• The Korean Journal of Pain
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• v.7 no.1
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• pp.1-12
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• 1994

• Bulletin of the Korean Chemical Society
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• v.29 no.3
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• pp.656-662
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• 2008

Antagonists of the d -opioid receptor are effective in overcoming resistance against analgesic drugs such as morphine. To identify novel antagonists of the d -opioid receptor that display high potency and low resistance, we performed 3D-QSAR analysis using chemical feature-based pharmacophore models. Chemical features for d -opioid receptor antagonists were generated using quantitative (Catalyst/HypoGen) and qualitative (Catalyst/HipHop) approaches. For HypoGen analysis, we collected 16 peptide and 16 non-peptide antagonists as the training set. The best-fit pharmacophore hypotheses of the two antagonist models comprised identical features, including a hydrophobic aromatic (HAR), a hydrophobic (HY), and a positive ionizable (PI) function. The training set of the HipHop model was constructed with three launched opioid drugs. The best hypothesis from HipHop included four features: an HAR, an HY, a hydrogen bond donor (HBD), and a PI function. Based on these results, we confirm that HY, HAR and PI features are essential for effective antagonism of the d -opioid receptor, and determine the appropriate pharmacophore to design such antagonists.

• The Korean Journal of Pain
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• v.24 no.1
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• pp.7-12
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• 2011

Background: Adenosine has been shown to have a wide spectrum of unique pain-relieving effects in various clinical situations. The aim of this study was to investigate the effects of intraoperative adenosine infusion on acute opioid tolerance and opioid induced hyperalgesia induced by remifentanil in adult patients undergoing tonsillectomy. Methods: For this study, ninety patients were randomly allocated into groups that receive either adenosine (adenosine group) or saline (remifentnail group) intravenously under remifentanil based anesthesia and saline (sevoflurane group) under sevoflurane anesthesia. The patients in adenosine group received adenosine at dose of $80\;{\mu}g$/kg/min, and those in remifentnail group and sevoflurane group received an equal volume of saline 10 minutes after the induction of anesthesia until the end of surgery. Intraoperative evaluation included time weighted mean remifentanil dose, and postoperative evaluations included degree of pain severity at 1, 6, 12, and 24 hours, time to first postoperative requirement, and analgesic dose required during 24 hours after operation. Results: Time weighted mean remifentanil dose during intraoperative period in adenosine group was significantly lower than that of remifentnail group (P = 0.00). The first postoperative analgesic were required earlier in remifentanil group than sevoflurane group or adenosine group (P = 0.00). Pethidine requirement during 24 hours in sevoflurane group and adenosine group was significantly lower than that of remifentnail group (P = 0.00). The visual analog scale scores for pain in sevoflurane group and adenosine group were significantly lower than those of remifentnail group for 12 hours after operation (P = 0.00). Incidence of hypotension (P = 0.024) and number of ephedrine administered (P = 0.011) in adenosine group were significantly higher than those of sevoflurane group. Conclusions: The above results suggest that intraoperative adenosine infusion prevent acute opioid tolerance and opioid induced hyperalgesia induced by remifentanil.

• Korean Journal of Clinical Pharmacy
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• v.28 no.4
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• pp.279-284
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• 2018

Objective: To compare the analgesic effects and adverse drug reactions (ADRs) of fentanyl intravenous patient-controlled analgesia (ivPCA) with nefopam, a centrally acting analgesic agent with demonstrated opioid sparing activity, as compared to ketorolac in a tertiary teaching hospital. Methods: A retrospective evaluation of electronic medical records was conducted on patient records including either nefopam or ketorolac with opioid ivPCA for post-operative pain management in general surgery department from January to December 2014. The status of pain control and ADRs were collected. Results: Out of 6,330 general surgery cases, nefopam was given in 153 prescriptions (6.9%) and ketorolac in 81 prescriptions (3.6%). The level of pain control was not different between two groups (70.9% vs. 75.3%; p = 0.51), but ADRs were more frequently reported in nefopam group (9.8% vs. 2.5%; p < 0.05). New ADRs of hot flushes (n = 1) and paresthesia in hands (n = 1) were reported in nefopam group and they were unlisted in the approved package insert. No serious ADRs were reported in both groups. Conclusion: Our findings presented that nefopam showed a similar analgesic effect and higher ADR rates compared to ketorolac as an adjuvant to fentanyl iv PCA for post-operative pain management in general surgery patients in South Korea.

• Proceedings of the Korean Society of Applied Pharmacology
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• 1994.04a
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• pp.303-303
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• 1994

ICV infusion of morphine (MOR) produces strong analgesia in man and animals. The analgesic effect is thought to be mediated by the centrifugal inhibtory control, But neural mechanisms of the analgesic effect of ICV morphine are not well understood. For example, in the previous studies, ICV morphine does not inhibit nociceptive transmission in the spinal cord. On the contrary, ICV MOR often excites activity of dorsal horn neuron in the spinal cord. In the present study, we found that ICV MOR had dust actions on activity of dorsal horn neuron that it produced both inhibition and excitation of dorsal horn neurons. Since MOR exerts i Is action via three different types of opioid receptors, we further sought to investigate if there are differential effects of opioid receptor agonists on dorsal horn neurons when administered ICV.

• Advances in Traditional Medicine
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• v.7 no.4
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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.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.6
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• pp.449-454
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• 2012

Purpose: Intravenous sedation with midazolam is common in contemporary dentistry. That is effective for anxious patients, but additional analgesic agent needs to be used, because midazolam alone doesn't have an analgesic effect. This study was performed to select an analgesic agent between an opioid agent, and nonsteroidal anti-inflammatory drugs as adjunctives in intravenous sedation with midazolam. Methods: The subjects were 60 patients who visited the Department of Oral and Maxillofacial Surgery, Sacred Heart Hospital, Hallym University, between August 2009 and February 2010. Conscious sedation was performed on 20 patients of 3 groups (control group, ketorolac group, and fentanyl group), who were divided randomly. The analgesic agent was administrated preoperatively. For sedation, vital signs were recorded. After sedation and operation, subjective questionnaires of the patient and operator were implemented. Results: All of the $SPO_2$, blood pressure, and heart rates stayed within the normal range for sedation. The sedation depth and analgesic effect of the ketorolac group and fentanyl group were similar. In the case of sedation depth, 12 patients in the ketorolac group and 14 patients in the fentanyl group had no memory of surgery. In the case of analgesic effect, the visual analogue scale of pain scored 2~3 in 13 patients in the ketorolac group, and 0~2 in 12 patients in the fentanyl group. The satisfaction of patients and doctors was also similar. Conclusion: Considering the management and complication of an opioid agent, non-steroidal anti-inflammatory drugs is more effective than an opioid agent.

• The Korean Journal of Pain
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• v.37 no.1
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• pp.41-50
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• 2024

Background: Recognizing the seriousness of the misuse and abuse of medical narcotics, the South Korean government introduced the world's first narcotic management system, the Narcotics Information Management System (NIMS). This study aimed to explore the recent one-year opioid prescribing patterns in South Korea using the NIMS database. Methods: This study analyzed opioid prescription records in South Korea for the year 2022, utilizing the dispensing/administration dataset provided by NIMS. Public data from the Korean Statistical Information Service were also utilized to explore prescription trends over the past four years. The examination covered 16 different opioid analgesics, assessed by the total number of units prescribed based on routes of administration, type of institutions, and patients' sex and age group. Additionally, the disposal rate for each ingredient was computed. Results: In total, 206,941 records of 87,792,968 opioid analgesic units were analyzed. Recently, the overall quantity of prescribed opioid analgesic units has remained relatively stable. The most prescribed ingredient was oral oxycodone, followed by tapentadol and sublingual fentanyl. Tertiary hospitals had the highest number of dispensed units (49.4%), followed by community pharmacies (40.2%). The highest number of prescribed units was attributed to male patients in their 60s. The disposal rates of the oral and transdermal formulations were less than 0.1%. Conclusions: Opioid prescription in South Korea features a high proportion of oral formulations, tertiary hospital administration, pharmacy dispensing, and elderly patients. Sustained education and surveillance of patients and healthcare providers is required.

• Natural Product Sciences
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• v.17 no.4
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• pp.303-308
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• 2011

Spirodela polyrrhiza L. Schleid. (Lemnaceae), also known as 'duckweed', is a traditional medicine in Korea. The whole plant is used to treat many diseases, including the common cold, edema, acute nephritis, and urticaria. The present study investigated antinociceptive properties of the EtOAc soluble fraction of S. polyrrhiza (ESP). The antinociceptive activities of ESP were studied using experimental models of pain, including thermal nociception methods, such as the tail immersion test and the hotplate test. Moreover, we studied chemical nociception induced by intraperitoneal acetic acid and subplantar formalin in mice. ESP exhibited dose-dependent antinociceptive activity in both thermal and chemical pain models. In a drug combination test using the opioid receptor antagonist naloxone, diminished analgesic activities of ESP were observed, indicating that the antinociceptive activity of ESP is mediated by opioid receptors.

• Journal of Dairy Science and Biotechnology
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• v.24 no.2
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• pp.21-24
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• 2006

The ubiquitous presence of lactoferrin(LF) receptor in human as reported by the research group of Prof. Bo Lonnerdal, Univ. California (Suzuki, Y. A.,2001) encouraged us to search for the unknown physiological roles of Lf. Under the collaboration with Prof. Etsumori Harada, Tottori Univ., and his research group, we have found two novel biological activities of LF as the control of the lipid metabolism and the effect on the central nervous system. Relating to the lipid metabolism, LF could, in animal experiments, reduce triglyceride and total cholesterol both in blood and liver (Takeuchi, T et αl., 2003). LF increased plasms HDL-C and lowered LDL-C. In the central nervous system, LF showed anti-nociceptive activity mediated by ${\mu}$-opioid receptor in the rat spinal cord (Hayashida, K. et al., 2003). LF enhanced analgesic action of morphine synergistically via nitric oxide synthesis (Hayashida, K., et al., 2003) LF showed opioid-mediated suppressive effect on distress induced by maternal separation in rat pups (Takeuchi, T., et al., 2003).