620 resultados para Opioid Addicts
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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OBJETIVO: analisar os conhecimentos dos pediatras que atuam com pacientes neonatais em relação à avaliação e o tratamento da dor do recém-nascido. MÉTODOS: estudo transversal com 104 pediatras (de um total de 110) que trabalhavam em 1999 a 2001, nas sete unidades de terapia intensiva e nos 14 berçários da cidade de Belém, e responderam a um questionário escrito com perguntas a respeito do seu perfil demográfico e do conhecimento de métodos de avaliação e de tratamento da dor no recém-nascido. RESULTADOS: cem por cento dos médicos referiram acreditar que o recém-nascido sente dor, mas apenas um terço deles conhecia alguma escala para avaliar a dor nessa faixa etária. A maioria dos entrevistados referia perceber a presença de dor no recém-nascido por meio de parâmetros comportamentais. O choro foi o preferido para avaliar a dor do bebê a termo; a mímica facial para o prematuro, e a freqüência cardíaca para o neonato em ventilação mecânica. Menos de 10% dos entrevistados diziam usar analgesia para punções venosas e capilares; 30 a 40% referiam empregar analgesia para punções lombares, dissecações venosas, drenagens de tórax e ventilação mecânica. Menos da metade dos entrevistados referiu aplicar medidas para o alívio da dor no pós-operatório de cirurgia abdominal em neonatos. O opióide foi o medicamento mais citado para a analgesia (60%), seguido pelo midazolam (30%). CONCLUSÃO: os pediatras demonstraram pouco conhecimento a respeito dos métodos de avaliação e tratamento da dor no período neonatal. Há necessidade de reciclagens e de atualização no tema para os profissionais de saúde que atuam com recém-nascidos doentes.
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Methadone is a little used opioid in veterinary practice, and there are still questions about its use. The objective of this study was to evaluate the effects of intramuscular (IM) or intravenous (IV) administration of methadone on cardiopulmonary parameters and times of extubation and recovery in female dogs submitted to ovariohysterectomy. Sixteen adult female dogs were used and premedicated with levomepromazine (0.6mg/kg, IM). After 20 minutes, propofol (5mg/kg, IV) was used for induction and anesthesia was maintained with isoflurane. After 10 minutes, methadone at 0.3mg/kg was administered intravenously in IVG and intramuscularly in IMG. The measurement of heart (HR) and respiratory rates (RR), median arterial pressure (MAP), esophagic temperature (ET) and concentration of end-tidal carbon dioxide (PE'CO2) was performed immediately before the administration of the opioid (T0), after 20 minutes (T1) and then at 10-minute intervals (T2, T3, T4 and T5). The statistical analysis used was profile (5%). HR, APM, RR, PE'CO2, BT and SpO2 did not differ significantly among times or between groups at any time. Times of extubation and recovery were higher in IVG. It is possible to conclude that IV and IM administration of methadone did not produce changes in the cardiorespiratory parameters of that specie.
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Drugs commonly used in anesthesia practice may significantly alter the oxidative state of blood cells. This mechanism could contribute to the immune suppression that occurs transiently in the early postoperative period. Thus, we assessed the effects of continuous rate infusion (CRI) of propofol associated or not with tramadol on hematologic parameters in dogs. Eight adult mongrel dogs were anesthetized on 2 occasions, 15 d apart. Two groups were formed: control group (CG) and tramadol group (GT). Propofol was used for induction (10mg kg-1) followed by a CRI (0.7mg kg-1minute-1). The animals were positioned in lateral recumbency and mechanically ventilated with inspired oxygen fraction of 0.6. In TG, tramadol (2mg kg-1) followed by a CRI (0.5mg kg-1minute-1) was administered in dogs. In the CG the sodium chloride (NaCl) solution at 0.9% was administered followed by its CRI, in the same volume that was used in TG. The measurement was taken before anesthesia induction (Tbasal), 30 minutes after induction (T0) and then at 30-minute intervals (T30 to T60). Red blood cells, hematocrit, hemoblogin concentration and total leukocytes count decreased from T0 in both groups. In TG, lymphocytes count at Tbasal [1.86 (0.82) x103µl-1] was greater than at T0, T30 and T60 [0.96(0.50), 0.92(0.48) and 0.95(0.48) x103µl-1, respectively]. No significant differences were observed for platelets neutrophil, eosinophil, basophil and monocyte count. In dogs, propofol-anesthesia associated or not with tramadol promoted decrease in blood cell count and should be used with caution in immunossupressed patients.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Objective: The present study aimed to investigate the influence of methadone on cardiorespiratory parameters, electrocardiogram and clinical sedation in dogs. Further possible side effects are reported.Study designProspective experimental cross-over study.DogsEight, 1-4-year-old, various breeds of dogs of both genders weighing 9-36kg.MethodsEach dog was treated three times: methadone 0.3mgkg(-1) (M0.3), 0.5mgkg(-1) (M0.5) and 1.0mgkg(-1) (M1.0) intramuscularly. Respiratory rate, heart rate and arterial blood pressure were recorded as well as electrocardiographic evaluation of lead II. Clinical sedation in each treatment received a score (0-3) after drug administration and at 30minute intervals until scores and measurements returned to baseline values.ResultsA significant decrease in heart rate was seen with each dose of methadone and bradycardia (HR<60bpm) was noted in a few dogs at each dose. A clinically significant arrhythmia occurred in one dog at 1mgkg(-1) that required reversal with butorphanol. There was no significant difference in SAP, MAP and DAP between treatments. Some side effects such as salivation, defecation, vocalization and panting, after administration of methadone were observed. There were no differences in mean values of heart rate, P-wave and QRS complex duration and QT interval between treatments.Conclusion and clinical relevanceMethadone administration was associated with panting and a decrease in heart rate at all doses tested in this study. The cardiac rhythm should be monitored carefully in dogs when methadone is administered on its own, especially at higher doses.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Introduction: The use of psychoactive substances by the student population has been the object of various studies in Brazil. Objective: To determine the prevalence of substance use among students. Methods: Quantitative study with a closed questionnaire based on standardized assessment instruments was developed. It consists of questions related to types of psychoactive substance use, abuse, frequency and duration of use, self-criticism regarding the use, consequences of use in relation to health, and misdemeanors committed under the influence of psychoactive substances. The sample included the participation of 268 students. A total of 183 (68.3%) questionnaires were analyzed, and only those with positive result for substance abuse at some point in life, the remainder, 85 (31%) questionnaires, had negative responses to psychoactive substances. Results: Students’ responses to the two years surveyed indicated that the first psychoactive substance used was alcohol (77.9%), followed by tobacco use (10.9%), and marijuana (7.6%). Of the students surveyed, 145 (79.2%) answered that still make use of psychoactive substances, and the current frequency of use varies from one or more times per week. When asked about the possibility of being or becoming drug addicts, 169 (92.3%) responded that they are not or will not become dependent. Conclusion: The results indicate the high rate of substance use among college students surveyed, and point to their contradiction to consider such psychoactive substances harmful to their health.
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The article analyses some characteristics of drug consumption at this moment. Two sources of data are used: interviews made, between 2005 and 2008, with addicts and two narratives about drugs, released by the published market (Arti cial Paradise by Charles Baudelaire and !e Last Opium Dem by Nick Tosches). Two concepts are priorized: boredom and insu"ciency vexatious. By them, the article shows that nowadays capitalism dynamic, centred in the continuous production of past devaluation and in the impulse toward a triumphant competitivity, it is impoverishing coletive life and it is spreading out on a large scale the use of psicoactive substances.
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Endo-oligopeptidase A, EC 3.4.22.19, converts small enkephalin-containing peptides into the corresponding enkephalins in vitro. We investigated the presence of endooligopeptidase A in the retina and its possible colocalization with enkephalins in retinal neurons. The specific activity of endo-oligopeptidase A found in pigeon retinae (30.3 +/- 7.3 mU/mg, mean +/- standard deviation) was four times higher than in rabbit retinae (7.0 +/- 1.1 mU/mg). The enzyme activity was not modified by EDTA, but it was enhanced by dithiothreitol and inhibited by zinc and 5,5'-dithiobis(2-nitrobenzoic acid). Immunohistochemical experiments with a purified antiserum against rabbit endo-oligopeptidase A revealed labeled neurons in both the inner nuclear layer and the ganglion cell layer of pigeon and rabbit retinae. Double-labeling immunofluorescence experiments demonstrated that about 90% of neurons containing endo-oligopeptidase A-like immunoreactivity also contained [Leu5]-enkephalin-like immunoreactivity. These colocalization results may represent an important step toward the demonstration of the possible involvement of endo-oligopeptidase A in enkephalin generation in vivo.
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The endopeptidase 22.19 (EC 3.4.22.19) has been associated with the metabolism of neuropeptides by its ability to convert small enkephalin-containing peptides (8 to 13 amino acids) into enkephalins. In addition, this enzyme cleaves the Arg8-Arg9 bond of neurotensin and the Phe5-Ser6 bond of bradykinin. We analyzed the circadian variation of endopeptidase 22.19 in the whole and individual areas of the rat brain. Endopeptidase 22.19 activity was analyzed by high-performance liquid chromatography (HPLC) using bradykinin as an operative substrate. Enzymatic specific activities were analyzed by rhythmometric methods and indicate a circadian fluctuation of endopeptidase 22.19 specific activity (mU of enzyme/mg of protein) in the whole brain [p < 0.001, mesor (M) = 7.62, amplitude (A) = 2.89, and acrophase (phi) = 23:08 h], striatum (p < 0.001, M = 2.92, A = 0.62, phi-23:03 h), hypothalamus (p < 0.001, M = 3.15, A = 0.86, phi-01:12 h), periaqueductal gray matter (p < 0.005, M = 2.62, A = 0.34, phi = 22:35 h), and cerebellum (p < 0.0 14, M = 4.27, A = 0.88, phi = 17:12 h). The circadian rhythmicity in endopeptidase 22.19 specific activity suggests that light may have an effect on the peptidase activity in whole brain and in areas of the central nervous system and may be essential for the mechanisms of circadian fluctuations of neuropeptides in the brain.
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The dependency of psychoactive substances whether licit or illicit, among adolescents is a topic that has aroused much discussion today. One of the psychoactive substance that has caught the attention of authorities and experts, its potential dependence, increasing the number of addicts and speed with which triggers the human degeneration is the crack (a derivative of cocaine - Erythroxylon coca), used via the smoked administration. Understanding the phenomenon of increasing their use requires an analysis of the concepts of addiction throughout history, current research encompassing scientific findings in epidemiology and statistics involving several types of pharmacological substances, and especially the analysis of data related specifically to crack the focus of our theme. In order to contribute to ongoing discussions and offer possible alternatives for effective intervention, especially in schools, we conducted a survey that sought to find evidence of a possible relationship between crack use and moral reasoning. Since our work specifically theoretical nature, we use to reach our goals, assumptions, two researchers in the concept of human morality: Jean Piaget (1994) and Lawrence Kohlberg (1992) both traveling within the proposed cognitive-evolutionary human development. For an understanding of the proposals of these two researchers, we use research to (Lepre, 2005), as guiding thesis of this work. The results presented indicate that adolescents who use crack are very close to a level of moral reasoning pre-conventional and conventional, although it is important to state that more accurate results require further research on the subject, including those involving field research. Yet we can conclude that prevention must go through a dialogue that privileges the moral education as possible means of effective intervention against the use of crack, allowing the construction of autonomy... (Complete abstract click electronic access below)
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The equine anesthesia is proven to be a high risk procedure, for both patient and anesthetist, compared to other animal species. In these conditions, a good anesthetic protocol that can deliver sedation, making access and manipulation easier, analgesia fair enough to realize cirurgical procedures, and minimal physiologic changes would be ideal. Since there aren’t any drugs suporting all these qualities, the Neuroleptoanalgesic Associations show themselves as a valuable technique to provide anesthetic quality and safety, possibly diminishing our drug of choice’s doses, therefore offering less fisiological changes and easier monetary access in some cases. This paper objective was to list all these associations found in literature, evaluating their advantages and practical applications
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Pós-graduação em Cirurgia Veterinária - FCAV