Side Effects of mosunetuzumab-axgb injection: A Synthesis of Findings from 12 Studies

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Original Abstract of the Article

Major Research Findings

Opioid analgesics like morphine are commonly used to manage postoperative pain. However, these medications can lead to unwanted side effects such as nausea, vomiting, itching, and constipation. 6 , 3 , 4 , 11 , 9 . These side effects can negatively impact patients' quality of life and make it challenging to continue treatment.

Several studies have explored using opioid antagonists like naloxone in conjunction with opioids to minimize these side effects. Naloxone works by attaching to opioid receptors and counteracting the effects of opioids. 6 , 5 , 3 , 11 . Additionally, combining morphine with droperidol can lower the occurrence of nausea and vomiting. 2 .

Reasons for Side Effects

Opioid analgesics achieve their pain-relieving effects by attaching to opioid receptors in the brain. However, these opioid receptors are also involved in responses like nausea, vomiting, itching, and constipation. Therefore, these side effects are a possibility when taking opioid analgesics.

Common Side Effects

Nausea and Vomiting

Taking opioid analgesics can lead to side effects such as nausea and vomiting. 2 , 3 , 10 . This is believed to be due to opioids stimulating the nausea center in the brain. Combining morphine with droperidol can reduce the incidence of nausea and vomiting. 2 .

Itching

Opioid analgesics can cause side effects like itching. 3 , 9 . This is thought to result from opioids promoting the release of neurotransmitters like histamine. Using opioid antagonists such as naloxone in conjunction can alleviate itching. 5 , 9 .

Constipation

Opioid analgesics can lead to side effects like constipation. 8 . This is thought to be caused by opioids suppressing intestinal motility. Ensuring adequate hydration and consuming dietary fiber are crucial for preventing constipation.

Respiratory Depression

Opioid analgesics can cause respiratory depression because they suppress the respiratory center. 8 . Opioid antagonists such as naloxone can reverse respiratory depression.

Drowsiness

Taking opioid analgesics can cause side effects like drowsiness. 11 , 10 . This is believed to be due to opioids suppressing the activity of neurotransmitters in the brain. If you experience drowsiness, refrain from driving or operating dangerous machinery.

Countermeasures for Side Effects

Nausea and Vomiting

To mitigate nausea and vomiting, antiemetics like droperidol can be used in combination. 2 . Eating small meals frequently and staying hydrated are also effective strategies.

Itching

To alleviate itching, opioid antagonists such as naloxone can be used in combination. 5 , 9 . Cooling the affected area with a cold towel is also helpful.

Constipation

To prevent constipation, sufficient hydration and dietary fiber intake are crucial. Taking laxatives can also be beneficial.

Respiratory Depression

In case of respiratory depression, administering opioid antagonists like naloxone is necessary. 8 .

Drowsiness

To reduce drowsiness, the dosage of the opioid can be decreased or the dosing interval can be extended. Consuming stimulants like caffeine can also be effective. However, stimulants are addictive, so they should be taken under the guidance of a doctor.

Comparison Between Studies

Commonalities Between Studies

Many studies have demonstrated that opioid analgesics can cause side effects such as nausea, vomiting, itching, and constipation.

Differences Between Studies

Some studies have shown that using opioid antagonists like naloxone in conjunction can reduce opioid side effects. Nevertheless, the effectiveness of naloxone may vary depending on the specific opioid and the patient's condition.

Points to Note Regarding Application to Real Life

Opioid analgesics are widely employed to alleviate postoperative pain. However, these medications can cause side effects such as nausea, vomiting, itching, and constipation. When taking opioid analgesics, be mindful of these side effects and consult with your doctor if needed.

Limitations of Current Research

Research on opioid side effects is still not comprehensive. In particular, more investigation is required regarding the long-term effects of opioid antagonists like naloxone.

Future Research Directions

Further research is necessary to find more effective strategies for reducing opioid side effects. Additionally, the long-term impacts of opioid antagonists like naloxone need to be studied in greater detail.

Conclusion

Opioid analgesics are effective medications for relieving postoperative pain, but they can cause side effects such as nausea, vomiting, itching, and constipation. When taking opioid analgesics, be aware of these side effects and consult your doctor if necessary. Further research is needed to discover more effective methods for mitigating opioid side effects.

Literature analysis of 12 papers
Positive Content
10
Neutral Content
0
Negative Content
2
Article Type
11
1
1
1
12
1.

Epidural morphine with butorphanol in pediatric patients.

Author: LawhornC D, BrownR E

Side effect reduction

Butorphanol 40 micrograms/kg added to epidural morphine 80 micrograms/kg was found to be effective in decreasing the occurrence of side effects caused by neuraxial opioids in pediatric patients. The study involved 20 children between the ages of 2 and 17 years undergoing spinal, abdominal, or thoracic procedures.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

Patient-controlled analgesia with morphine and droperidol following caesarean section under spinal anaesthesia.

Author: RussellD, DuncanL A, FrameW T, HigginsS P, AsburyA J, MillarK

Reduced nausea
Reduced vomiting
Drowsiness

Droperidol, when added to morphine for patient-controlled analgesia (PCA) after caesarean section under spinal anesthesia, reduced the incidence of nausea and emesis. However, it also caused drowsiness in two patients, which limited the usefulness of the technique.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

3.

Comparison of intravenous nalbuphine infusion versus naloxone in the prevention of epidural morphine-related side effects.

Author: WangJ J, HoS T, TzengJ I

Postoperative pain management
Nausea and vomiting
Pruritus

This study compared the efficacy of nalbuphine and naloxone intravenous infusions in preventing epidural morphine-related side effects, such as nausea, vomiting, and pruritus.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Effects of prophylactic nalmefene on the incidence of morphine-related side effects in patients receiving intravenous patient-controlled analgesia.

Author: JoshiG P, DuffyL, ChehadeJ, WesevichJ, GajrajN, JohnsonE R

Reduces opioid-related side effects

This study was designed to determine the dose-response relation for nalmefene for the prevention of morphine-related side effects in patients receiving intravenous patient-controlled analgesia.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Epidural naloxone reduces pruritus and nausea without affecting analgesia by epidural morphine in bupivacaine.

Author: ChoiJ H, LeeJ, BishopM J

Preserved analgesia
Reduced side effects
None reported

Epidural naloxone reduced morphine-induced side effects in a dose-dependent fashion without reversal of the analgesic effect.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

Effect of combining naloxone and morphine for intravenous patient-controlled analgesia.

Author: SartainJames B, BarryJohn J, RichardsonChristopher A, BranaganHelen C

Reduced morphine side effects

This study investigated the effects of combining morphine and naloxone via patient-controlled analgesia (PCA) on morphine-related side effects. The combination of morphine and naloxone via PCA was found to decrease the incidence of side effects compared to morphine alone.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

7.

[Patient-controlled analgesia with lornoxicam in patients undergoing gynecological surgery].

Author: GongZ Y, YeT H, QinX T, YuG X, GuoX Y, LuoA L

Effective pain relief
Fewer adverse events

Lornoxicam provides an alternative to morphine or tramadol for the treatment of postoperative pain, with fewer adverse events.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : Chinese

8.

Management of opioid side effects in cancer-related and chronic noncancer pain: a systematic review.

Author: McNicolEwan, Horowicz-MehlerNathalie, FiskRuth A, BennettKyle, Gialeli-GoudasMaria, ChewPriscilla W, LauJoseph, CarrDaniel,

Constipation
Delirium
Myoclonus
Nausea
Pruritus
Respiratory depression
Sedation
Vomiting

This systematic review assessed the management of opioid side effects in cancer pain management and chronic noncancer pain. Well-designed trials are needed to provide evidence-based guidelines for managing opioid side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

9.

Effects of epidural naloxone on pruritus induced by epidural morphine: a randomized controlled trial.

Author: JeonY, HwangJ, KangJ, HanS, RheeK, OhY

Reduced pruritus severity

Continuous epidural infusion of naloxone combined with morphine is effective in reducing the incidence and severity of pruritus induced by epidural morphine.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

10.

Cognitive-affective and somatic side effects of morphine and pentazocine: side-effect profiles in healthy adults.

Author: RileyJoseph L, HastieBarbara A, GloverToni L, FillingimRoger B, StaudRoland, CampbellClaudia M

Cognitive side effects
Somatic side effects

This study examined the subjective effects of morphine and pentazocine on somatic and cognitive/affective side effects using questionnaires.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

11.

A small-dose naloxone infusion alleviates nausea and sedation without impacting analgesia via intravenous tramadol.

Author: JiaDong-Lin, NiCheng, XuTing, ZhangLi-Ping, GuoXiang-Yang

Reduced nausea
Reduced sedation
Reduced vomiting

A small dose of naloxone infusion reduced tramadol-induced side effects without reversing its analgesic effects in patients undergoing cervical vertebrae surgery.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

12.

Does adding low doses of oral naltrexone to morphine alter the subsequent opioid requirements and side effects in trauma patients?

Author: FarahmandShervin, AhmadiOmid, DehpourAhmadreza, KhashayarPatricia

Reduced nausea

Ultra-low-dose naltrexone combined with morphine does not alter opioid requirements in patients with extremity trauma but may reduce the risk of nausea.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

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