Blind prescribing: a study of junior doctors' prescribing preparedness in an Australian emergency department.

Objectives: The present study examined junior residents' and registrars' preparedness to prescribe in an Australian ED. It measured the medication knowledge of participants and identified antecedent factors relevant to prescribing practice.

Methods: This is a prospective, exploratory study of the prescribing practices of 40 junior doctors.

Endogenous opioid analgesia in peripheral tissues and the clinical implications for pain control.

Opioid receptors are widely expressed in the central and peripheral nervous system as well as in numerous nonneuronal tissues. Both animal models and human clinical data support the involvement of peripheral opioid receptors in analgesia, particularly in inflammation where both opioid receptor expression and efficacy are increased. Immune cells have been shown to contain numerous opioid peptides such as beta-endorphin (END), met-enkephalin (ENK), and dynorphin-A (DYN), although the predominant opioid peptide involved in immune-cell mediated antinociception is thought to be END.

The effects of pH on beta-endorphin and morphine inhibition of calcium transients in dorsal root ganglion neurons.

Unlabelled: During inflammation, immune cells migrate into inflamed tissue and release opioid peptides that activate opioid receptors on peripheral sensory neurons to reduce pain. A characteristic of the inflamed environment in which these opioids act is acidic pH. Activation of opioid receptors leads to a decrease in the calcium component of neuronal action potentials.