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Journal of Opioid Management

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https://www.readbyqxmd.com/read/29733100/does-nalbuphine-have-a-niche-in-managing-pain
#1
Mellar P Davis, Carlos Fernandez, Sally Regel, Mary Lynn McPherson
Nalbuphine has been commercially available for 40 years for the treatment of acute pain; few studies have centered on management of chronic pain. Nalbuphine unique pharmacology is an advantage in pain management. It is µ antagonist, partial κ agonist for G-proteins and beta-arrestin-2. Benefits are related to G-protein interactions resulting in less nausea, pruritus, and respiratory depression than morphine. At low doses, nalbuphine reduces side effects particularly respiratory depression without loss of analgesia when combined with potent opioids...
March 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29733099/long-term-opioid-users-with-chronic-noncancer-pain-assessment-of-opioid-abuse-risk-and-relationship-with-healthcare-resource-use
#2
Anna D Coutinho, Kavita Gandhi, Rupali M Fuldeore, Pamela B Landsman-Blumberg, Sanjay Gandhi
OBJECTIVE: Identify opioid abuse risk factors among chronic noncancer pain (CNCP) patients receiving long-term opioid therapy and assess healthcare resource use (HRU) among patients at elevated abuse risk. DESIGN: Data were obtained from an integrated administrative claims database. Classification and Regression Tree (CART) analysis identified risk factors potentially predictive of opioid abuse, which were used to classify the overall population into cohorts defined by levels of abuse risk...
March 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29733098/oxycodone-is-safe-and-effective-for-general-anesthesia
#3
Stefan Wirz, Richard K Ellerkmann, Martin Soehle, Christian-Dieter Wirtz
PURPOSE: In clinical practice, using different opioid analgesics is common during the induction and maintenance of general anesthesia and for postoperative analgesia. However, if the opioid analgesic could be limited to a single drug, we hypothesized that the risk of adverse drug interactions could be reduced, with fewer adverse effects. We examined the use of oxycodone as a single opioid in a well-defined cohort of orthopedic patients undergoing general anesthesia. METHODS: In this retrolective, monocentric investigation, we reviewed data from 83 patients who underwent general anesthesia and received intravenous oxycodone as the sole analgesic (0...
March 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29733097/the-effects-on-patient-retention-after-opioid-weaning-in-an-internal-medicine-residency-clinic
#4
Charles P Opperman, Melissa M Butler, Andrew K Stroud, Michael R Sun
A retrospective, cross-sectional study was completed on 220 patients to determine the effects of implementation of an aggressive policy to curb opioid misuse/abuse in an internal medicine residency clinic. Our findings suggest that the development of a clear and consistent protocol for approaching patients on chronic controlled substances, as well as the initiation of regular didactic sessions addressing chronic pain and pain management, led to a dramatic reduction in the number or opioid prescriptions written by our resident providers without much reduction in patient volume...
March 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29733096/does-familiarity-with-cdc-guidelines-continuing-education-and-provider-characteristics-influence-adherence-to-chronic-pain-management-practices-and-opioid-prescribing
#5
Jean C McCalmont, Kim D Jones, Robert M Bennett, Ronald Friend
OBJECTIVES: (1) To assess providers' experience and knowledge of chronic noncancer pain (CNCP) management. (2) To assess providers' utilization of the Centers for Disease Control and Prevention (CDC) 2016 Guideline for Prescribing Opioids for Chronic Pain. (3) To assess the influence of the 2016 CDC guideline on provider confidence in managing CNCP and adherence to the CDC recommendations. METHODS: A cross-sectional, web-based survey conducted with 417 Oregon prescribing providers, divided into three continuing medical education (CME) groups composed of minimal (0-3), moderate (4-10), and high (≥11) hours of training...
March 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29733095/assessment-of-outcomes-following-high-dose-opioid-tapering-in-a-veterans-healthcare-system
#6
Lauren Hundley, Shelley Spradley, Scott Donelenko
OBJECTIVE: To assess the impact of tapering of chronic high dose opioid therapy in veterans prompted by the implementation of the Opioid Safety Initiative in 2013. DESIGN: IRB and VA Office of Research and Development-approved retrospective, observational chart review. SETTING: North Florida/South Georgia Veterans Health System Patients: Veterans on high dose opioid therapy (≥300 mg of morphine equivalents per day) for chronic non-cancer pain as of 1/1/2012 with an opioid agreement discontinuation note documented in the medical record were included...
March 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29733094/safety-profile-of-intraoperative-methadone-for-analgesia-after-major-spine-surgery-an-observational-study-of-1-478-patients
#7
Lauren K Dunn, Sandeep Yerra, Shenghao Fang, Mark F Hanak, Maren K Leibowitz, Salome B Alpert, Siny Tsang, Marcel E Durieux, Edward C Nemergut, Bhiken I Naik
OBJECTIVE: To investigate the incidence of perioperative adverse events in patients receiving intravenous methadone for major spine surgery. DESIGN: Retrospective review of perioperative records from March 2011 and February 2016. SETTING: University of Virginia Healthsystem. PATIENTS: Adult patients undergoing elective spinal fusion of two or more levels. MAIN OUTCOME MEASURES: Incidence of respiratory depression, time to extubation, hypotension, hypoxemia, reintubation, cardiac complications, and death...
March 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29733093/the-parenteral-opioid-shortage-causes-and-solutions
#8
Hanna Hollingsworth, Chris Herndon
No abstract text is available yet for this article.
March 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29733092/sourcing-of-opioid-analgesics-for-nonmedical-use-are-veterinarians-the-latest-frontier
#9
Cayley Russell, Benedikt Fischer, Thiago M Fidalgo
No abstract text is available yet for this article.
March 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29508897/hydromorphone-use-for-acute-pain-misconceptions-controversies-and-risks
#10
REVIEW
Maryann Mazer-Amirshahi, Sergey Motov, Lewis S Nelson
Hydromorphone (HM) is a potent opioid analgesic that is commonly administered in the emergency department (ED) and other acute care settings, such as medical surgical wards. In recent years, there has been a significant increase in the ED administration of HM relative to other opioids. Although HM is an effective analgesic, its use has been commonly implicated in adverse drug events and medication errors. In addition, intravenous HM has potent euphoric effects that may contribute to its abuse liability. There are limited data regarding how acute parenteral administration of opioid analgesics in the setting of high rates of preexisting chronic opioid use (medical or nonmedical) may contribute to or reinforce addictive behavior, making the potential contribution of rising HM administration to subsequent prescription opioid abuse and overdose uncertain...
January 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29508896/oxycodone-naloxone-in-postoperative-pain-management-of-surgical-patients
#11
REVIEW
Ioannis D Gkegkes, Evelyn Eleni Minis, Christos Iavazzo
BACKGROUND: The role of analgesia is crucial in the management of postoperative pain. Different combinations of oral analgesics have been proposed in the past. The oxycodone/naloxone (OXN) combination is a recent addition and is being used by different surgical specialties. The aim of our study was to clarify the possible role, advantages, and disadvantages of OXN in the pain management of surgical patients. METHOD: The authors retrieved the included studies after performing a systematic search in PubMed and Scopus...
January 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29508895/a-snap-shot-of-patients-recall-attitudes-and-perceptions-of-their-pain-contracts-from-a-family-medicine-resident-outpatient-clinic
#12
Robinder Bahniwal, Jarrett Sell, Abdul Waheed
OBJECTIVE: Determine patient recall, attitudes, and perceptions of their pain contract in a family medicine resident out-patient clinic. DESIGN: A cross-sectional study design using a telephone survey to all eligible subjects who signed a hardcopy pain contract from August 29, 2014 to May 19, 2016 at a resident outpatient clinic. SETTING: Penn State Hershey Family and Community Medicine Residency clinic. PARTICIPANTS: All patients who signed a hardcopy pain contract at the practice site who met specific inclusion criteria...
January 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29508894/discharge-prescribing-of-enteral-opioids-after-initiation-as-a-weaning-strategy-from-continuous-opioid-infusions-in-the-intensive-care-unit
#13
Bridgette Kram, Kylie M Weigel, Michelle Kuhrt, Daniel L Gilstrap
OBJECTIVE: To evaluate the proportion of patients receiving a hospital discharge prescription for a scheduled enteral opioid following initiation as a weaning strategy from a continuous opioid infusion in the Intensive Care Unit (ICU). DESIGN: Retrospective, observational study. SETTING: Five adult ICUs at a large, quaternary care academic medical center. PATIENTS: Endotracheally intubated, opioid-naive adults receiving a continuous opioid infusion with a concomitant scheduled enteral opioid initiated...
January 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29508893/correlates-of-opiate-misuse-based-on-aberrant-urine-drug-tests-for-patients-on-chronic-opiate-therapy-in-a-safety-net-academic-primary-care-clinic
#14
Smita Bakhai, Bright Thilagar, Jessica L Reynolds, Kenneth E Leonard
OBJECTIVE: Determine correlates of opiate misuse based on urine drug test (UDT) among patients on chronic opiate therapy (COT) for chronic noncancer pain. DESIGN: A cross-sectional study. SETTING: Urban, academic clinic. PARTICIPANTS: UDT performed in 206 patients on COT for at least 3 months duration within a one-year period. Patients were classified based on UDT results: (1) Appearance of Opiate Adherence: Positive UDT for prescribed opiate and negative for illicit drugs and nonprescribed control substances; (2) Opiate Misuse; Overt nonadherence: (a) Positive UDT for illicit drugs and/or nonprescribed controlled substances AND positive or negative for prescribed opiates (b) Overdose; (3) Possible opiate nonadherence: Negative for prescribed opiates and negative for illicit and nonprescribed controlled substances...
January 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29508892/the-role-of-transdermal-compounding-in-opioid-safety
#15
Caitlin V Bucher, A J Day, Maria Carvalho
Since the number of prescriptions for opioid medications have continued to rise, there have been questions about the safety of using opioids in pain management. Traditionally, opioid analgesics were reserved for a few select conditions, such as terminal illness and surgery, but currently opioids have been readily prescribed for multiple conditions. The objective of this manuscript is to clarify the current state of opioid use and to discuss alternative transdermal analgesic therapies in pain management. Transdermal compounded medications are patient-specific and customizable to include different types of drugs, in various dosage strengths, that are to be delivered simultaneously in one application...
January 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29508891/a-rasch-analysis-of-the-current-opioid-misuse-measure-for-patients-with-chronic-pain
#16
Courtney Morris, Kathy E Green, Lilian L Chimuma
OBJECTIVE: Pilot study to assess psychometric indices of the Current Opioid Misuse Measure (COMM). DESIGN: Correlational. SETTING: Patients with varied chronic pain from a family healthcare center. PATIENTS: Inclusion criteria were over 21 years of age and prescribed opioids for any-origin noncancer pain; 46 patients were enrolled. OUTCOME MEASURE(S): The COMM, the Pain Self-Efficacy Questionnaire (PSE-Q), and the Patient Health Questionnaire-9 (PHQ-9) and a demographic -questionnaire...
January 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29508890/letter-to-the-editor-substance-use-disorder%C3%A2-substance-induced-disorder-clinics-for-pain-medication-addictions-and-addicted-patients-pains-futuristic-need-for-pain-physicians-sub-specializing-in-addiction-medicine
#17
LETTER
https://www.readbyqxmd.com/read/29308594/evaluating-the-abuse-potential-of-opioids-and-abuse-deterrent-opioid-formulations-a-review-of-clinical-study-methodology
#18
REVIEW
Beatrice Setnik, Kerri A Schoedel, Naama Levy-Cooperman, Megan Shram, Glenn C Pixton, Carl L Roland
With the development of opioid abuse-deterrent formulations (ADFs), there is a need to conduct well-designed human abuse potential studies to evaluate the effectiveness of their deterrent properties. Although these types of studies have been conducted for many years, largely to evaluate inherent abuse potential of a molecule and inform drug scheduling, methodological approaches have varied across studies. The focus of this review is to describe current "best practices" and methodological adaptations required to assess abuse-deterrent opioid formulations for regulatory submissions...
November 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/29308593/application-of-hot-melt-extrusion-technology-in-immediate-release-abuse-deterrent-formulations
#19
RANDOMIZED CONTROLLED TRIAL
Klaus Wening, Sebastian Schwier, Hans-J Stahlberg, Eric Galia
OBJECTIVE: Hot-melt extrusion (HME) technology has been used for manufacturing extended-release abuse-deterrent formulations (ADFs) of opioid-type analgesics with improved tamper-resistant properties. Our objective was to describe application of this technology to immediate-release (IR) ADFs. DESIGN: For development of a sample IR ADF (hydrocodone 10 mg/acetaminophen 325 mg) based on HME, feasibility studies were performed using different excipients. The formulation selected for further development was evaluated via in vitro test battery...
November 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/29308592/abuse-deterrent-features-of-an-extended-release-morphine-drug-product-developed-using-a-novel-injection-molding-technology-for-oral-drug-delivery
#20
REVIEW
Nikolaj Skak, Torben Elhauge, Jeffrey M Dayno, Karsten Lindhardt
OBJECTIVE: A novel technology platform (Guardian™ Technology, Egalet Corporation, Wayne, PA) was used to manufacture morphine abuse-deterrent (AD), extended-release (ER), injection-molded tablets (morphine-ADER-IMT; ARYMO® ER [morphine sulfate] ER tablets; Egalet Corporation), a recently approved morphine product with AD labeling. The aim of this article is to highlight how the features of Guardian™ Technology are linked to the ER profile and AD characteristics of morphine-ADER-IMT...
November 2017: Journal of Opioid Management
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