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Opioids and neuroprotection: the role of glial cells
Honc, Ondřej ; Novotný, Jiří (advisor) ; Kováčová, Ľubica (referee)
High energy deamand and insulation via the blood-bain barrier are the main reasons for neuronal sensitivity to oxygen or energy deficiency. Even short or mild periods of hypoxia/ischemia (H/I) could fataly impact the CNS enviroment. The area on the edge of the tissue affected by H/I and adjacent unaffected tissue is called the penumbra. Here, we can observe additional H/I related processes - gliosis allied with sterile inflammation and censecutive apoptosis. Opioid receptors attenuate H/I impact on CNS in both acute and consecutive phases. In acute phases, opioid receptors regulate ion homeostasis and attenuate glutamate toxicity; in consecutive phases, lower gliosis manifestation. Both these actions have significant neuroprotective effects. Ability of opioid receptor to lower sterile inflammation in CNS could be used in a series of neurodegenerative diseases, eg. Alzheimer disease or amyotrophic lateral screlosis. Glial cells participate on ion homeostasis, glutamate uptake, and production of antiinflammatory substances; one can, therefore, assume that a significant part of neuroprotective effects of OR is related to glial cells. The opioid system and its signaling pathways has not been fully elucidated yet. I present global overview of this phenomenon and describe some recent findings regarding...
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Secondary and tertiary drug abuse prevention
Havlovičová, Kristina ; Šotolová, Eva (advisor) ; Mlčková, Marie (referee)
This bacelor work deals with the subjective perception of significance of substitution treatment by it's clients. It's aim is to find out, how the clients of this treatment perceive it's significance primarily in their lives. Out of the data gained from the research it is obvious that despite some negatives of the substitution treatment it's clients considers it to be very positive especially because it allows them to get involve in the society and to live the "normal life". Suprisingly, in comparison with the orientation of intact population the clients almost completely ignore the influence of substitution on their state of health and the risk of transer of infection diseases. Powered by TCPDF (www.tcpdf.org)
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Clinical importance and mechanisms of action of morphine and methadone
Slušná, Michaela ; Novotný, Jiří (advisor) ; Hejnová, Lucie (referee)
This bachelor thesis deals with gathering the information regarding the clinical importance of opioid drugs, particularly morphine and methadone, and their mechanism of action. Awareness of health professionals and the general public on opioid is inadequate. This evokes unnecessary anxiety of uninformed patients by the treatment of this kind of drugs. This thesis contains information that should know each worker in the health sector. It deals with pharmacodynamics, which is important for understanding the effects of drugs, both biochemical and physiological as well as pharmacokinetics, which describes how the body compensates for the delivered drug. Usage of morphine and methadone is currently irreplaceable. Morphine is a strong analgesic effective control of pain of different origin. Methadone is used for the substitutive treatment of people addicted to opioids. The side effects occurring during the treatment with opioids are acceptable with regard to severe pain, which is attenuated by opioids.
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Neonatal opioid withdrawal syndrome
Chernova, Alika ; Novotný, Jiří (advisor) ; Brejchová, Jana (referee)
abstinenční syndrom (NAS) je důsledkem užívání opiátů během těhotenství. Závažnost projevů NAS zaleží nejen na typu používané opioidní látky, ale i na gestačním věku a dalších používaných látkách, jako jsou tabák anebo antibiotika. μ různým příznaky NAS a změnami délky pobytu v nemocnici a farmakologické léčby. ráce zahrnuje popis molekulárních principů vzniku rizik užívání těchto látek v období gravidity metody léčby vzniklého neonatálního syndromu Klíčová slova: Neonatální abstinenční syndrom, těhotenství, z
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Opioids in caesarean section
Nosková, Pavlína ; Bláha, Jan (advisor) ; Málek, Jiří (referee) ; Vymazal, Tomáš (referee)
The thesis is focused on perioperative use of opioids during caesarean section. The general part is concerned with pharmacology of opioids due to their practical use during general and regional anaesthesia and postoperative analgesia with particular focus on remifentanil. Emphasis is put on the placental transfer of opioids into breast milk which has the possible influence on postnatal adaptation of the newborns and breastfeeding/lactation. The first part of the research describes current anaesthetic practice and opioid use in obstetrics in the Czech Republic according to the OBAAMA-CZ study in 2011. The second study on a unique group of 151 parturients showed that bolus application of remifentanil at a dose of 1 μg/kg at the time of 30 seconds before induction of general anaesthesia for caesarean section significantly stabilizes maternal hemodynamic parameters (blood pressure, heart rate) and reduces the stress response to tracheal intubation and skin incision. On the contrary, no influence on depth of anaesthesia (monitored by BIS) was found. But we demonstrated a slight effect of remifentanil on the assessment of postnatal adaptation of newborns at first minute after delivery. However, this attenuation was very short and in the fifth minute the results were already fully comparable to the control...
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The effect of opioids on immunoregulatory and migratory properties of mesenchymal stem cells.
Echalar, Barbora ; Zajícová, Alena (advisor) ; Funda, David (referee)
Opioids are one of the oldest analgesics used to relieve pain. Besides their therapeutic properties, they also have negative side effects, which include impaired tissue regeneration. Therefore, it can be assumed that opioids also have a negative effect on stem cells which are responsible for tissue healing. One of stem cell populations involved in wound regeneration are mesenchymal stem cells (MSCs). MSCs are undifferentiated, multipotent cells that could be find in almost all tissues. They have immunoregulatory properties and they can migrate to the site of inflammation or injury where they contribute to healing of tissues. Therefore, the purpose of this thesis was to evaluate the effect of morphine and methadone on properties and migration of MSCs. Their effect on the metabolic activity of MSCs and also on the production of cytokines and growth factors was measured. The effect of these opioids on the immunoregulatory properties of MSCs acting on both innate and adaptive immune cells in vitro was studied. The effect of morphine on expression of adhesive molecules on MSCs was also examined. Furthermore, the effect of morphine on migration properties of systemically administered exogenous MSCs in vivo was investigated in mouse models. Distribution of MSCs to individual organs and to the site of...
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Attachment, Pain and Opioids in Nursing
Lukášová, Běla ; Javůrková, Alena (advisor) ; Bratová, Andrea (referee)
Resources The research, carried out around the world, suggests there is an obvious relationship between the opioid addiction and attachment by patients with chronic non-tumorous pain with opioid treatment. Thesis aims The goal of this bachelor thesis is to compare attachment and pain distress of patients with chronic non-tumorous pain treated with strong opioids and of patients with chronic non-tumorous pain without opioid treatment with healthy checks and to find significant attachment predictors in patients treated for chronic non-tumorous pain with strong opioids. It also focuses on evaluation of relations between pain intensity, pain distress and socio-demographic variables (age, employment, education, social status) and clinical parameters (opioid equianalgesic dose, opioid type, oral/transdermal); attachment within multiple regression in both patient groups and healthy checks; depressions in both patient groups and healthy checks; and health perception in both patient groups and healthy checks. Sample definition and methods The data collection for this bachelor thesis was carried out at the Department of Pain Research and Treatment, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital and at the Department of Rehabilitation and Sports Medicine, 2nd Faculty of...
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The role of epigenetic mechanisms in opiate dependence
Hronová, Anna ; Novotný, Jiří (advisor) ; Netolický, Jakub (referee)
Addiction and tolerance develop with the chronic use of opioids. Opioid drug abuse has social, economic and health consequences. The most commonly abused opioid drug is heroin, but so is morphine, which is used in medicine as an analgesic. Drug dependence includes potentially long-term behavioural abnormalities that are induced by repeated use of opioid drugs. The persistence of behavioural chan- ges suggests that there are long-term changes in gene expression. Research has shown the crucial role of epigenetic mechanisms in managing long-term changes in gene expression. Studies have revealed increased levels of permissive histone acetylation, decreased levels of repressive histone methylation, and changes in DNA methylation patterns and non-coding RNA expression. Within the action of opioids, these epigenetic modifications are limited to the mesolimbic and limbic systems, which play a role in the processing of emotions, motivation or reward. There is still much work to be done in the field of research into the influence of epigenetic mechanisms in opiate dependence. However, research to date has significantly shifted the understanding of how opioids cause permanent changes in brain function with their results and findings.
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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...
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The impact of opioids on the effect of cytostatic agents on the C6 and CCF-STTG1 astrocytoma cell lines
Honc, Ondřej ; Novotný, Jiří (advisor) ; Růžička, Jiří (referee)
Despite its numerous side effects, morphine and the opioids derived from this drug, belong among the only effective options for treatment of pain linked to oncological illness. The effect of opioids on the efficiency of cytostatics in vitro has been the subject of many papers but the results are often contradictory, which could be probably caused by the great variability of experimental models and approaches. Some recent studies indicate that the consequences of activation of opioid signaling in astrocytes display certain differences from other cell types. Glioblastoma multiforme, the tumor derived from astrocytes, belong among those with the worst prognosis, mostly for the frequent resistance to cytostatics. In this thesis we focused on the effect of morphine, methadone and DADLE on the efficiency of cytostatics of temozolomide, doxorubicin and vincristine on the cell lines C6 and CCF-STTG1 derived from glioblastomas. Also, we examined the effect of the above mentioned opioids on the level of oxidative cellular stress and using N-acetylcysteine, a ROS scavenger, we verified the role of oxidative stress in cellular systems activated by the effect of the mentioned opioids on the efficiency of cytostatics. We also assessed opioid receptors and the receptor TLR4 in the examined cell lines. The...
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