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https://www.readbyqxmd.com/read/29148351/opioid-prescribing-by-nurse-practitioners-in-medicare-part-d-impact-of-state-scope-of-practice-legislation
#1
Elissa Ladd, Casey Fryer Sweeney, Anthony Guarino, Alex Hoyt
Many state legislatures restrict nurse practitioner (NP) scope of practice as a way of addressing patient safety concerns. The purpose of this study was to investigate the influence of state NP scope of practice laws on the prescription of oxycodone and hydrocodone containing medications by NP and MD/DO/PA prescribers to Medicare Part D beneficiaries. Using the Medicare Part D public use file, we analyzed oxycodone and hydrocodone containing prescriptions per Medicare Part D beneficiary by prescriber type, NP state scope of practice, and geographic variables...
August 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29133240/prediction-of-human-cns-pharmacokinetics-using-a-physiologically-based-pharmacokinetic-modeling-approach
#2
Yumi Yamamoto, Pyry A Välitalo, Yin Cheong Wong, Dymphy R Huntjens, Johannes H Proost, An Vermeulen, Walter Krauwinkel, Margot W Beukers, Hannu Kokki, Merja Kokki, Meindert Danhof, Johan G C van Hasselt, Elizabeth C M de Lange
Knowledge of drug concentration-time profiles at the central nervous system (CNS) target-site is critically important for rational development of CNS targeted drugs. Our aim was to translate a recently published comprehensive CNS physiologically-based pharmacokinetic (PBPK) model from rat to human, and to predict drug concentration-time profiles in multiple CNS compartments on available human data of four drugs (acetaminophen, oxycodone, morphine and phenytoin). Values of the system-specific parameters in the rat CNS PBPK model were replaced by corresponding human values...
November 10, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29121034/the-impact-of-advanced-opioid-drugs-and-analgesic-adjuvants-on-murine-macrophage-oxygen-burst
#3
Michael Kozlowski, Katarzyna Nazimek, Magdalena Wąsik, Iwona Filipczak-Bryniarska, Krzysztof Bryniarski
Macrophages (Mf) are a versatile group of phagocytic cells responsible for fulfilling a variety of immune functions, most notably for mounting the initial anti-microbial response and for the clearance of cellular debris and apoptotic bodies. The key processes for fulfilling these functions include the production of reactive oxygen intermediates (ROIs) and nitric oxide (NO). Mf also express a variety of receptors, including opioid, serotonin, and norepinephrine receptors, and thus can react to various substances...
2017: Folia Medica Cracoviensia
https://www.readbyqxmd.com/read/29120973/acute-intoxications-and-fatalities-from-illicit-fentanyl-and-analogues-an-update
#4
Simona Pichini, Renata Solimini, Paolo Berretta, Roberta Pacifici, Francesco Paolo Busardò
Illicit fentanyl and its analogues are very dangerous synthetic opioids, with high abuse potential and severe adverse effects including coma and death. They are used as adulterants in street heroin, cocaine, and methamphetamine, or as heroin substitutes sold to unaware users with a high risk of overdoses. Fentanyl and its analogues have also been identified in counterfeit medicinal products, such as oxycodone, hydrocodone, and alprazolam tablets, or as components of speedball mixtures together with cocaine or other stimulants...
November 8, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/29114833/effect-of-a-single-dose-of-oral-opioid-and-nonopioid-analgesics-on-acute-extremity-pain-in-the-emergency-department-a-randomized-clinical-trial
#5
Andrew K Chang, Polly E Bijur, David Esses, Douglas P Barnaby, Jesse Baer
Importance: The choice of analgesic to treat acute pain in the emergency department (ED) lacks a clear evidence base. The combination of ibuprofen and acetaminophen (paracetamol) may represent a viable nonopioid alternative. Objectives: To compare the efficacy of 4 oral analgesics. Design, Settings, and Participants: Randomized clinical trial conducted at 2 urban EDs in the Bronx, New York, that included 416 patients aged 21 to 64 years with moderate to severe acute extremity pain enrolled from July 2015 to August 2016...
November 7, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29108405/gabapentin-given-before-laparoscopic-sleeve-gastrectomy-reduces-postoperative-oxycodone-consumption-in-obese-patients-a-randomized-double-blind-placebo-controlled-trial
#6
Anna Rupniewska-Ladyko, Małgorzata Malec-Milewska, Ewa Kraszewska, Michal Pirozynski
BACKGROUND: Post-operative pain can be prevented. Gabapentin may be effective in this role. Our primary objective was to test the hypothesis that a prophylactic administration of gabapentin in obese patients before surgery has an opioid-sparing effect and reduces postoperative oxycodone consumption more efficiently than placebo. METHODS: The study enrolled 113 patients undergoing laparoscopic sleeve-gastrectomy under general anesthesia. The patients were randomly allocated to the control or gabapentin group and received a single oral dose of gabapentin 1200 mg or a matching placebo 1 h before surgery...
November 6, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29101905/conversion-factors-for-assessment-of-driving-impairment-after-exposure-to-multiple-benzodiazepines-z-hypnotics-or-opioids
#7
Maren Cecilie Strand, Jørg Mørland, Lars Slørdal, Bettina Riedel, Cato Innerdal, Trond Aamo, Grete Mathisrud, Vigdis Vindenes
AIMS: Norway has introduced legal concentration limits in blood for 28 non-alcohol drugs in driving under the influence cases. As of 2016 this legislation also regulates the assessment of combined effects of multiple benzodiazepines and opioids. We herein describe the employed methodology for the equivalence tables for concentrations of benzodiazepines/z-hypnotics and opioids implemented in the Norwegian Road Traffic Act. METHODS: Legislative limits corresponding to impairment at blood alcohol concentrations (BAC) of 0...
October 20, 2017: Forensic Science International
https://www.readbyqxmd.com/read/29099060/clinical-pharmacogenetics-of-cytochrome-p450-associated-drugs-in-children
#8
Ida Aka, Christiana J Bernal, Robert Carroll, Angela Maxwell-Horn, Kazeem A Oshikoya, Sara L Van Driest
Cytochrome P450 (CYP) enzymes are commonly involved in drug metabolism, and genetic variation in the genes encoding CYPs are associated with variable drug response. While genotype-guided therapy has been clinically implemented in adults, these associations are less well established for pediatric patients. In order to understand the frequency of pediatric exposures to drugs with known CYP interactions, we compiled all actionable drug-CYP interactions with a high level of evidence using Clinical Pharmacogenomic Implementation Consortium (CPIC) data and surveyed 10 years of electronic health records (EHR) data for the number of children exposed to CYP-associated drugs...
November 2, 2017: Journal of Personalized Medicine
https://www.readbyqxmd.com/read/29098567/oxycodone-naloxone-prolonged-release-a-review-in-severe-chronic-pain
#9
Esther S Kim
Oral oxycodone/naloxone prolonged release (PR) [Targin(®), Targinact(®), Targiniq(®)] is a 12-hourly opioid receptor agonist and opioid receptor antagonist fixed-dose combination product that is approved in countries in the EU for the management of severe pain (adequately manageable only with opioid analgesics) in adults. Oral naloxone prevents oxycodone from binding to μ-receptors in the gastrointestinal (GI) tract, thereby counteracting opioid-induced constipation (OIC). In short-term (5- to 12-week) clinical trials of adults with moderate to severe, chronic pain and OIC (OXN3001, OXN3006, OXN3506), oxycodone/naloxone PR significantly improved OIC while providing noninferior analgesia relative to oxycodone PR; results were consistent between cancer and non-cancer patients in OXN3506...
December 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29084357/adverse-events-associated-with-medium-and-long-term-use-of-opioids-for-chronic-non-cancer-pain-an-overview-of-cochrane-reviews
#10
REVIEW
Charl Els, Tanya D Jackson, Diane Kunyk, Vernon G Lappi, Barend Sonnenberg, Reidar Hagtvedt, Sangita Sharma, Fariba Kolahdooz, Sebastian Straube
BACKGROUND: Chronic pain is common and can be challenging to manage. Despite increased utilisation of opioids, the safety and efficacy of long-term use of these compounds for chronic non-cancer pain (CNCP) remains controversial. This overview of Cochrane Reviews complements the overview entitled 'High-dose opioids for chronic non-cancer pain: an overview of Cochrane Reviews'. OBJECTIVES: To provide an overview of the occurrence and nature of adverse events associated with any opioid agent (any dose, frequency, or route of administration) used on a medium- or long-term basis for the treatment of CNCP in adults...
October 30, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29080523/fatal-poisonings-involving-propoxyphene-before-and-after-voluntary-withdrawal-from-the-united-states-market-an-analysis-from-the-state-of-florida
#11
Chris Delcher, Guanming Chen, Yanning Wang, Svetla Slavova, Bruce A Goldberger
The synthetic opioid propoxyphene was a schedule IV controlled substance with multiple reported health risks before the US Food and Drug Administration issued a request for voluntary market withdrawal in November 2010. The purpose of this study is to investigate the characteristics and occurrences of propoxyphene-related deaths in Florida before and after voluntary market removal. Decedent-level toxicology data from Florida's Medical Examiners Commission was used to compare the temporal, polysubstance use, sociodemographic, and geographic profiles associated with propoxyphene-involved deaths for a pre-withdrawal (November 2008-November 2010) and post-withdrawal (December 2010-December 2012) period...
October 14, 2017: Forensic Science International
https://www.readbyqxmd.com/read/29065039/opioid-prescribing-practices-by-orthopaedic-trauma-surgeons-after-isolated-femur-fractures
#12
Basem Attum, Andres Buitrago Rodriguez, Nichelle Harrison, Adam Evans, William Obremskey, Manish Sethi, Alex Jahangir
OBJECTIVE: The purpose of this retrospective study was to identify opioid prescribing practices, determine the number of morphine milliequivalents (MMEs) prescribed by orthopaedic/non-orthopaedic members to narcotic naive and previously exposed patients and provide narcotic prescribing recommendations. METHODS: Patients over 18 years old with an isolated femur fracture sustained between 2013 and 2015 were identified using the CPT code 27506. Prescribing information was obtained from the State Controlled Substance Monitoring Database (CSMD)...
October 14, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29061956/oxycodone-resistance-due-to-rifampin-use-in-an-osteosarcoma-patient-with-tuberculosis
#13
Akio Sakamoto, Manato Yamashita, Yuta Hori, Takeshi Okamoto, Atsushi Shimizu, Shuichi Matsuda
BACKGROUND Oxycodone is a semisynthetic opioid receptor agonist, and is frequently used for pain control in patients with cancer. Most oxycodone is metabolized by N-demethylation to noroxycodone by CYP3A. Rifampin is a strong inducer of several drug-metabolizing enzymes, including CYP3A. Hence, rifampin-induced CYP3A activity may decrease the effect of oxycodone. CASE REPORT Osteosarcoma is a highly aggressive primary bone tumor of childhood and adolescence. Here, we report a 30-year-old male with osteosarcoma of the femur with lung metastases in the upper lobe...
October 24, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29058837/-oxynorm%C3%A2-instant-versus-tradonal%C3%A2-odis-as-level-2-analgesic-in-an-emergency-service-a-monocentric-double-blind-randomized-non-inferiority-study
#14
C Van Brussel, Q Delefortrie, B Kerzmann, C Grégoire, J-F Adam
Pain is one of the most common reasons for consultation in the ER. As far as class II analgesics are concerned, tramadol is most usually used. According to some data from the literature, it would seem that oxycodone and tramadol are equivalent in terms of analgesia. We have tried to prove that oxycodone (Oxynorm® instant) is not less effective than tramadol (Tradonal® odis) in an emergency unit. This is a prospective, monocentric, randomized study carried out amongst ambulatory patients. Those included in the study were given 1 g of paracetamol and a weight-ajusted dose of either tramadol or oxycodone...
October 2017: Revue Médicale de Liège
https://www.readbyqxmd.com/read/29048960/twitter-based-detection-of-illegal-online-sale-of-prescription-opioid
#15
Tim K Mackey, Janani Kalyanam, Takeo Katsuki, Gert Lanckriet
OBJECTIVES: To deploy a methodology accurately identifying tweets marketing the illegal online sale of controlled substances. METHODS: We first collected tweets from the Twitter public application program interface stream filtered for prescription opioid keywords. We then used unsupervised machine learning (specifically, topic modeling) to identify topics associated with illegal online marketing and sales. Finally, we conducted Web forensic analyses to characterize different types of online vendors...
December 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/29048952/increasing-availability-of-illicit-and-prescription-opioids-among-people-who-inject-drugs-in-a-canadian-setting-2010-2014
#16
Joel Ho, Kora DeBeck, M-J Milloy, Huiru Dong, Evan Wood, Thomas Kerr, Kanna Hayashi
BACKGROUND: Nonmedical use of prescription opioid and illicit opioid has been increasing at an alarming rate in North America over the past decade. OBJECTIVE: We sought to examine the temporal trends and correlates of the availability of illicit and prescription opioids among people who inject drugs (PWID) in Vancouver, Canada. METHODS: Data were derived from three prospective cohort studies of PWID in Vancouver between 2010 and 2014. In semiannual interviews, participants reported the availability of five sets of illicit and prescription opioids: (1) heroin; (2) Percocet (oxycodone/acetaminophen), Vicodin (hydrocodone/acetaminophen), or Demerol (meperidine); (3) Dilaudid (hydromorphone); (4) Morphine; (5) oxycontin/OxyNEO (controlled-release oxycodone)...
October 19, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/29047196/to-what-extent-do-data-from-pharmaceutical-claims-under-estimate-opioid-analgesic-utilisation-in-australia
#17
Natasa Gisev, Sallie-Anne Pearson, Emily A Karanges, Briony Larance, Nicholas A Buckley, Sarah Larney, Timothy Dobbins, Bianca Blanch, Louisa Degenhardt
PURPOSE: Although pharmaceutical claims are an essential data source for pharmacoepidemiological studies, these data potentially under-estimate opioid utilisation. Therefore, this study aimed to quantify the extent to which pharmaceutical claims from Australia's national medicines subsidy programs (Pharmaceutical Benefits Scheme [PBS] and Repatriation Schedule of Pharmaceutical Benefits [RPBS]) under-estimate prescription-only and total national opioid utilisation across time and for different opioids...
October 19, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29046518/pretreatment-with-oxycodone-simultaneously-reduces-etomidate-induced-myoclonus-and-rocuronium-induced-withdrawal-movements-during-rapid-sequence-induction
#18
Xiaoxia An, Caixia Li, Zayd Sahebally, Xiaohong Wen, Bing Zhao, Xiangming Fang
BACKGROUND Etomidate and rocuronium are often paired in rapid-sequence anesthesia induction. However, the effect of pretreatment with oxycodone on myoclonic and withdrawal movements has not been previously investigated. The aim of this study was to evaluate the effects of oxycodone on the incidence and severity of etomidate-induced myoclonus and rocuronium-induced nociceptive withdrawal movements during rapid-sequence anesthesia induction. MATERIAL AND METHODS We randomly divided 120 patients into the saline group (group S) and the oxycodone group (group O) (n=60 in each group)...
October 19, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29041942/patient-reported-health-related-quality-of-life-work-productivity-and-activity-impairment-during-treatment-with-alo-02-extended-release-oxycodone-and-sequestered-naltrexone-for-moderate-to-severe-chronic-low-back-pain
#19
Arnold J Weil, Elizabeth T Masters, Alexandra I Barsdorf, Almasa Bass, Glenn Pixton, Jacquelyn G Wilson, Gernot Wolfram
BACKGROUND: The efficacy of ALO-02, an abuse-deterrent formulation containing extended-release oxycodone and sequestered naltrexone, in the treatment of chronic low back pain (CLBP) was studied in a 12-week randomized controlled trial. Primary efficacy endpoint results have been published previously (Rauck et al., 2015). The current paper focuses on patient-reported outcomes for health-related quality of life (HRQL), work productivity, and activity impairment that were assessed during this study...
October 17, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/29038236/efficacy-of-prophylactic-treatment-for-oxycodone-induced-nausea-and-vomiting-among-patients-with-cancer-pain-point-a-randomized-placebo-controlled-double-blind-trial
#20
Hiroaki Tsukuura, Masayuki Miyazaki, Tatsuya Morita, Mihoko Sugishita, Hiroshi Kato, Yuka Murasaki, Bishal Gyawali, Yoko Kubo, Masahiko Ando, Masashi Kondo, Kiyofumi Yamada, Yoshinori Hasegawa, Yuichi Ando
BACKGROUND: Although opioid-induced nausea and vomiting (OINV) often result in analgesic undertreatment in patients with cancer, no randomized controlled trials have evaluated the efficacy of prophylactic antiemetics for preventing OINV. We conducted this randomized, placebo-controlled, double-blind trial to evaluate the efficacy and safety of prophylactic treatment with prochlorperazine for preventing OINV. MATERIALS AND METHODS: Cancer patients who started to receive oral oxycodone were randomly assigned in a 1:1 ratio to receive either prochlorperazine 5 mg or placebo prophylactically, given three times daily for 5 days...
October 16, 2017: Oncologist
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