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Opioid dependence: mechanisms of development of withdrawal syndrome and its treatment
Hosenseidlová, Pavla ; Novotný, Jiří (advisor) ; Ujčíková, Hana (referee)
This work deals with opioids, opioid-induced withdrawal syndrome, and its treatment. Opioids are the most commonly used analgesics in medicine, and so far, there hasn't been a better alternative for them in most health cases. However, with long-term use, dependence can develop relatively quickly, and they have a high potential for abuse. When opioid use is discontinued, withdrawal syndrome occurs, and its symptoms resemble those of the flu, including muscle and joint pain, feeling cold and having a runny nose, nausea and vomiting, diarrhea, and tachycardia. These symptoms can be very intense and are often accompanied by psychological manifestations such as anxiety and depression. The treatment of opioid withdrawal syndrome is based on alleviating both physical and psychological symptoms. Most commonly, treatment involves using opioid agonists or antagonists with accompanying therapy for psychological manifestations. It is also important to include psychotherapy in the treatment process because the addiction in many cases stems from unresolved psychological or socio-economic issues.
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The effect of long-term morphine application on clock genes expression in the rat brain
Pačesová, Dominika ; Bendová, Zdeňka (advisor) ; Roubalová, Lenka (referee) ; Polidarová, Lenka (referee)
The circadian and opioid systems are systems involved in maintaining homeostasis in the body. Disruption of the circadian system disturbs the proper timing of physiological processes, which can result in the development or exacerbation of pre-existing pathological conditions, including addiction. One of the factors that can influence the precise synchronization of the circadian system is the use and abuse of opioids. The interrelationship between the circadian and opioid systems is poorly studied. To this end, the present study investigated the effect of morphine and methadone on the rat circadian system in adulthood and during development. The aim of this dissertation was to observe the effect of acute morphine administration on the expression of clock genes in the suprachiasmatic nuclei (SCN) of adult rats, and to investigate the effect of long-term morphine or methadone administration and withdrawal on the expression of clock genes in the SCN and on the activity of the enzyme AA-NAT in the pineal gland of adult rats. Proper development of the circadian clock contributes significantly to the maintenance of health in adulthood and ensures good adaptability of the organism to changes in the external environment. No study to date has focused on examining the effects of opioid administration during...
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Pharmacotherapy in the treatment of opioid addiction
Bodinková, Jolana ; Novotný, Jiří (advisor) ; Kašík, Petr (referee)
Opiate addiction represents a difficult problem, both medically and socially. With millions of affected people, either by such kinds of addiction or its side effects, across the globe, the condition requires its resolution to be effective, which can be provided by opioid pharmacotherapy, either methadone-, buprenorphine- or naloxone-based. In regard to increasing numbers of not only cases but also deaths, related to drug overdose, opiate addiction treatments still remain underused in medical settings. This thesis summarizes pharmacotherapy practices used during opioid use disorder treatments. Its main part predominantly focuses on the description of therapeutical procedures, their advantages, and deficiencies. Keywords: opioid abuse, pharmacotherapy, methadone, buprenorphine, naloxone
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Case study of a client included in methadone substitution programme
Petrišková, Lucie ; Vondráčková, Petra (advisor) ; Radimecký, Josef (referee)
of bachelor thesis Keywords: methadone- susbstitution therapy- client- substitution programme-causes The bachelor thesis deals with the effect of client participation in the complete substitution treatment programme with methadone, which aims to demonstrate a positive effect not only on the client itself, but also on its vicinity. The theoretical part deals with methadone, its effects and the progressive placing into the treatment of addicted clients, firstly abroad and then in the Czech Republic. It deals with forms of treatment working in the Czech Republic with a detailed description of a complex substitution therapy. At the end of the theoretical part are discussed the causes of origin of an addiction on the addictive substances. The practical part is a case study of two clients - married couple, what describes in detail their life before the treatment, during the treatment and at her one year after the treatment, when she has been included in the substitution programme for ten years and is ending with a voluntary departure from the program with the zero dose of methadone - the client successfully abstains. The conclusion of the thesis is devoted to evaluation whether the target of work was fulfilled, when it demonstrates the positive impact of the methadone substitution treatment on client and...
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Addictology services in the capital city of Prague with a focus on substitution treatment
Janyška, Jakub ; Šotolová, Eva (advisor) ; Mlčková, Marie (referee)
The thesis is devoted to the issue of addiction services with a focus on substitution treatment. Theoretical part focuses on presenting of susbstitution treatment, its history and description of the substitution substances and their effects on the human body. Describes the abuse of substitution treatment by problem drug users and tries to map out the various addiction treatment services with a focus on substitution treatment in Prague. The research section defines the attitude of society towards the establishment and functioning of Prague substitution centers. The thesis concludes with an overview of addiction services and substitution programs in the capital city of Prague. Powered by TCPDF (www.tcpdf.org)
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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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Methadone and its usage in treatment of opioid drug addiction
Chona, Kembe ; Svoboda, Petr (advisor) ; Hejnová, Lucie (referee)
Methadone, a synthetic opioid created in the 1940s is a potent mu opioid receptor agonist. Opioid receptors form a sub-group of the GPCR super-family. Their most significant role is the inhibition of neural pathways by regulating the activity of ionic channels and effector proteins. µ-opioid receptors are the site of action of heroin, methadone and other classical opioid agonists. Due to the opioid receptors distribution in both the central nervous system and peripheral tissues, methadone affects a wide variety of functions in the organism. Methadone induces many of the effects of classical opioids including analgesia, respiratory suppression, sedation, euphoria. While originally being developed as an analgesic it had soon shown potential for other therapeutic methods. Methadone maintenance therapy was introduced in 1963, by professor Vincent P. Dole and his team. It quickly became clear that methadone substitution therapy is indeed very effective and shows the highest ability to retain patients. Thanks to its high oral bioavailability, higher intrinsic efficacy and long terminal half-life methadone is the first choice drug for opioid substitution therapy. Methadone, used in appropriate doses produces only mild adverse effects and has the ability to normalize physiological homeostasis disrupted by...
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Descriptive analysis and evaluation of the opioid substitution treatment in Kazakhstan
Čečeleva, Olga ; Zábranský, Tomáš (advisor) ; Mravčík, Viktor (referee)
Background: In Kazakhstan, opioid substitution therapy (OST) has been a controversial topic since its introduction in 2008. Aim: To examine and analyse factors influencing approach towards OST among OST patients, opioid-dependent drug users who could re-consider engagement in this therapeutic method, as well as attitudes of selected key organisations and their representatives. Methods: A survey method complemented by semi-structured individual and group interviews has been selected. One hundred respondents participated in the study between October and December 2015. The first group consisted of 46 OST patients. The second group consisted of 54 respondents who met criteria for opioid dependence. This group included patients of residential treatment centres, former OST patients and current injecting drug users. Key persons were interviewed about their attitudes. Results: Patients receiving OST, with the average treatment duration of 29.4 months, reported improved health, improved social functioning and financial well-being, as well as reduction of their involvement in crime. This group showed better results in all examined categories. Most (80 %) were satisfied with the treatment, even though a number of shortcomings have been reported. All OST patients considered necessary to expand the availability...
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