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https://www.readbyqxmd.com/read/27897471/use-of-risk-mitigation-practices-by-family-nurse-practitioners-prescribing-opioids-for-the-management-of-chronic-non-malignant-pain
#1
Sahil Chaudhary, Peggy Compton
BACKGROUND: Ongoing opioid analgesic use in patients suffering from chronic non-malignant pain (CNMP) has been associated with the development of opioid misuse, abuse, addiction, and overdose. To prevent these adverse outcomes, it is important that family nurse practitioners (FNPs) implement recommended risk mitigation practices (RMPs) when treating CNMP patients with opioids. METHODS: A national sample of 856 FNPs was invited to answer an online survey about their utilization of opioids and RMPs in treating CNMP...
November 29, 2016: Substance Abuse
https://www.readbyqxmd.com/read/27881622/stability-of-21-cocaine-opioid-and-benzodiazepine-drug-analytes-in-spiked-meconium-at-three-temperatures
#2
Fang Wu, Stephanie J Marin, Gwendolyn A McMillin
In this study, the stability of 21 cocaine, opioid and benzodiazepine analytes in spiked meconium was investigated at three storage temperatures: 4°C, room temperature (RT), and 37°C (body temperature). The drugs/metabolites included were hydrocodone, hydromorphone, codeine, morphine, 6-acetylmorphine (6-AM), oxycodone, oxymorphone, cocaine, cocaethylene, benzoylecgonine, m-hydroxybenzoylecgonine, diazepam, oxazepam, temazepam, nordiazepam, chlordiazepoxide, lorazepam, alprazolam, alpha-hydroxyalprazolam, clonazepam, 7-aminoclonazepam, midazolam, alpha-hydroxymidazolam and zolpidem...
November 22, 2016: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/27846789/impact-of-breakthrough-pain-on-community-dwelling-cancer-patients-results-from-the-national-breakthrough-pain-study
#3
Nathaniel P Katz, Kavita L Gajria, Alicia C Shillington, Judith J Stephenson, Qing Harshaw
OBJECTIVE: To characterize cancer-related breakthrough pain (BTcP) among community-dwelling patients with cancer. METHODS: Data from the National Breakthrough Pain Study, a cross-sectional observational survey describing breakthrough pain (BTP) in the community, were analyzed for a subset of patients with BTcP. Eligible patients were community-dwelling adults with commercial insurance and insurance claims consistent with cancer and chronic pain who consented to a structured telephone interview...
December 5, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27844470/transient-low-testosterone-levels-after-oral-hydrocodone-may-contribute-to-misdiagnosis-of-hypogonadism
#4
Harry W Daniell
CONTEXT: Multiple morning testosterone levels are needed to establish the presence of male hypogonadism and to justify its replacement therapy. Any influence on these levels by short-term opioid ingestion has not, however, been reported. CASE DESCRIPTION: Serial testosterone levels are reported at 2-hour intervals once weekly for 22 weeks in a man after his ingestion of 0, 5, or 10 mg of hydrocodone. CONCLUSIONS: Five milligrams of hydrocodone did not significantly alter postingestion testosterone levels, but 10 mg ingestion lowered them at 2, 4, and 6 hours postingestion...
September 2016: Journal of Opioid Management
https://www.readbyqxmd.com/read/27824618/feasibility-and-utility-of-the-individualized-hydrocodone-therapy-based-on-phenotype-pharmacogenetics-and-pharmacokinetic-dosing
#5
Oscar A Linares, Michel Tod, Annemarie L Daly, Raymond C Boston
No abstract text is available yet for this article.
December 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27803072/factors-associated-with-the-prophylactic-prescription-of-a-bowel-regimen-to-prevent-opioid-induced-constipation
#6
Nancy Y Chen, Eugene Nguyen, Sheree M Schrager, Christopher J Russell
OBJECTIVE: Identify factors associated with the prophylactic prescription of a bowel regimen with an inpatient opioid prescription. METHODS: This was a retrospective cohort study from June 1, 2013, to October 31, 2014 of pediatric inpatients prescribed an oral or intravenous opioid on the general medical/surgical floors. We identified patients with or without a prophylactic prescription of a bowel regimen. We obtained patient demographics, prescriber training level and service and used multivariate logistic regression to analyze the factors associated with prophylactic bowel regimen and opioid prescription...
November 2016: Hospital Pediatrics
https://www.readbyqxmd.com/read/27776785/has-the-rescheduling-of-hydrocodone-changed-ed-prescribing-practices
#7
Elizabeth C Oehler, Rachel L Day, David B Robinson, Lawrence H Brown
OBJECTIVE: The objective was to examine the effect of hydrocodone-containing product (HCP) rescheduling on the proportion of prescriptions for HCPs given to patients discharged from the emergency department (ED). METHODS: Electronic queries of ED records were used to identify patients aged 15 years and older discharged with a pain-related prescription in the 12 months before and after HCP rescheduling. Prescriptions were classified as HCPs; other Schedule II medications (eg, oxycodone products); other Schedule III medications (eg, codeine products); and non-Schedule II/III products (eg, nonsteroidal anti-inflammatory drugs)...
September 3, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27775894/a-book-type-dried-plasma-spot-card-for-automated-flow-through-elution-coupled-with-on-line-spe-lc-ms-ms-bioanalysis-of-opioids-and-stimulants-in-blood
#8
Imelda Ryona, Jack Henion
Despite many benefits including simple point-of-care sample collection, reduced costs, and simplified shipping and storage, dried blood spot (DBS) techniques have faced adoption resistance such as the hematocrit (Hct) effects and the established preference for bioanalysis of plasma rather than whole blood. One way to potentially circumvent these challenges is to adopt the concept of a dried plasma spot (DPS) technique. One approach to accomplishing this is through an on-card red blood cell (RBC) filtration to generate plasma from whole blood without the need for centrifugation...
October 24, 2016: Analytical Chemistry
https://www.readbyqxmd.com/read/27764026/suitability-of-the-dri-hydrocodone-hydromorphone-immunoassay-in-the-clinical-environment-at-a-lower-cutoff-validation-with-lc-ms-ms-analysis
#9
Robert B Dixon, Amitava Dasgupta
BACKGROUND: We evaluated the analytical performance of the DRI hydrocodone/hydromorphone assay by comparing semiquantitative values obtained by this assay with values obtained by a liquid chromatography combined with tandem mass spectrometry (LC-MS/MS) method. We also evaluated the possibility of lowering the cutoff of the DRI assay from 300 to 100 ng/mL. METHODS: We compared semiquantitative values obtained by the DRI assay in 97 specimens with values obtained by the LC-MS/MS method including 10 specimens containing hydrocodone and/or hydromorphone concentrations between 105...
December 2016: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/27727038/decreased-opioid-prescribing-in-a-pediatric-emergency-department-after-the-rescheduling-of-hydrocodone
#10
Corrie E Chumpitazi, Chris A Rees, Elizabeth A Camp, M Brooke Bernhardt
BACKGROUND: The Drug Enforcement Administration (DEA) changed hydrocodone-containing products (HCPs) from Schedule III to II status on October 6, 2014, making codeine-containing products (CCPs) the only non-Schedule II oral opioid agents. OBJECTIVES: We sought to describe prescribing patterns of oral opioid agents in the pediatric emergency department before and after the 2014 DEA rescheduling of HCPs. METHODS: We performed a cross-sectional study evaluating prescribing patterns in the pediatric emergency department at an urban, academic, quaternary care children's hospital system for 6 months before and 6 months after the DEA rescheduling of HCPs...
October 7, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27718163/hydrocodone-bitartrate-er-hysingla-%C3%A2-er-a-review-in-chronic-pain
#11
Sohita Dhillon
Hydrocodone bitartrate extended-release (Hysingla(®) ER; referred to hereafter as hydrocodone ER) was the first single-entity hydrocodone formulation recognized by the US FDA as having abuse-deterrent properties. It is indicated for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate. Once-daily oral hydrocodone ER provides consistent plasma hydrocodone concentrations and sustained analgesia over the 24-h dosing interval...
November 2016: Clinical Drug Investigation
https://www.readbyqxmd.com/read/27704485/health-care-utilization-and-costs-associated-with-nausea-and-vomiting-in-patients-receiving-oral-immediate-release-opioids-for-outpatient-acute-pain-management
#12
Elizabeth Marrett, Winghan Jacqueline Kwong, Feride Frech, Chunlin Qian
INTRODUCTION: Nausea and vomiting (NV) are common side effects of opioid use and limiting factors in pain management. This study sought to quantify the frequency of antiemetic prescribing and the impact of NV on health care resource utilization and costs in outpatients prescribed opioids for acute pain. The perspective was that of a commercial health plan. METHODS: Medical and pharmacy claims from IMS PharMetrics Plus were used to identify patients initiating opioid therapy with a prescription for an oxycodone-, hydrocodone- or codeine-containing immediate-release product for acute use (≤15-day supply) between October 1, 2013 and September 30, 2014...
December 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27702939/degradation-of-opioids-and-opiates-during-acid-hydrolysis-leads-to-reduced-recovery-compared-to-enzymatic-hydrolysis
#13
Pongkwan Sitasuwan, Cathleen Melendez, Margarita Marinova, Kaylee R Mastrianni, Alicia Darragh, Emily Ryan, L Andrew Lee
Drug monitoring laboratories utilize a hydrolysis process to liberate the opiates from their glucuronide conjugates to facilitate their detection by tandem mass spectrometry (MS). Both acid and enzyme hydrolysis have been reported as viable methods, with the former as a more effective process for recovering codeine-6-glucuronide and morphine-6-glucuronide. Here, we report concerns with acid-catalyzed hydrolysis of opioids, including a significant loss of analytes and conversions of oxycodone to oxymorphone, hydrocodone to hydromorphone and codeine to morphine...
October 2016: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/27664059/pharmacy-use-by-dual-eligible-non-elderly-veterans-with-private-healthcare-insurance
#14
Brian C Lund, Mary E Charlton, Alan N West
BACKGROUND: Utilization of private sector healthcare services among dual enrolled veterans with private healthcare insurance plans (PHIP) has not been well-characterized. Concurrent use of Veterans Health Administration (VHA) and non-VHA pharmacies may increase risk for adverse outcomes. Thus, the objectives of this study were to determine the extent to which dual VHA-PHIP enrollees obtain medications through VHA and non-VHA pharmacies and to characterize medications obtained through non-VHA pharmacies...
2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27662264/pharmacokinetics-of-guaifenesin-pseudoephedrine-and-hydrocodone-in-a-combination-oral-liquid-formulation-administered-as-single-and-multiple-doses-in-healthy-chinese-volunteers-and-comparison-with-data-for-individual-compounds-formulated-as-antuss-%C3%A2
#15
Shuhua Deng, Wencan Huang, Xiaojia Ni, Ming Zhang, Haoyang Lu, Zhanzhang Wang, Jinqing Hu, Xiuqing Zhu, Chang Qiu, Dewei Shang, Yuefeng Zhang, Linghui Xiong, Yuguan Wen
1. A new oral liquid formulation combining guaifenesin, pseudoephedrine and hydrocodone is effective in improving the symptoms of common cold. The pharmacokinetic properties of the individual components were evaluated in a randomized, open-label, 4-period study in 12 healthy Chinese volunteers following single and multiple doses. The data were compared with data for the individual ingredients in Antuss(®). 2. In the single-dose period, exposure levels (AUC and Cmax) for guaifenesin, pseudoephedrine and hydrocodone increased directly as the dose of the oral liquid formulation increased from 5 to 15 mL...
September 23, 2016: Xenobiotica; the Fate of Foreign Compounds in Biological Systems
https://www.readbyqxmd.com/read/27651514/oral-abuse-potential-pharmacokinetics-and-safety-of-once-daily-single-entity-extended-release-hydrocodone-hyd-in-recreational-opioid-users
#16
Stephen C Harris, Alessandra Cipriano, Ram P Kapil, Naama Levy-Cooperman, Salvatore V Colucci, Pierre Geoffroy, Talar Hopyan
OBJECTIVES:  A once-daily, extended-release hydrocodone bitartrate tablet with abuse-deterrent properties (Hysingla ER [HYD]) is available for the treatment of chronic pain in appropriate patients. This study evaluated the oral abuse potential and pharmacokinetics (PK) of HYD intact, chewed, or milled to fine particles in comparison with hydrocodone solution or placebo. DESIGN:  Single-center, double-blind, randomized, five-period, five-treatment crossover study...
September 19, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27625146/periapical-microsurgery-the-effects-of-locally-injected-dexamethasone-on-pain-swelling-bruising-and-wound-healing
#17
Elena Kan, Marcelo Santos Coelho, Jonathan Reside, Steven J Card, Peter Z Tawil
INTRODUCTION: The purpose of this prospective, double-blind, randomized clinical trial was to evaluate the postoperative healing of endodontic periapical microsurgery after local administration of dexamethasone. METHODS: Sixty patients were divided into 2 groups. The dexamethasone group received a single local submucosal injection of 4 mg dexamethasone, and the placebo group received a submucosal injection of saline solution at the conclusion of standardized periapical microsurgery...
September 10, 2016: Journal of Endodontics
https://www.readbyqxmd.com/read/27623143/trends-in-the-distribution-of-opioids-in-puerto-rico-1999-2013
#18
Sausan El Burai Félix, Karin A Mack, Christopher M Jones
OBJECTIVE: Limited information has been published about opioid prescribing practices in Puerto Rico. The objective of this study was to create baseline trends of opioids distributed over a period of fourteen years in Puerto Rico. METHODS: We examined data from the U.S. Drug Enforcement Administration's Automation of Reports and Consolidated Orders System (ARCOS) for the period 1999-2013. ARCOS data reflects the amount of controlled substances legally dispensed. Analyses include the distribution of opioids (in morphine milligram equivalent kg per 10,000 persons) by year and entity (pharmacy, hospital, practitioner)...
September 2016: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/27621048/nitrous-oxide-for-pain-management-during-in-office-hysteroscopic-sterilization-a-randomized-controlled-trial
#19
Emily N Schneider, Regan Riley, Eve Espey, Shiraz I Mishra, Rameet H Singh
OBJECTIVES: To evaluate whether inhaled nitrous oxide with oxygen (N2O/O2) is associated with less pain compared to oral sedation for pain management during in-office hysteroscopic sterilization. STUDY DESIGN: This double blinded randomized controlled trial enrolled women undergoing in-office hysteroscopic sterilization. All participants received pre-procedure intramuscular ketorolac and a standardized paracervical block. The intervention group also received N2O/O2 via a nasal mask titrated to a maximum 70%:30% mixture by a nurse during the procedure and placebo pills pre-procedure and the active control group received inhaled O2 during the procedure and 5/325 mg hydrocodone/acetaminophen and 1 mg lorazepam pre-procedure...
September 9, 2016: Contraception
https://www.readbyqxmd.com/read/27606038/the-prevalence-and-determinants-of-controlled-substance-discrepancies-in-a-level-i-trauma-hospital
#20
Chukwuma Anyanwu, Oliver Egwim
BACKGROUND: Healthcare institutions are often faced with challenges and accreditation requirements for improving treatment quality, reducing waste, and avoiding diversion of drugs, particularly controlled substances. Many automated systems have replaced manual systems but may be fraught with challenges, especially when multiple users are involved. OBJECTIVE: To describe the characteristics of controlled substance discrepancies observed in a Level I trauma hospital for Medicare...
May 2016: American Health & Drug Benefits
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