-Silesian Region
DOBIÁŠOVÁ, Marcela
The bachelor thesis is devoted to the issue of the use of opioid analgesics, their effect on traffic accidents and accidents caused under the influence. Opioid analgesics, which belong to the group of narcotic and psychotropic substances, are still a topical topic, as a large number of traffic accidents are caused by drivers who are under their influence. The theoretical part is devoted mainly to history, classification of opioid analgesics, distribution of narcotic and psychotropic substances, list of drugs containing narcotic and psychotropic substances in the Czech Republic, occurrence of side effects, addictions, route of administration, detection of addictive substances in the body, but also drug policy strategy in Moravian-Silesian Region, the Czech Republic and the European Union. The practical part is focused on the comparison of traffic accidents caused under the influence of opioid analgesics in the years 2014-2018 in the Moravian-Silesian Region. In the practical part, I processed the results based on the statistics of the Police of the Czech Republic. After evaluating the results, it was found that in the period 2014-2018, the number of traffic accidents under the influence of opioid analgesics increased in the Moravian-Silesian Region, but there was a decrease in traffic accidents caused under the influence of alcohol. At the same time, there was a reduction in the number of people who were slightly injured, severely injured and killed. The result also showed that the most accidents that were caused in the period under the influence of addictive substances were in the South Moravian Region.
|
|
|
Rat gut microbiome composition and metabolic faecal markers upon morphine withdrawal
Mičke, Bianka ; Novotný, Jiří (advisor) ; Pácha, Jiří (referee)
The primary purpose of this pilot study was a long-term monitoring of the gut microbiome composition and fecal markers of metabolism in rats following the completion of 10-day intraperitoneal administration of increasing morphine doses (from 10 to 50 mg/kg/day) and in the corresponding control groups of rats that didn't administrate morphine. This study involved the introduction of new methods for microbiome and metabolome research, statistical evaluation of results and interpretation of data, or hypothesis to explain the effects of morphine on the gut microbiome and fecal metabolome composition compared to the resulting data of similarly oriented studies. The actual experiment was conducted on male Wistar rats aged 2 months and weighing approximately 300 g, which were maintained on a standard chow diet. The analysis and evaluation of the resulting data showed that there were changes in the composition of the gut microbiome and fecal metabolome in the experimental group compared to the control group during the reporting period but the induced changes were rather temporary. Further studies should be performed using a significantly larger experimental and control group as well as higher time series granularity. Keywords: morphine, opioids, withdrawal, gut microbiome, faecal metabolome
|
|
|
Potential role of opioids in neuroprotection
Gebauer, Martin ; Novotný, Jiří (advisor) ; Rudajev, Vladimír (referee)
The opioids have been used by mankind for more than two millennia, but effect and mechanism of their action on the cells has been unveiling in the last few decades. The mechanism itself is often still unknown, but its effect is observed only. There are several groups of opioid receptors which are able to bind opioids. These groups are characterized by their differe nt affinity to opioids, in some cases by their different effects on cells and by their representation in the various areas in the CNS. Thus, the effects induces by these opioid are very different in many cases. This thesis summarizes the current knowledge about coronary heart disease and the potential of opioids for the prevention and their effect during ischemia, also summarizes the effects of morphine on the CNS. During ischemia δ-opioid receptors play a major role, because they inhibit or block the proapoptotic effects of ischemia on many levels. These receptors are also involved in inducing and maintaining the animal hibernation and protect animal's body against very harmful effects of hibernation, e.g lack of oxygen and nutrients. Morphine is opioid which has been used as anesthetic for longest time. It is well-known opioid and it has the most known derivates. This thesis also summarizes most significant effects of morphine on...
|
|
|
Effect of morphine on the resistance of the heart to ischemia
Mošovská, Linda ; Neckář, Jan (advisor) ; Žurmanová, Jitka (referee)
2. Abstract Opioids are considered as dangerous and addictive substances, mainly due to synthetic opioids such as heroin. It was discovered, that these substances can play an important role in myocardial ischemia because they can limit the damage of the heart tissue that occurs during a heart attack. Since that heart attack is the most common cardiovascular disease, the protective effect is significant. Cardioprotective effect is mainly mediated through δ opioid receptors, but the few studies have shown cardioprotective effect mediated through κ opioid receptors. The protective effect occurs by activation of opioid receptors by their agonists (eg. morphine or TAN-67), either before ischemia (opioid preconditioning) or before reperfusion (opioid postconditioning). The signaling pathway of cardioprotection include mitochondrial KATP channel, Gi/o proteins, protein kinase C, tyrosine kinases and reactive oxygen species.
|
|
|
Opioid receptors and their signaling system in the myocardium
Ladislav, Marek ; Novotný, Jiří (advisor) ; Neckář, Jan (referee)
The main objective of this bachelor thesis is to systematically collect and sort information about opioid receptors and their signaling system in the myocardium. Heart activity is controlled mainly by adrenergic signaling, and this work therefore contains also some data concerning the characteristic and significance of other relevant receptors. For better understanding, general basic information about opioid system, especially about the receptors and their signaling, is also provided. Relatively little is known about opioid receptors in the myocardium even though these receptors may have an important role especially in various pathophysiological conditions. There can be several reasons for this. The possibility of further characterization of opioid receptors in the myocardium is rather difficult due to the relatively small number of these receptors in heart tissue. The situation is somewhat complicated also by some differences in the modulation of cardiac function among different species. The complete molecular mechanism by which opioid receptors act on the myocardium has not yet been fully uncovered. Especially in the case of humans this knowledge can be crucial, because these receptors and their ligands could be used for medical purposes.
|
|
|
Alternative methods in managing postoperative pain in living donor renal transplantant recipients
Nová, Michaela ; Hocková, Jana (advisor) ; Dynáková, Šárka (referee)
The main criteria for managing good postoperative care include the effective and appropriate choice of pain therapy. Experiencing pain is a purely individual feeling for each of us, so it is very important to have adequate and sufficient analgesia during this period. Modern management of post-operative pain therapy uses preparations of various pharmacological groups that potentiate and thereby more effectively reduce pain. By this mechanism, we can reduce the total dose of analgesics given, and more particularly, reduce the dose of opioids that have a higher risk of side effects. In this project i want to show how the analgesic catheter could be useful as alternative possibility in algorithm therapy of postoperative pain. Analgesic catheter enable continual local anesthetics administration, exactly 0,5% bupivacaine, which is operating in surgical wound. Main goal of the study is to find out and verify if analgesic catheter is method which provides continual analgesia strong enough to results in lower use of opioids. The research data will be determined by quantitative research using a questionnaire survey. Non standardized self-production questionnaire. will be given in a paper form to non-medical healthcare staff, who perform nursing activities The spectrum of patients is very specific; they are...
|
|
|
Socioeconomic status and criminal problems of problematic opioids and metamphetamine users
Zittová, Lucie ; Mravčík, Viktor (advisor) ; Nechanská, Blanka (referee)
of the thesis Introduction: This dissertation focuses on socioeconomic status and problems with law of problematic opioid and methamphetamine users. Long-term intensive use of drugs leads not only to health impacts, but also social such as the inability of financial autonomy, indebtedness, unemployment, failure to comply with the respective social roles, fiduciary social functioning, poor housing etc. Great number of users are influenced by the drug in situations such as interpersonal relationship, family functioning and partnerships, there is a change of social status, social isolation or exclusion. Effective interventions and service development should always start with a good knowledge of the situation and needs of the user, who claims the service. Claim: The goal of this thesis is finding socioeconomic status and criminal situation of problematic methamphetamine and opioids users consequently draw recommendations towards services that work with these clients. Methods: Cross-sectional questionnaire study was carried among clients who have started a treatment episode or contacted selected facility type such as a contact centre, psychiatric AT ambulance, therapeutic community, medium-term inpatient treatment or replacement therapy. Recruitment into the study took place from June 2015 until October...
|
|
|
Design of Pilot Clinical Trial of Treatment of Hepatitis C in Polyvalent Problem Drug Users with Pharmacological Substitution of Opioids and Methamphetamine (HCV-PPDUSOM)
Oktábec, Zbyněk ; Gabrhelík, Roman (advisor) ; Minařík, Jakub (referee)
Charles University in Prague First Faculty of Medicine Study programme: Specialization in Health Care Branch of Study: Addictology PharmDr. Bc. Zbyněk Oktábec, Ph.D. et Ph.D. Design of Pilot Clinical Trial of Treatment of Hepatitis C in Polyvalent Problem Drug Users with Pharmacological Substitution of Opioids and Methamphetamine (HCV-PPDUSOM) Master's Thesis Advisor: Mgr. Roman Gabrhelík, Ph.D. Prague, 2016 Abstract Hepatitis C is one of the most serious blood-borne complications of somatic health status of drug users. The HCV-positive injecting drug users are therefore directly indicated for the treatment of this type (and other types also) of hepatitis. Problematic adherence and treatment compliance is obvious in this group. Both foreign and domestic experiences show that stabilization of the use of illegal (and/or illegally acquired) substances is the essential part of the treatment of hepatitis. The interaction of the high quality treatment of somatic, psychosocial and add-on pharmacological care, including the substitution of illegal (and/or illegally acquired) drugs, leads to patient's increased compliance and adherence to HCV treatment. This diploma thesis is presenting both the theoretical frame and the study design of the pilot clinical trial of HCV treatment with the supportive substitution...
|
guest ::
