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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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Changes on the opiate scene in the Czech Republic after 1990 and analysis of current situation among problem opioid users: a survey of clients in Czech low-threshold treatment programmes
Malinovská, Jana ; Mravčík, Viktor (advisor) ; Janíková, Barbara (referee)
Opioid use among problem drug users in the CR can be divided into several developmental periods, starting with the heroin epidemic after 1990 with the decline of methamphetamine use and followed by leakage of buprenorphine products to the black market. There is currently a continuous use of buprenorphine from the black market and an increase in use of opioid analgesics. The theoretical part of the work was concerned with the development of opioid use in the Czech Republic after 1990 and with the trends during the years from 1990 until the present. The practical part consisted of a cross-sectional study; a semi structured questionnaire was used to collect the data. The research sample was made of 68 clients who had previously used an opioid drug and visited the Prague contact centres Drop In, o.p.s. and Stage 5, Progressive, o.p.s. where the data were collected during December 2016 and February 2017. The data were analysed using descriptive statistics. The most used opioids in the last month were Subutex®, Suboxone® and heroin, to the lesser extent opium and fentanyl. Czech "braun", methadone, Vendal®, morphine and Addnok® were used only sporadically. Respondents had also experience with use of other opioids, such as Palladone®, Tramal®, Ravata® and codeine. The most common form of drug application...
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Pharmaceutical Industry and Healthcare Policy
Babilon-Crockett, Max ; Háva, Petr (advisor) ; Dlouhý, Martin (referee)
This thesis is concerned with assessing the involvement of the pharmaceutical industry with the United States' health system. We will consider the role that the industry plays in the greater system, and how its activities influence the environment around it. This is done through a case study, in the context of the United States experiencing a so-called "opioid epidemic." This crisis is a serious problem for the health system, and society as a whole, which predominantly involves prescription pharmaceuticals. We will undertake an examination of the pharmaceutical industry's relationship with that crisis through a strong reliance on critical discourse analysis, rooted in systems theory. Despite being a critical component in the American health system, and the one directly responsible for the creation of pharmaceuticals, we will see that the industry is predominantly treated as an ally in addressing the opioid epidemic, rather than complicit in its emergence. This indicates that the industry successfully influences the discourse surrounding its role and responsibilities as a component of the health system. Keywords Pharmaceutical industry, lobbying, healthcare, PhRMA, health system, opioid, prescription drugs
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"Monitoring and Analysis of the Contents of Websites Focused on Amphetamine and Opioids Users in the Czech Republic"
Habarta, Jiří ; Gabrhelík, Roman (advisor) ; Barták, Miroslav (referee)
The thesis describes the course and results of the research into interventions through the internet websites in the Czech language for the users of opioids and amphetamines. Nowadays the internet forms an inseparable part of most people's lives from all social classes. This fact is reflected in the interests of both service providers for drug users and laymen interested in drug issues. Unfortunately, according to current research we do not know much about what information and in which quality and range can people find about drug issues on the internet. Therefore, the aim of this thesis was to find and analyse internet websites focused on the users of illegal drugs (opioids and amphetamines) in the Czech republic. The Internet websites were evaluated not only with respect to the contents and range of the information provided but also with respect to topicality, functionality and objectivity. What was found were 13 complex Czech websites, 7 professional HR organisations and also 6 non-professional HR websites. The websites of professional organisations in most cases fulfilled the essential criteria of authority, objectivity and topicality. Among non-professional websites there were high-quality ones containing a wide range of information and correct approach to drug issues but there were also two...
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