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Rebecca McDonald, Nancy D Campbell, John Strang
BACKGROUND: Opioid overdose is a major cause of mortality, but injury and fatal outcomes can be prevented by timely administration of the opioid antagonist naloxone. Pre-provision of naloxone to opioid users and family members (take-home naloxone, THN) was first proposed in 1996, and WHO Guidelines were issued in 2014. While widespread in some countries, THN is minimally available or absent elsewhere. This review traces the development of THN over twenty years, from speculative harm reduction proposal to public health strategy...
May 25, 2017: Drug and Alcohol Dependence
George K Avetian, Phillip Fiuty, Silvana Mazzella, Dave Koppa, Vivian Heye, Pratibha Hebbar
OBJECTIVE: Naloxone hydrochloride, an opioid antagonist, has been approved as a concentrated 4 mg dose intranasal formulation for the emergency treatment of known or suspected opioid overdose. This new formulation is easier to use and contains a higher dose of naloxone compared with earlier, unapproved kits. A survey of first responders and community-based organizations was conducted to understand initial real-world experiences with this new formulation for opioid overdose reversal...
June 7, 2017: Current Medical Research and Opinion
John F Kelly, Nilo Fallah-Sohy, Julie Cristello, Brandon Bergman
BACKGROUND: Opioid overdose deaths have become a major public health crisis. While efforts have focused mostly on helping opioid-addicted individuals directly, family members suffer also from the grave and enduring unpredictability associated with opioid addiction and often play a vital role in helping addicted loved ones access care. Little is known, however, about resources to help affected family members. Here we describe results from the first quantitative and qualitative investigation of a free and growing support organization for family members of addicted individuals ("Learn to Cope" [LTC]; www...
February 17, 2017: Journal of Substance Abuse Treatment
Gyanendra Acharya, Sunil Mehra, Ronakkumar Patel, Simona Frunza-Stefan, Harmanjot Kaur
Bariatric surgery is well established in reducing weight and improving the obesity-associated morbidity and mortality. Hyperammonemic encephalopathy following bariatric surgery is rare but highly fatal if not diagnosed in time and managed aggressively. Both macro- and micronutrients deficiencies play a role. A 42-year-old Hispanic female with a history of Roux-en-Y Gastric Bypass Procedure was brought to ED for progressive altered mental status. Physical exam was remarkable for drowsiness with Glasgow Coma Scale 11, ascites, and bilateral pedal edema...
2016: Case Reports in Critical Care
(no author information available yet)
No abstract text is available yet for this article.
January 4, 2016: Medical Letter on Drugs and Therapeutics
Katherine Harmon, Amy Ising, Scott Proescholdbell, Clifton Barnett, Steve Marshall, Anna Waller
STATEMENT OF PURPOSE: The NC Division of Public Health, in collaboration with UNC Chapel Hill, is improving injury surveillance data as part of the NC Surveillance Quality Improvement (SQI) Project. The project has focused on improving emergency department (ED) data in the statewide public health surveillance system NC DETECT. Unlike statewide mortality and hospital discharge data, NC DETECT ED data are available in near real time with over 75% of ED visits assigned at least one billing code within two weeks of the visit...
April 2015: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
Mark Faul, Michael W Dailey, David E Sugerman, Scott M Sasser, Benjamin Levy, Len J Paulozzi
OBJECTIVES: We determined the factors that affect naloxone (Narcan) administration in drug overdoses, including the certification level of emergency medical technicians (EMTs). METHODS: In 2012, 42 states contributed all or a portion of their ambulatory data to the National Emergency Medical Services Information System. We used a logistic regression model to measure the association between naloxone administration and emergency medical services certification level, age, gender, geographic location, and patient primary symptom...
July 2015: American Journal of Public Health
(no author information available yet)
No abstract text is available yet for this article.
September 2014: Rhode Island Medical Journal
Matthew Zuckerman, Stacy N Weisberg, Edward W Boyer
No abstract text is available yet for this article.
January 2015: Prehospital Emergency Care
(no author information available yet)
No abstract text is available yet for this article.
April 2014: Rhode Island Medical Journal
Shiayin Yang, Youngsook Yoon
SESSION TYPE: Critical Care Student/Resident Case Report Posters IIPRESENTED ON: Tuesday, October 23, 2012 at 01:30 PM - 02:30 PMINTRODUCTION: Intensive care patients often have multiple comorbidities and very complex treatment plans. Pinpointing an exact precipitating factor responsible for a patient's rapid health decline is difficult. Late or inappropriate identification can further complicate the picture. Swift action and maintaining a broad differential is paramount in order to correctly identify the cause and treat appropriately...
October 1, 2012: Chest
Peter C Britton, Amy S B Bohnert, James D Wines, Kenneth R Conner
OBJECTIVE: The purpose of this study is to develop a procedure for assessing unintentional overdose (OD) in opiate abusers that differentiates it from intentional OD, and provides reliable information about the incident. METHODS: A sample of 121 patients in a methadone maintenance program at an urban university hospital completed a baseline assessment. A total of 70 participants completed an identical assessment at least 14 days later. The ability of an OD item to differentiate unintentional OD from intentional OD was tested, as was the test-retest reliability of questions assessing symptoms and treatment of OD...
January 2012: Addictive Behaviors
Robert H Howland
Blocking dopamine (DA) receptors in the basal ganglia can cause parkinsonian symptoms, acute dystonia, akathisia, tardive dyskinesia (TD), and neuroleptic malignant syndrome. TD is characterized by abnormal, involuntary, irregular motor movements involving muscles of the head, limbs, or trunk. Many drug therapies have been tried for TD, but none are approved by the U.S. Food and Drug Administration. The second-generation antipsychotic drugs should be considered as a treatment of first choice for clinically significant TD, because they will also be potentially effective as a primary treatment for the underlying disorder...
June 2011: Journal of Psychosocial Nursing and Mental Health Services
Robert H Howland
Opioid receptors are widely distributed throughout the nervous system. In addition to their central role in brain pathways mediating pain, endogenous opioid peptides function as neuromodulators and opioid systems are involved in many physiological functions. Opioid receptor drugs, including methadone (Dolophine), buprenorphine (Buprenex, Subutex), naltrexone (Revia), naloxone (Narcan), and buprenorphine/naloxone (Suboxone), are the focus of this article. This class of drugs is likely to be further developed for the treatment of addictions and mood disorders...
May 2010: Journal of Psychosocial Nursing and Mental Health Services
Karen Barker, Don Hunjadi
They wake the unconscious, cure the very ill and even rescue patients from death's door. They're miracle drugs, and thousands of ambulance services across the country carry them. For those onlookers and new EMS providers who see a patient wake up from a deep, unconscious state, it's a captivating experience. The most common of these drugs is dextrose. But there's another--meet Narcan.
August 2008: JEMS: a Journal of Emergency Medical Services
Debra Kerr, Paul Dietze, Anne-Maree Kelly
AIMS: This paper reviews available literature regarding the effectiveness, safety and utility of intranasal (i.n.) naloxone for the treatment of heroin overdose. METHODS: Scientific literature in the form of published articles during the period January 1984 to August 2007 were identified by searching several databases including Medline, Cinahl and Embase for the following terms: naloxone, narcan, intranasal, nose. The data extracted included study design, patient selection, numbers, outcomes and adverse events...
March 2008: Addiction
Gregory B Collins, Mark S McAllister
Buprenorphine (Subutex) is a safe and effective treatment for opioid dependence, and has very low potential for abuse, especially when it is combined with naloxone (Narcan) in a single sublingual tablet (Suboxone). New regulations allow physicians who are certified in buprenorphine therapy to offer it in their offices, a development that can substantially increase patient access to treatment.
July 2007: Cleveland Clinic Journal of Medicine
Tinka Markham Piper, Sasha Rudenstine, Sharon Stancliff, Susan Sherman, Vijay Nandi, Allan Clear, Sandro Galea
BACKGROUND: Fatal heroin overdose is a significant cause of mortality for injection drug users (IDUs). Many of these deaths are preventable because opiate overdoses can be quickly and safely reversed through the injection of Naloxone [brand name Narcan], a prescription drug used to revive persons who have overdosed on heroin or other opioids. Currently, in several cities in the United States, drug users are being trained in naloxone administration and given naloxone for immediate and successful reversals of opiate overdoses...
2007: Harm Reduction Journal
Beverly Greenwald
This article uses a case study to demonstrate the proper use of Narcan (naloxone hydrochloride injection, USP) for the reversal of the effects of opiates which can occur during moderate or "conscious" sedation for procedures in the endoscopy setting. Alternative treatments for the sedation, hypotension, and respiratory depression are discussed, as are instructions and rationale for partial reversal. Guidelines to ensure patient safety are also presented.
January 2004: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
Phillip O Coffin, Crystal Fuller, Liza Vadnai, Shannon Blaney, Sandro Galea, David Vlahov
Preliminary research suggests that naloxone (Narcan), a short-acting opiate antagonist, could be provided by prescription or distribution to heroin users to reduce the likelihood of fatality from overdose. We conducted a random postal survey of 1100 prescription-authorized health care providers in New York City to determine willingness to prescribe naloxone to patients at risk of an opiate overdose. Among 363 nurse practitioners, physicians, and physician assistants responding, 33.4% would consider prescribing naloxone, and 29...
June 2003: Journal of Urban Health: Bulletin of the New York Academy of Medicine
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