Thesis (M.S.)--University of Michigan, 1982.

Thesis (M.S.)--Michigan State University. Dept. of Large Animal Clinical Sciences, 2008. / "The objectives of this study were to determine the effects of tramadol on behavior, heart rate, respiratory rate, and locomotion and to assess the effect of tramadol on the response to a thermal cutaneous stimulus"--From abstract. Title from PDF t.p. (viewed on July 24, 2009) Includes bibliographical references. Also issued in print.

Thesis (M.S.)--University of Michigan, 2003. / Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 1982.

Thesis (Ph. D. (Pharmacy))--Rhodes University, 2005.

Ph.D.

OBJECTIVE: To study the association between benzodiazepine prescribing patterns including dose, type and dosing schedule and the risk of drug overdose death among US veterans receiving opioid analgesics. DESIGN: Case-cohort study SETTING: Veterans Health Administration (VHA), 2004 through 2009. PARTICIPANTS: US veterans, primarily male, who received opioid analgesics between 2004 and 2009. All veterans who died of a drug overdose (n = 2,400) while receiving opioid analgesics and a random sample of veterans (n = 420,386) who received VHA medical services and opioid analgesics were included in the study. Main outcome measure: Drug overdose death, defined as any intentional, unintentional or indeterminate poisoning death caused by any medication or drug, determined by cause of death information from the National Death Index. RESULTS: Twenty seven percent of veterans who received opioid analgesics also received benzodiazepines during the study period. Approximately half of the drug overdose deaths (n=1,185) occurred when veterans were concurrently prescribed benzodiazepines and opioids. Risk of drug overdose death increased based on benzodiazepine prescription history: formerly prescribed vs. not prescribed (adjusted hazard ratio [HR]=2.33, 95% confidence interval [CI]: 2.05-2.64); currently prescribed vs. not prescribed (HR=3.86, CI:3.49-4.26). Risk of drug overdose death increased as daily benzodiazepine dose increased. When compared to clonazepam, temazepam was associated with a decreased drug overdose death risk (HR=0.63, CI: 0.48-0.82). Benzodiazepine dosing schedule was not associated with drug overdose death risk. CONCLUSIONS: Among veterans receiving opioid analgesics, receipt of benzodiazepines was associated with an increased risk of drug overdose death in a dose-response fashion.

Orientador: Stélio Pacca Loureiro Luna / Banca: Antonio José de Araújo Aguiar / Banca: Carlos Augusto Araújo Valadão / Banca: Suzane Lilian Beier / Banca: Juliana Tabarelli Brondani / Resumo: O uso de analgésicos em animais é justificado moral e cientificamente. Para tal, é necessário que os profissionais saibam reconhecer e tratar a dor de forma adequada em animais. Objetivou-se correlacionar diversos dados demográficos para obter o perfil do médico veterinário brasileiro de grandes e pequenos animais. O questionário da pesquisa foi composto por: dados pessoais, utilização de fármacos analgésicos, analgesia, conduta no alívio da dor, uso de analgésicos em diversos procedimentos de grandes e pequenos animais, avaliação da dor e atualizações. A estatística foi realizada pelo programa SAS for Windows versão 9.1.3 com estatística descritiva com análise de frequência. Para as comparações simples foi utilizado o teste de qui-quadrado (x2). Foram obtidos 1.298 questionários de pequenos animais e 713 de grandes. Mulheres e profissionais graduados havia menos de dez anos conferiram maiores escores de dor que homens e profissionais formados havia mais de dez anos, porém a duração do tratamento não diferiu entre os gêneros. Os opioides mais utilizados para a analgesia foram tramadol (79%) e morfina (50,5%), em cães e gatos, e butorfanol (43,4%) e tramadol (39%) em grandes animais. Os efeitos adversos mais reportados dos opioides em gatos foram depressão respiratória e excitação. Em cães os principais efeitos adversos assinalados foram depressão respiratória e êmese. Para grandes animais, as preocupações com o uso desses fármacos foram: risco de excitação e síndrome cólica equina. Mais de 50% dos veterinários não utilizava opioides em bovinos. Os anti-inflamatórios não esteroidais (AINEs) mais escolhidos para pequenos animais foram meloxicam (81%) e cetoprofeno (70,4%), e flunixin meglumine (83,2%) e cetoprofeno (67,6%) em grandes animais. Os efeitos... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The use of analgesics in animals is morally and scientifically justified. According to that, the professionals should know how to recognize and treat pain in animals. The aim of this study was to correlate the demographic data of the Brazilian veterinarians, with the use of analgesics, the factors that affected the decision on the use of analgesia, attitudes, knowledge and methods of obtaining information on the evaluation and treatment of pain in animals. The questionnaire was composed of demographics, personal data, use of analgesics in general and specific procedures, analgesia, attitudes in the assessment and relief of pain and types of information in the area. The descriptive statistics with frequency analysis was performed using SAS for Windows 9.1.3. Chi-square (x2) for simple comparisons test was used. Questionnaires were obtained from 1298 small and 713 large animal veterinarians. Women and veterinarians graduated for less than ten years attributed higher pain scores than men, and veterinarians graduated for over ten years, but the frequency and duration of analgesic treatment did not differ between gender. The most commonly used opioid for analgesia of small animals were tramadol (79%) and morphine (50.5%) for dogs and cats, and butorphanol (43.4%) and tramadol (39%) for large animals. The most important side effects of opioids in small animals were respiratory depression and excitement, for cats and emesis in dogs and excitement and colic syndrome in 4 horses. NSAIDs of choice for small animals were meloxicam (81%) and ketoprofen (70.4%) and for large animals, flunixin meglumine (83.2%) and ketoprofen (67.6%). Side effects of NSAIDs most frequently reported for all species were gastric changes and nephrotoxicity. The most important limiting factors for the use of NSAIDs and opiods were the side effects for horses and the cost for cattles. The cats received lower pain... (Complete abstract click electronic access below) / Doutor

Made available in DSpace on 2014-06-11T19:27:25Z (GMT). No. of bitstreams: 0 Previous issue date: 2012-02-22Bitstream added on 2014-06-13T19:56:09Z : No. of bitstreams: 1 almeida_mr_me_botfm.pdf: 222592 bytes, checksum: 05b672385b2d5a4637d5ffd83bfcfbc3 (MD5) / Avaliaram-se os efeitos analgésicos de morfina e/ou cetamina em 24 cadelas hígidas com peso de 11,01± 8,69 kg e idade de 27±17 meses, submetidas à ovariosalpingohisterectomia (OSH) eletiva. Os animais foram tratados imediatamente após a indução anestésica com: morfina (GM, n=8, 0,5 mg/kg IM), cetamina (GC, n=8, 2,5 mg/kg IM) ou morfina associada à cetamina nas mesmas doses anteriores. Avaliou-se o escore de sedação e a dor de forma encoberta (cega) por meio de escala analógica visual (EAV) e Escala de Glasgow Modificada (EGM), às duas horas antes do procedimento cirúrgico e 1, 2, 4, 8,12 e 24 horas após a extubação. Os resgates analgésicos foram realizados com morfina 1 mg/kg e caso não suficiente, no momento seguinte, com meloxicam 0,2 mg/kg, ambos IM, quando a pontuação da EGM atingisse 33% do valor total. Para as variáveis nãoparamétricas utilizou-se o teste de Friedman seguido de Dunn, para avaliar as diferenças de cada grupo ao longo do tempo, o teste de Kruskal-Wallis seguido de Dunn para avaliar as diferenças entre os grupos em cada momento e o número de resgates analgésicos. Para as variáveis paramétricas, utilizou-se o ANOVA seguido do teste de Tukey, todos com 5% de significância. Exceto para EGM onde os valores em GM foram superiores à GCM à 1h, não houve outras diferenças entre os grupos. O número de resgates analgésicos foi superior em GM, já que todos animais necessitaram resgate em 11 ocasiões. Apenas um animal do GC e dois do GCM necessitaram de dois e três resgates respectivamente. A analgesia oferecida pela administração pré-incisional de cetamina foi mais efetiva do que a oferecida pela morfina e este fármaco pode ser utilizado para analgesia preemptiva em cadelas submetidas à OSH / The aim of this study was to evaluate the analgesic effects of morphine and/or ketamine in 24 healthy bitches, weighing 11.01± 8.69 kg and aging 27±17 months, submitted to elective ovariohysterectomy. The animals were submitted one of the three treatments after the anaesthetic induction: morphine (GM, n=8, 0,5 mg/kg IM), ketamine (GC, n=8, 2.5 mg/kg IM) or ketamine combined to morphine using the same doses described previously. Sedation score and pain assessment was performed blindly before surgery and at 1, 2, 4, 8,12 and 24 hours after extubation, using the visual analogue scale and Glasgow modified pain scale (GMPS). Rescue analgesia was performed with morphine 1 mg/kg and of not sufficient followed by meloxicam 0.2 mg/kg, both IM, when the GMPS reached 33% of the total score. Parametric data were analysed using Friedman´s test followed by Dunn´s test for differences in time. Kruskal-Wallis´ followed by Dunn´s test were performed to investigate differences in number of analgesic rescues and between groups at each time. Paramentric data were evaluated by ANOVA followed by Tukeys´s test, with 5% of statistical significance. Except for GMPS, where the values of GM were greater than for GCM at 1h post-operatively, there wrere no other differences between groups. The number of rescue analgesia was greater in GM, as all animals needed rescue analgesia in 11 occasions, while only one dog from GC and two from GCM needed two and three analgesic rescues respectively. Analgesia provided by pre-incisional ketamine was more effective when compared to morphine. According to that ketamine alone may be used as a preemptive analgesic in bitches undergoing ovariohysterectomy

Orientador: Stelio Pacca Loureiro Luna / Banca: Juliana Tabarelli Brondani / Banca: Silvia Renata Gaido Cortopassi / Resumo: Avaliaram-se os efeitos analgésicos de morfina e/ou cetamina em 24 cadelas hígidas com peso de 11,01± 8,69 kg e idade de 27±17 meses, submetidas à ovariosalpingohisterectomia (OSH) eletiva. Os animais foram tratados imediatamente após a indução anestésica com: morfina (GM, n=8, 0,5 mg/kg IM), cetamina (GC, n=8, 2,5 mg/kg IM) ou morfina associada à cetamina nas mesmas doses anteriores. Avaliou-se o escore de sedação e a dor de forma encoberta (cega) por meio de escala analógica visual (EAV) e Escala de Glasgow Modificada (EGM), às duas horas antes do procedimento cirúrgico e 1, 2, 4, 8,12 e 24 horas após a extubação. Os resgates analgésicos foram realizados com morfina 1 mg/kg e caso não suficiente, no momento seguinte, com meloxicam 0,2 mg/kg, ambos IM, quando a pontuação da EGM atingisse 33% do valor total. Para as variáveis nãoparamétricas utilizou-se o teste de Friedman seguido de Dunn, para avaliar as diferenças de cada grupo ao longo do tempo, o teste de Kruskal-Wallis seguido de Dunn para avaliar as diferenças entre os grupos em cada momento e o número de resgates analgésicos. Para as variáveis paramétricas, utilizou-se o ANOVA seguido do teste de Tukey, todos com 5% de significância. Exceto para EGM onde os valores em GM foram superiores à GCM à 1h, não houve outras diferenças entre os grupos. O número de resgates analgésicos foi superior em GM, já que todos animais necessitaram resgate em 11 ocasiões. Apenas um animal do GC e dois do GCM necessitaram de dois e três resgates respectivamente. A analgesia oferecida pela administração pré-incisional de cetamina foi mais efetiva do que a oferecida pela morfina e este fármaco pode ser utilizado para analgesia preemptiva em cadelas submetidas à OSH / Abstract: The aim of this study was to evaluate the analgesic effects of morphine and/or ketamine in 24 healthy bitches, weighing 11.01± 8.69 kg and aging 27±17 months, submitted to elective ovariohysterectomy. The animals were submitted one of the three treatments after the anaesthetic induction: morphine (GM, n=8, 0,5 mg/kg IM), ketamine (GC, n=8, 2.5 mg/kg IM) or ketamine combined to morphine using the same doses described previously. Sedation score and pain assessment was performed blindly before surgery and at 1, 2, 4, 8,12 and 24 hours after extubation, using the visual analogue scale and Glasgow modified pain scale (GMPS). Rescue analgesia was performed with morphine 1 mg/kg and of not sufficient followed by meloxicam 0.2 mg/kg, both IM, when the GMPS reached 33% of the total score. Parametric data were analysed using Friedman's test followed by Dunn's test for differences in time. Kruskal-Wallis' followed by Dunn's test were performed to investigate differences in number of analgesic rescues and between groups at each time. Paramentric data were evaluated by ANOVA followed by Tukeys's test, with 5% of statistical significance. Except for GMPS, where the values of GM were greater than for GCM at 1h post-operatively, there wrere no other differences between groups. The number of rescue analgesia was greater in GM, as all animals needed rescue analgesia in 11 occasions, while only one dog from GC and two from GCM needed two and three analgesic rescues respectively. Analgesia provided by pre-incisional ketamine was more effective when compared to morphine. According to that ketamine alone may be used as a preemptive analgesic in bitches undergoing ovariohysterectomy / Mestre