Tapentadol: Use and Abuse

Tapentadol is a synthetic opioid analgesic that has been on the market in India since 2011. According to international studies, there is a low danger of abuse and diversion. Prescription opioid pain reliever abuse remains a major public health concern. Tapentadol, a prescription painkiller, differs from opioids such as oxycodone and morphine in that it has two modes of action: opioid receptor agonism and norepinephrine reuptake inhibition. Tapentadol has been on the market in India for eight and a half years. Our center was the topic of a single peer-reviewed research in 2017 that detailed two instances of abuse. Tapentadol is less likely to be diverted, abused, addicted, overdosed, or sold on the street than other prescribed opioids. This article reviews uses, pharmacological properties and abuse of tapentadol as it is the most serious issues like addiction, seeking behavior, withdrawal, and physical dependency .The main challenge with tapentadol use is controlling the ratio of MOR agonist to NRI. Finally, tapentadol provides both nociceptive and neuropathic pain relief, but there are concerns about abuse and reliance. Keywords: Tapentadol, Abuse, Opioid, Addiction.

Examination of Hysterosalpingography in Patients With Suspected Infertility at The Radiology Department of Dr.R. Soetrasno Rembang Hospital

Hysterosalpingography (HSG) is the most commonly used imaging diagnostic to determine the tubal patency in patient with indications of infertility. The technique used in the HSG procedure is different in some studies. The aim of this study was to determine the technique of hysterosalpingography (HSG) examination with patients suspected of infertility in dr.R. Soetrasno Rembang hospital. The method was a case study approach. Results showed HSG examination using plain photo Anteroposterior (AP) projection, AP projection with 3 cc contrast media and 7 cc contrast media, then post evacuation. The AP projection already revealed uterus, fallopian tubes, spill on the peritoneum, reduce radiation dose, and the pain of patients. They used 3 cc and 7 cc of contrast media because the examination did not use fluoroscopy. The 3 cc of contrast media views the uterus only then 7 cc view the fallopian tube and its spill. HSG plays a crucial role to determine the cause of infertility, especially to evaluate the morphology and patency of the fallopian tubes in women so the radiology team should become familiar with examination techniques used, give the patient education to avoid movement, and hold their body motionless also taking a mild pain reliever before the HSG examination.

The use of complementary and alternative medicine and pain relievers among refugees resettled in the USA

Purpose The purpose of this study is to describe the use of complementary and alternative medicine (CAM), pain reliever use and the expectations refugees have of physicians about their practice of CAM use in the USA. Individuals with a refugee background are one of the populations who use CAM for treatment. However, to date, there is insufficient empirical evidence to describe CAM use among refugees resettled in the USA. In addition, collecting information about the use of pain relievers would help better understand the experiences of individuals with a refugee background. Design/methodology/approach Data was collected from August 2018 to November 2019 using a self- or interviewer-administered survey from 94 refugees 18 years of age or older who had settled in the USA. Findings This study found the following: CAM practice is very common among refugees resettled in the USA, most refugees use non-prescription pain medicine and refugees prefer to see physicians who understand CAM. This study contributes valuable findings in the usage of CAM among refugees and determines that CAM is commonly used among refugees resettled in the USA for pain management. Originality/value By better understanding CAM, physicians can address a direct need for the refugee population-seeking health care in the USA and other countries that host refugee resettlement.

HUBUNGAN PENGETAHUAN REMAJA PUTRI DENGAN PERAN ORANG TUA MENGENAI HOT HERBAL COMPRESS DI SMKK PRIMA INDONESIA

Painful menstruation is a symptomatic phenomenon, including abdominal cramps, backache and pain.The only traditional treatment Is Hot Herbal Compress. Hot Herbal Compress is a tool and material used as a hot compress which containseffect as a pain reliever and provide relaxation that comes from the aroma of these natural ingredients.Indonesian Health Demographic Survey (2017), 76% of adolescent experienced menstrual pain during menstruation, 58% of female adolescents who did not experience menstrual pain during menstruation. This study aims to determine therelationship between knowledge of adolescent with the role of parents regarding hot herbal compress to relieve painful menstruation. This type of analytic research with cross sectional approach. The sampling technique used purposive sampling involving 40 adolescent at SMKK Prima Indonesia and the results showed that most of the knowledge of adolescent about hot herbal compresses to relieve painful menstruation was less (52.5%) and based on the role of parents regarding hot herbal compresses. To relieve painful menstruation most did not participate (57.5%). There is a relationship between the knowledge of adolescent knowledge and the role of parents regarding hot herbal compresses to relieve painful menstruation at SMKK Prima Indonesia in 2020 with a p value = 0.000

Wild Honey Poisoning: A Case Report from Remote Mountains

Wild honey is consumed as a tonic in different parts of the world with a belief of increasing libido and treating various musculoskeletal, gastrointestinal and cardiovascular symptoms. However, honey produced from the nectar of several species of the Ericaceae (Rhododendron) family may contain grayanotoxins which act on sodium ion channels and place them in partially open state which causes symptoms like sweating, dizziness and altered sensorium owing to their effect on cardiac muscles and nervous system. We report a case of 60 years male who consumed wild honey as a pain reliever and later presented to the emergency room of Manang District Hospital with bradycardia, hypotension and altered mental status.

Alkaloid Cytotoxic Test on Ethanol Extract from Itchy Leaves (Laportea decumana (Roxb.) Wedd.)

The Itchy leaf [Laportea decumana (Roxb.) Wedd] is a plant that is widely used as traditional medicine by Papuans as a pain reliever. The purpose of this study was to determine the total level of alkaloids in itchy leaf extract and to test the cytotoxic activity using the BSLT method. The research series began with the extraction stage with the maceration method using 96% ethanol, which tested the alkaloid level. The test was carried out using the gravimetric method and the cytotoxic test using the alkaloid level test results using the BSLT method on shrimp larvae (Artemia salina L). The results showed that itchy leaf extract contained a total alkaloid level of 6.46%. Cytotoxic testing using the BSLT method showed an LC50 of 54.33 ppm and was found to be toxic.

Opioid Prescribing Mediating State Policy Intervention Effects on Drug Overdose Mortality

The Centers for Disease Control and Prevention reported 70 630 drug overdose deaths for 2019 in the United States, 70.5% of which were opioid-related. Preliminary estimates now warn that drug overdose deaths likely surpassed 86 000 during 2020. Despite a 57.4% decrease in opioid prescribing since a peak in 2012, the opioid death rate has increased 105.8% through 2019, as the share of those deaths involving fentanyl increased from 16.4% to 72.9%. This letter seeks to determine whether the opioid prescribing and mortality paradox is robust to accepted methods of causal policy analysis and if prescribing rates mediate the effects of policy interventions on overdose deaths. Using loge-loge ordinary least squares with three different specifications as sensitivity analyses for all 50 states and Washington, DC for the period 2001-2019, the elasticities from the regressions with all control variables report operational prescription drug monitoring programs (PDMPs) reduce prescribing rates 8.7%, while mandatory PDMPs increase death rates from opioids 16.6%, heroin and fentanyl 19.0%, cocaine 17.3% and all drugs 10.5%. There is also weak evidence that recreational marijuana laws reduce prescribing, increases in prescribing increase pain reliever deaths, pill mill laws increase cocaine deaths, and medical marijuana laws increase total overdose deaths, with demographic variables suggesting states with more male, less non-Hispanic white, and older citizens experience more overdoses. Weak mediation effects were observed for pain reliever, cocaine, and illicit opioid deaths, while broad reductions in prescribing have failed to reduce opioid overdoses.

Auswirkungen geburtshilflicher Analgesie mit systemischen Opioiden auf das Neugeborene – eine Übersichtsarbeit

Zusammenfassung Einleitung Dreiviertel aller Gebärenden erhalten während der Geburt eine Analgesie. Es stehen regionale und systemische Analgesieverfahren zur Verfügung. Diese Übersichtsarbeit analysiert die Datenlage zu den Auswirkungen einer geburtshilflichen Analgesie mit systemischen Opioiden auf das Neugeborene. Methoden Die Datenbanken PubMed und Cochrane Library wurden nach den folgenden Begriffen durchsucht: „Meptazinol“, „Meptid“, „analgesia“, „painkiller“, „pain reliever“, „obstetrics“, „labor“, „labour“, „delivery“, „neonate“, „newborn“, „child“, „baby“, „infant“, „fetus“, „fetal“, „opioid“ und „opiate“ sowie zusätzlich eine MeSH Terms Suche in PubMed durchgeführt. Ergebnisse Von 355 potenziell relevanten Studien wurden 23 Studien in diese Arbeit eingeschlossen. Die Studien variierten stark in Qualität, Stichprobengröße und Outcome-Kriterien. Das neonatale Outcome war häufig nur ein sekundärer Endpunkt. Selten wurden signifikante Unterschiede bezogen auf das Outcome der Neugeborenen zwischen den verschiedenen systemischen Opioiden oder im Vergleich zu Kontrollgruppen berichtet. In 12 Studien wurden die APGAR-Werte der Neugeborenen zwischen Behandlungsgruppen verglichen, wobei sich bei 10 (83%) dieser Studien keine Unterschiede zeigten. Diskussion/Ausblick Die Evidenzlage zu Auswirkungen geburtshilflicher Analgesie mit systemischen Opioiden ist insgesamt gering und Studien zum Langzeit-Outcome von Neugeborenen fehlen. Auch die Frage, ob eine postnatale Überwachung der Neugeborenen notwendig ist, kann nicht klar beantwortet werden. Studien mit prospektivem Studiendesign sollten durchgeführt werden.