Evaluation of new analgesics. Butorphanol and nalbuphine

Lewis, J. R.

doi:10.1001/jama.243.14.1465

Cited by 9 publications

(6 citation statements)

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“…These attributes have little relevance for the vast majority of patients who have cancer pain. The mixed agonist-antagonist subclass, particularly pentazocine, is also associated with a greater incidence of psychotomimetic effects (Kantor, Hopper, & Laska, 1981;Lewis, 1980). Only pentazocine is currentlv available in an oral formulation in the United States.…”

Section: Journ4l Of Psychosocial Oncologymentioning

confidence: 99%

Pharmacologic Approaches to the Control of Cancer Pain

Portenoy

1990

Journal of Psychosocial Oncology

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Section: Journ4l Of Psychosocial Oncologymentioning

confidence: 99%

Pharmacologic Approaches to the Control of Cancer Pain

Portenoy

1990

Journal of Psychosocial Oncology

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“…While very limited study with nalbuphine has been performed in cats, at least in humans, it has been found that both nalbuphine and butorphanol are rapidly absorbed from the IM route and have a similar pharmacokinetic profile. 9,10 These are likely the factors as to why the time to induction and number of injections required were not found to be significantly different between the two groups of cats in the present study. Additionally, the sedative and adverse effects of nalbuphine and butorphanol are similar in humans, 9 which may explain the nonsignificance of the time to recovery and number of cats requiring reversal between the two groups.…”

Section: Discussionmentioning

confidence: 67%

“…1,9 Nalbuphine and butorphanol are both agonists of the kappa opioid receptor and are mu receptor antagonists. In humans, their pharmacokinetics are considered to be similar, with a rapid onset of <20 mins, peak effects within 30-60 mins and a duration of action of 3-6 h. 10 However, the one prior study in cats reported nalbuphine to have a shorter duration of action than butorphanol. 11 Butorphanol has been extensively investigated as a safe and effective anesthetic component in cats.…”

Section: Introductionmentioning

confidence: 99%

Use of nalbuphine as a substitute for butorphanol in combination with dexmedetomidine and tiletamine/zolazepam: a randomized non-inferiority trial

Kreisler

Cornell

Smith

et al. 2019

Journal of Feline Medicine and Surgery

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Objectives The goal of this study was to determine whether a drug combination using nalbuphine with dexmedetomidine and tiletamine/zolazepam is non-inferior to one that uses butorphanol. Methods All healthy cats presenting solely for gonadectomy to two trap–neuter–return mobile clinic days were randomly assigned to induction with a combination of tiletamine/zolazepam 3 mg/kg, dexmedetomidine 7.5 µg/kg and either butorphanol or nalbuphine at 0.15 mg/kg. All participants were blinded to the identity of the combinations. The primary endpoint was clinician satisfaction, comprised of the mean of four satisfaction ratings on a 7-point Likert scale (highly dissatisfied through to highly satisfied) recorded for induction, maintenance of anesthesia, surgery and recovery. Exploratory endpoints included each individual score, number of injections, duration of induction, duration of recovery and need for reversal agent. To assess non-inferiority for the primary endpoint and individual scores, the difference and 95% confidence intervals (CIs) of the difference between the mean clinical scores for the nalbuphine and butorphanol-based combinations were calculated and compared with a prespecified non-inferiority margin of 20% (1.4 points). Results Seventy-two cats were enrolled, 36 in each group. The mean ± SD composite score for the combination with nalbuphine was 6.06 ± 0.59 (95% CI 5.86–6.25) points, while the combination with butorphanol was 6.22 ± 0.62 (95% CI 6.01–6.43). The difference between mean scores was 0.17 (–0.12 to 0.45), which did not exceed the prespecified boundary of 1.4, establishing the non-inferiority of nalbuphine. No individual clinical score for nalbuphine was inferior to butorphanol, and there were no significant differences for any secondary endpoints. Conclusions and relevance The clinical experience of the nalbuphine-based combination was non-inferior to the butorphanol-based combination. Nalbuphine is an effective substitute for butorphanol, providing another option if butorphanol is unavailable due to shortage, controlled status or cost, without requiring a change in anesthetic workflow.

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“…A distribuição dos peptídeos da POMC é relativamente restrita ao SNC. Seus níveis são mais elevados no núcleo arqueado, que se projeta amplamente nas regiões límbicas, tronco encefálico e medula espinal (Lewis, 1980), ou seja, em muitas estruturas do encéfalo humano onde a estimulação elétrica alivia a dor (Pilcher et al, 1988). Os peptídeos derivados da pró-encefalina ocorrem em diversas regiões do SNC relacionados ao processamento da dor (lâminas I e II do CPME, núcleo do trato espinal do nervo trigêmeo, substância cinzenta p eriaqüedutal mesencefálica), modulação do comportamento (amígdalas, hipocampo, loco cerúleo, córtex cerebral), controle motor (núcleo caudado, globo pálido) e à regulação das funções neurovegetativas (bulbo) e neuroendocrinológicas (eminência mediana) (Pasternak, 1993).…”

Section: Analgésicos Opióidesunclassified

“…A depressão respiratória, a obstipação, as náuseas, os vômitos e a dependência decorrentes de seu uso são mediados pelos receptores µ. Não há relato sobre seu uso prolongado por via IT (Lewis, 1980). Não induz depressão respiratória, constrição pupilar ou efeito psicomimético e não exerce atividade farmacológica na ausência dos opióides (Omoigui, 1995).…”

Section: Agonistas-antagonistasunclassified

Infusão intratecal de opióides para tratamento de dor crônica não decorrente de câncer

Júnior¹,

Alves²

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Dedicatória A minha querida esposa Cláudia, pelo amor e companheirismo, sempre presentes em todos os momentos de minha vida. Amor, sem você nada disto seria sido possível. Aos meus queridos pais, Nilton e Mara, por todo amor, carinho e dedicação, e a quem devo tudo que sou. Aos meus filhos, Paulo e Ignácio, de quem tantos momentos juntos foram subtraídos para que chegássemos a este resultado. Sem dúvida a razão de tudo que eu faço. vii Esta tese está de acordo com as seguintes normas, em vigor no momento desta publicação:

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Evaluation of new analgesics. Butorphanol and nalbuphine

Cited by 9 publications

References 0 publications

Pharmacologic Approaches to the Control of Cancer Pain

Pharmacologic Approaches to the Control of Cancer Pain

Use of nalbuphine as a substitute for butorphanol in combination with dexmedetomidine and tiletamine/zolazepam: a randomized non-inferiority trial

Infusão intratecal de opióides para tratamento de dor crônica não decorrente de câncer

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