Morphine Versus Midazolam as Upfront Therapy to Control Dyspnea Perception in Cancer Patients While Its Underlying Cause Is Sought or Treated

Navigante, Alfredo; Castro, Miriam Susana; Cerchietti, Leandro

doi:10.1016/j.jpainsymman.2009.10.003

Cited by 79 publications

(64 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The population would be earlier in the disease than the participants at the end of life in Navigante's study. 11 The primary outcome will also need to be considered carefully. The current pilot used the intensity of breathlessness, but the unpleasantness may arguably also be a reasonable primary outcome.…”

Section: Benzodiazepines In Breathlessness 743mentioning

confidence: 99%

The Role of Benzodiazepines in Breathlessness: A Single Site, Open Label Pilot of Sustained Release Morphine Together with Clonazepam

Allcroft

Margitanovic

Greene

et al. 2013

Journal of Palliative Medicine

View full text Add to dashboard Cite

Section: Benzodiazepines In Breathlessness 743mentioning

confidence: 99%

The Role of Benzodiazepines in Breathlessness: A Single Site, Open Label Pilot of Sustained Release Morphine Together with Clonazepam

Allcroft

Margitanovic

Greene

et al. 2013

Journal of Palliative Medicine

View full text Add to dashboard Cite

“…Other drugs that may effectively relieve these symptoms are combined in one syringe to ease the administration, especially when patients are being treated at home. Morphine is often co-administered with one or more antiemetics (metoclopramide, hyoscine butylbromide, haloperidol, and levomepromazine) for the treatment of chronic nausea and vomiting [4], with haloperidol for the treatment of delirium [5] and with midazolam for the management of dyspnoea and anxiety [6]. Therefore, the analgesic effects of these drug combinations in rats have been investigated.…”

Section: Discussionmentioning

confidence: 99%

“…Haloperidol and levomepromazine may be used for the control of psychiatric symptoms such as delirium [5]. Patients suffering from severe dyspnoea often benefit from co-administration of the short-acting benzodiazepine midazolam with morphine [6]. However, there exists only limited knowledge of pharmacodynamic morphine interactions with the aforementioned, commonly used adjuvant drugs.…”

Section: Introductionmentioning

confidence: 99%

Analgesic Effects of Morphine in Combination with Adjuvant Drugs in Rats

Leppert¹,

Okulicz-Kozaryn

Kamińska

et al. 2014

Pharmacology

View full text Add to dashboard Cite

Background: Morphine is co-administered with adjuvant drugs to treat pain, nausea, vomiting, dyspnoea and delirium in cancer patients. Aim of the Study: To investigate analgesic effects of morphine when co-administered with adjuvant drugs. Material and Methods: Two-month-old male Wistar rats received single morphine doses alone (0.45 and 0.9 mg/kg) or with midazolam (0.3 mg/kg), haloperidol (0.15 and 0.45 mg/kg), levomepromazine (0.35 mg/kg), metoclopramide (1.0 mg/kg), and hyoscine butylbromide (1.7 mg/kg) as single subcutaneous injections. Analgesia was measured by the tail-flick test after 15, 30, 45, 60, and 90 min of drug administration. In the case of significant analgesia enhancement, analgesic and sedative effects were explored in 3-, 5-, 6-, 8-, and 11-month-old rats. Results: Significant morphine (0.9 mg/kg) analgesia enhancement was observed 60 min after haloperidol (0.15 and 0.45 mg/kg) and hyoscine butylbromide co-administration. The addition of haloperidol to morphine significantly increased analgesia in 6-, 8- and 11-month-old rats while in the case of hyoscine butylbromide co-administration this effect was observed only in 11-month-old rats. Conclusions: Haloperidol and hyoscine butylbromide enhanced morphine analgesia. Future studies may explore the repeated administration of these drug combinations in rats and humans. i 2014 S. Karger AG, Basel

show abstract

“…Haloperidol and levomepromazine may be used for the control of psychiatric symptoms such as delirium [6]. Patients suffering from severe dyspnea often benefit from co-administration of the short-acting benzodiazepine -midazolam -with morphine [7] or oxycodone [8]. However, there exists only limited knowledge of pharmacodynamic oxycodone interactions with the aforementioned, commonly used adjuvant drugs.…”

Section: Animals and Drug Treatmentmentioning

confidence: 99%

Analgesic and Anti–Inflammatory Effects of Oxycodone with Adjuvant Drugs in an Experimental Study of Nociceptive and Neuropathic Pain

Leppert¹,

Szulc²,

Kaczmarek³

et al. 2018

Neuropsychiatry

View full text Add to dashboard Cite

Objective: Opioids are often combined with adjuvants to treat symptoms that accompany pain and with adjuvant analgesics to treat neuropathic pain. Herein, we aim to investigate the analgesic and anti-inflammatory effects of oxycodone and selected adjuvants in rats.Methods: Analgesic and anti-inflammatory effects of oxycodone were assessed after single subcutaneous (SC) (0.56 mg/kg) injections in rats, with the following drugs: midazolam (0.3 mg/kg), haloperidol (0.45 mg/kg), ketamine (0.3 mg/kg), hyoscine butylbromide (1.7 mg/kg), levomepromazine (0.35 mg/kg), and metoclopramide (1.0 mg/kg). Analgesia was assessed by the tail flick test. Anti-inflammatory activity was evaluated using a plethysmometer after carrageenan-induced edema. For neuropathic pain, analgesia was explored using the tail flick and von Frey tests. Neuropathic pain was induced by vincristine (0.1 mg/kg, i.p.) in male Wistar rats.Results: All tested combinations of oxycodone with particular adjuvants showed increased analgesia in comparison to oxycodone alone. Compared to oxycodone alone, combinations with midazolam, haloperidol, hyoscine butylbromide, and levomepromazine prolonged analgesia. Anti-inflammatory activities were observed after coadministration of oxycodone paired with haloperidol and ketamine, which is a new aspect of the pharmacological profile of oxycodone. In the neuropathic pain model, vincristine lowered pain threshold in rats and inhibited growth of normal rat body weight. Oxycodone in combination with adjuvant analgesics showed more potent analgesia than oxycodone alone, especially in the tail-flick test. In most cases, the maximum effects were observed for 15-30 min since combined SC administration.Conclusions: Analgesic and anti-inflammatory effects were observed in oxycodone combined with selected adjuvants in rats; although the mechanism of these interactions is not yet well understood. Further studies should test these combinations after chronic administration and assess the benefits and risks associated with the use of the tested combinations in humans.

show abstract

Morphine Versus Midazolam as Upfront Therapy to Control Dyspnea Perception in Cancer Patients While Its Underlying Cause Is Sought or Treated

Cited by 79 publications

References 24 publications

The Role of Benzodiazepines in Breathlessness: A Single Site, Open Label Pilot of Sustained Release Morphine Together with Clonazepam

The Role of Benzodiazepines in Breathlessness: A Single Site, Open Label Pilot of Sustained Release Morphine Together with Clonazepam

Analgesic Effects of Morphine in Combination with Adjuvant Drugs in Rats

Analgesic and Anti–Inflammatory Effects of Oxycodone with Adjuvant Drugs in an Experimental Study of Nociceptive and Neuropathic Pain

Contact Info

Product

Resources

About