• Journal of Korean Biological Nursing Science
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• 제19권1호
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• pp.18-29
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• 2017

Purpose: This study investigates the status of medication use of the elderly with chronic disease taking non-opioid analgesics and attempts to identify factors influencing medication adherence. Methods: Data were collected from September 1 to October 19, 2016. A structured questionnaire was used for face-to-face interview with a convenience sample of 161, elderly people with chronic disease taking non-opioid analgesics. The survey included questions about status of medication use, medication adherence, symptom experience, depression and family function. Data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson's correlation coefficients, and stepwise multiple regression with IBM SPSS 23.0 program. Results: The mean score of medication adherence of the elderly with chronic disease was $4.48{\pm}2.35$. Experiences of side effects (${\beta}=.31$, p< .001), use of over-the-counter pain medication (${\beta}=.19$, p= .009), and family function (${\beta}=.16$, p= .031) were identified as significant predictors. The final model explained 18.0% of the variation of medication adherence of the elderly with chronic disease taking non-opioid analgesics (F= 12.30, p< .001). Conclusion: Therefore, as a strategy to improve medication adherence of the elderly with chronic disease, therapeutic intervention should be developed to improve family function and to manage with personalized plans considering experiences of side effects and use of over-the-counter pain medication.

• The Korean Journal of Physiology
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• 제29권2호
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• pp.301-307
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• 1995

To explore electrophysiological properties of the ${\delta}-Opioid$ receptors artificially expressed in the mammalian cell, effect of an opioid agonist DPDPE $(1\;{\mu}M)$ on the voltage-sensitive outward currents was examined in the HEK293 (human embryonic kidney) cells transfected with ${\delta}-Opioid$ receptor cDNA cloned from NG-108-15 $(neuroblastoma\;{\times}\;glioma\;hybrid)$ cDNA library. Also studied were effects of 8-bromo-cyclic AMP and naloxone on DPDPE-induced changes in the voltage sensitive outward current. The voltage sensitive outward currents were recorded using perforated patch technique at room temperature. In the non-transformed HEK293 cells, DPDPE did not alter voltage sensitive outward current, indicating that no native ${\delta}-Opioid$ receptor had been developed. However, $(1\;{\mu}M)$ DPDPE remarkably increased the voltage sensitive outward current in the transformed HEK293 cells. The increment in voltage sensitive outward current peaked in $7{\sim}10\;minutes$ after DPDPE application, and the maximum DPDPE-activated outward current $(313.1{\pm}12.3\;pA)$ was recorded when the membrane potential was depolarized to +70mv. Following pretreatment of the transformed HEK293 cells with 1 mM 8-bromo-cyclic AMP, DPDPE failed to increase the voltage sensitive outward currents. On the other hand, naloxone completely abolished DPDPE-activated voltage sensitive outward current in the transformed HEK293 cells. The results of present study suggest that in the transformed HEK293 cells an activation of the ${\delta}-Opioid$ receptors by an opioid agonist DPDPE increases the voltage-sensitive potassium current as a result of decrement in cyclic AMP level.

• Journal of Hospice and Palliative Care
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• 제27권1호
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• pp.45-49
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• 2024

Purpose: This study investigated palliative care physicians' attitudes regarding social issues related to opioid use. Methods: An email survey was sent to 674 physicians who were members of the Korean Society for Hospice and Palliative Care (KSHPC). Results: Data from 66 physicians were analyzed (response rate, 9.8%). About 70% of participants stated that their prescribing patterns were not influenced by social issues related to opioid use, and 90% of participants thought that additional regulations should be limited to non-cancer pain. Under the current circumstances, pain education for physicians is urgently needed, as well as increased awareness among the public. Half of the respondents identified the KSHPC as the primary organization responsible for providing pain education. Conclusion: Palliative care physicians' prescribing patterns were not influenced by social issues related to opioid use, and these issues also should not affect cancer pain control.

• 한국응용약물학회:학술대회논문집
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• 한국응용약물학회 1994년도 춘계학술대회 and 제3회 신약개발 연구발표회
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• pp.305-305
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• 1994

It has been shown that there are several subtypes of $\kappa$ opioid receptor, We have evaluated the properties of non-${\mu}$, non-$\delta$ binding of 〔$^3$H〕DIP, a nonselective opioid antagonist, in rat cortex membranes. Binding to ${\mu}$ and $\delta$ sites was inhibited by the use of an excess of competing selective agonists (DAMGO, DPDPE) for these sites. (-)Ethylketocyclazocine(EKC) inhibited 〔$^3$H〕DIP binding with Ki. of 70 nM. However, arylacetamides (U69593 and U50488H) gave little inhibition. Also, we have examined the opioid modulation of K$\^$+/(30 mM)-induced histamine release in rat frontal cortex slices labeled with 1-〔$^3$H〕histidine. The 〔$^3$H〕histamine release from cortex slices was inhibited by EKC, a $\kappa$$_1$-and $\kappa$$_2$-agonist, in a concentration-dependent manner(10 to 10,000 nM). The IC$\sub$50/ of EKC was 107 ${\pm}$ 6 nM. However, the $\delta$ receptor selective agonists, DPDPE and deltorphine II, ${\mu}$ receptor agonists, DAMGO and TAPS, $\kappa$$_1$-agonists, U69593 and U50488H, and $\varepsilon$-agonist, ${\beta}$-endorphin, did not inhibit histamine release even in micromoiar dose, indicating that ${\mu}$, $\delta$ or $\kappa$$_1$ receptors are not involved. The concentration-response curve of EKC was shifted to right in the presence of naloxone (300 nM), a ${\mu}$ preferential antagonist, norbinaltorphimine(300 nM), a $\kappa$$_1$ preferential antagonist and bremazocine(1 nM), a $\kappa$$_1$-agonist and $\kappa$$_2$-antagonist. These results suggest that $\kappa$$_2$ opioid receptor regulates histamine release in the frontal cortex of the rat.

• 대한약리학회지
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• 제30권1호
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• pp.1-9
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• 1994

Opioid 수용체에는 ${\mu},\;{\delta}$ 그리고 ${\kappa}$의 세가지 주된 형이 존재함이 알려져 있는 바, 최근 수용체 동정 기법과 선택적인 약물의 개발로 인해 그 아류들이 존재함이 보고되고 있다. 그러나 Opioid ${\kappa}_{2-}$ 수용체의 기능에 대해서는 이 수용체에 있어서의 선택적인 효현제 또는 길항제가 밝혀져 있지 않으므로써 현재까지 잘 알려져 있지 않다. 본 연구에서는 백서 대뇌피질 세표막표본에 opioid ${\mu}$와 ${\delta}$ 수용체를 과량의 DAMGO와 DPDPE로 봉쇄한 후 수종 ${\kappa}$수용체 결합자의 $[^3H]\;idprenorpnine(DIP)$ 결합억제효과와 이에 대한 sodium과 $GTY{\gamma}S$의 영향을 관찰하여 이를 지표로 각 ligand의 수용체에서의 작용양상을 검토하여 이를 토대로 동일 표본에서 $[^3H]diprenorpnine[^3H]DIP$ 결합은 DIP, ethylketocyclazocine 그리고 bremazocine에 의해 효과적으로 억제되었으나, ${\kappa}_1$, 수용체 효현제인 U69593에 의해서는 억제되지 않았다. Opioid ${\kappa}_1$, 및 ${\kappa}_2$-수용체 효현제인 EKC의 Ki치는 배양액내 NaCl을 NMDG로 알려진 $GTP{\gamma}S\;100{mu}M$ 첨가에 의해 증가되었다. 그러나 Bremazocine과 DIP의 Ki치는 sodium 제거 또는 $GTP{\gamma}S\;100{mu}M$ 첨가에 의해 증가되었다. 그러나 Bremazocine과 DIP의 Ki치는 sodium 제거 또는 $GTP{\gamma}S$ 첨가에 의해 영향받지 않았다. $1-[^3H]\;histidine$을 미리 부하한 대뇌피질 절편에서 $30mM\;K^+$ 에 의한 $[^3H]\;histamine$의 유리는 (-)EKC에 의하여 영향받지 않았다. (-)EKC의 histamine유리 억제효과는 naloxone, norbinaltorpmine 또는 bremazocine에 의하여 각각 억제되었다. 본 실험 성적은 백서 대뇌피질에서 histamine의 유리는 이 부위에 존재하는 opioid ${\kappa}_2$-수용체에 의하여 조절됨을 시사한다.

• The Korean Journal of Pain
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• 제37권2호
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• pp.119-131
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• 2024

There are growing concerns regarding the safety of long-term treatment with opioids of patients with chronic non-cancer pain. In 2017, the Korean Pain Society (KPS) developed guidelines for opioid prescriptions for chronic non-cancer pain to guide physicians to prescribe opioids effectively and safely. Since then, investigations have provided updated data regarding opioid therapy for chronic non-cancer pain and have focused on initial dosing schedules, reassessment follow-ups, recommended dosage thresholds considering the risk-benefit ratio, dose-reducing schedules for tapering and discontinuation, adverse effects, and inadvertent problems resulting from inappropriate application of the previous guidelines. Herein, we have updated the previous KPS guidelines based on a comprehensive literature review and consensus development following discussions among experts affiliated with the Committee on Hospice and Palliative Care in the KPS. These guidelines may assist physicians in prescribing opioids for chronic non-cancer pain in adult outpatient settings, but should not to be regarded as an inflexible standard. Clinical judgements by the attending physician and patient-centered decisions should always be prioritized.

• 한국임상약학회지
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• 제31권2호
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• pp.115-124
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• 2021

Background: With an increase in the number of breast cancer survivors, greater importance is attached to health-related quality of life, particularly pain and symptom control. This study aimed to identify the factors that are associated with pain in cancer patients based on the patterns of prescribing opioid, non-opioid, and adjuvant analgesics. Methods: This analysis included new patients who had developed breast cancer between 2003 and 2012. The degree of pain was analyzed based on the socio-demographic (age, income quintile, number of hospitalizations, and duration of disease), indicator (Body Mass Index; BMI, Charlson Comorbidity Index; CCI, Cumulative Analgesic Consumption Score; CACS), operation (mastectomy, lymph node dissection), and therapy (chemotherapy, radiation therapy), as well as complication-related variable (lymphedema). Results: As for the patterns of prescribing analgesics by stages, non-opioid and opioid analgesics constituted 30.7 and 69.3%, respectively. The mean value and variance of CACS were 5.596 and 12.567, respectively. The factors that significantly affected the degree of pain were age (≥50; IRR: 1.848, 95% CI 1.564-2.184, p=0.000), income quintile (IRR: 0.964, 95% CI 0.938-0.991, p=0.008), BMI (≥ 25; IRR: 1.479, 95% CI 1.222-1.795, p=0.000), CCI (≥ 4; IRR: 1.649, 95% CI 1.344-2.036, p=0.000), and lymphedema (yes; IRR: 1.267, 95% CI 1.006-1.610, p=0.047). Conclusions: It is necessary to develop systematic and comprehensive pain control measures to improve the quality of life for breast cancer survivors, especially for those who are 50 years or older, lie in the lower-income quintile, have BMI of ≥25 and CCI score ≥ 4, or have lymphedema.

• Journal of Hospice and Palliative Care
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• 제26권4호
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• pp.185-189
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• 2023

Purpose: Limited research has been conducted on the prevalence of non-medical opioid use (NMOU) in Korean cancer patients who have received prescription opioids (PO). This study aimed to identify the potential proportion of NMOU in cancer patients who had been prescribed opioids in Korea. Methods: A retrospective cohort analysis was conducted on 14,728 patients who underwent cancer-related treatment between January 2009 and December 2019, using electronically collected data from a tertiary hospital in Korea. Information regarding the type and duration of opioid use was gathered. A detailed review of medical charts was carried out, focusing on patients who had been prescribed opioids for over 60 days beyond a 12-month period following the completion of their cancer treatment (long-term PO users). Results: Out of the 5,587 patients who were prescribed PO and followed up for at least 12 months, 13 cases of NMOU were identified, representing 0.23% of the patient population. Among the 204 long-term PO users, the rate was 6.37% (13/204). The most commonly misused opioids were oxycodone and fentanyl. For the group confirmed to have NMOU, the median duration of prescription was 1,327 days in total. Of the 13 patients diagnosed with NMOU, 9 reported withdrawal symptoms, 3 exhibited craving behavior for opioids, and 1 experienced both symptoms. Conclusion: This study found that 0.23% of cancer patients who had been prescribed opioids in Korea demonstrated NMOU. Despite this relatively low rate, careful monitoring is necessary to minimize the risk of NMOU in this population, especially among long-term PO users.

• The Korean Journal of Pain
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• 제30권1호
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• pp.18-33
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• 2017

As the treatment of chronic non-cancer pain gradually increases, clinicians have more opportunities to encounter opioid prescription. However, guidelines for prescribing opioids for chronic non-cancer pain have never been published in Korea. The present guidelines were prepared by reviewing various research data. In cases in which the data were insufficient, recommendations were presented following discussion among experts affiliated with the Opioids Research Group in the Korean Pain Society. The present guidelines may need to be continuously revised and amended as more clinical evidence is acquired.

• Advances in Traditional Medicine
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• 제7권4호
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• pp.390-394
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• 2007

The present study was conducted to evaluate the analgesic activity of ethanolic extract of Andrographis paniculata (AP) in mice. The analgesic investigations were carried out using the acetic acid-induced abdominal writhing and the hot-plate tests. It was demonstrated that intraperitoneal (i.p.) administration of the extract at a dose of 30, 100, 300, 500 mg/kg, produced significant inhibition of abdominal constriction induced with 0.6% (v/v) acetic acid in dosedependent manner. It also demonstrated that the extract produced significant dose-dependent increase in the time of latency to a discomfort reaction in the hot-plate model. In addition, the analgesic effect of the ethanolic extract of AP was significantly reversed by a non-specific opioid receptor antagonist, naloxone. These results indicate that AP has an analgesic effect that was mediated through opioid receptors.