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https://www.readbyqxmd.com/read/28802595/variability-in-opioid-prescribing-for-children-undergoing-ambulatory-surgery-in-the-united-states
#1
William C Van Cleve, Eliot B Grigg
STUDY OBJECTIVE: We attempted to describe the opioid prescribing patterns for ambulatory pediatric surgery in the United States from 2007 to 2014. DESIGN: Retrospective database review. SETTING: Operating room ambulatory encounters as determined by the Truven Health Marketscan Commercial Claims and Encounters database. PATIENTS: A total of 929,874 ambulatory surgical encounters were identified in patients <18years of age and, of these, 439,286 encounters generated an analgesic prescription...
September 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28794653/real-world-utilization-of-once-daily-extended-release-abuse-deterrent-formulation-of-hydrocodone-a-comparison-with-the-pre-approval-randomized-clinical-trials
#2
Louise Taber, T Christopher Bond, Xuezhe Wang, Aditi Kadakia, Tracy J Mayne
BACKGROUND AND OBJECTIVE: Hydrocodone bitartrate extended release (Hysingla(®) ER, HYD) was previously studied in a 12-week randomized, double-blind, placebo-controlled trial and a 52-week open-label safety study. Both of these preapproval studies allowed dose titration to efficacy. The purpose of the present analysis was to compare dosing and utilization patterns in these previous clinical trials with real-world data (RWD) usage in a retrospective claim analysis performed 12-14 months post approval in the US...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28771942/patterns-of-abuse-and-routes-of-administration-for-immediate-release-hydrocodone-combination-products
#3
Theresa A Cassidy, Natasha Oyedele, Travis C Mickle, Sven Guenther, Simon H Budman
PURPOSE: Prescriptions for hydrocodone immediate-release (IR) combination products have recently decreased, yet they represent the majority of opioid prescriptions dispensed and are commonly abused analgesics among both adults and adolescents. Little data exist to understand the contribution of IR products to the problem of prescription opioid abuse. This study aimed to better understand abuse patterns for hydrocodone IR combination products among adult and adolescent substance abusers...
August 3, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28769582/cyp2d6-phenotypes-are-associated-with-adverse-outcomes-related-to-opioid-medications
#4
Jennifer L St Sauver, Janet E Olson, Veronique L Roger, Wayne T Nicholson, John L Black, Paul Y Takahashi, Pedro J Caraballo, Elizabeth J Bell, Debra J Jacobson, Nicholas B Larson, Suzette J Bielinski
BACKGROUND: Variation in the CYP2D6 gene may affect response to opioids in both poor and ultrarapid metabolizers, but data demonstrating such associations have been mixed, and the impact of variants on toxicity-related symptoms (e.g., nausea) is unclear. Therefore, we examined the association between CYP2D6 phenotype and poor pain control or other adverse symptoms related to the use of opioids in a sample of primary care patients. MATERIALS AND METHODS: We identified all patients in the Mayo Clinic RIGHT Protocol who were prescribed an opioid medication between July 01, 2013 and June 30, 2015, and categorized patients into three phenotypes: poor, intermediate to extensive, or ultrarapid CYP2D6 metabolizers...
2017: Pharmacogenomics and Personalized Medicine
https://www.readbyqxmd.com/read/28747087/safety-and-effectiveness-of-once-daily-hysingla-extended-release-tablets-in-patients-with-baseline-depression-or-anxiety
#5
Louise Taber, Ellie He, Steven R Ripa
AIM: Long-term safety and effectiveness of a once daily, single-entity, extended-release formulation of hydrocodone bitartrate (HYD) for the treatment of moderate to severe noncancer and nonneuropathic pain among patients with and without concurrent depression/anxiety at baseline. MATERIALS & METHODS: Post hoc analysis. RESULTS: HYD demonstrated a safety profile consistent with μ-opioid agonists: Serious adverse events in 12% patients with depression/anxiety including four deaths; 6% without depression/anxiety including one death...
July 27, 2017: Pain Management
https://www.readbyqxmd.com/read/28685589/surgeon-preference-influence-and-treatment-of-thumb-carpometacarpal-arthritis
#6
Zachary Deutch, Steven R Niedermeier, Hisham M Awan
BACKGROUND: The purpose of this study was to evaluate current surgical practice patterns, the factors that influence these patterns, and overall trends in the treatment of thumb carpometacarpal osteoarthritis. METHODS: An online survey containing 14 questions was sent to all active members of the American Society for Surgery of the Hand. Information on demographics and treatments was collected. Results were anonymously uploaded to an online spreadsheet. RESULTS: A total of 823 responses were recorded...
July 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28683172/opioids-for-cancer-pain-an-overview-of-cochrane-reviews
#7
REVIEW
Philip J Wiffen, Bee Wee, Sheena Derry, Rae F Bell, R Andrew Moore
BACKGROUND: Pain is a common symptom with cancer, and 30% to 50% of all people with cancer will experience moderate to severe pain that can have a major negative impact on their quality of life. Opioid (morphine-like) drugs are commonly used to treat moderate or severe cancer pain, and are recommended for this purpose in the World Health Organization (WHO) pain treatment ladder. The most commonly-used opioid drugs are buprenorphine, codeine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, oxycodone, tramadol, and tapentadol...
July 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28635179/changing-trends-in-opioid-use-among-u-s-rheumatoid-arthritis-patients
#8
Jeffrey R Curtis, Fenglong Xie, Christian Smith, Kenneth G Saag, Lang Chen, Timothy Beukelman, Melissa Mannion, Huifeng Yun, Stefan Kertesz
Introduction Opioid prescribing recently has come under intense scrutiny. However, longitudinal patterns of opioid prescription receipt in a population-based cohort of patients who have chronic pain, such as those with rheumatoid arthritis (RA), have not been well characterized. Methods We identified a cohort of RA patients based on 2006-2014 Medicare data and evaluated longitudinal time trends in regular opioid use (>=3 filled prescriptions in each 12 month interval). A separate analysis in 2014 assessed rheumatologist-specific variability in regular opioid prescription for RA patients...
June 21, 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28629738/nitrous-oxide-versus-oral-sedation-for-pain-management-of-first-trimester-surgical-abortion-a-randomized-study
#9
Rameet H Singh, Maria Montoya, Eve Espey, Lawrence Leeman
OBJECTIVE: The objective of the study was to compare nitrous oxide with oxygen (N2O/O2) to oral hydrocodone/acetaminophen and lorazepam for analgesia during first-trimester surgical abortion. STUDY DESIGN: This double-blind randomized trial assigned women undergoing first-trimester surgical abortion at<11 weeks' gestation to inhaled N2O/O2 vs. oral sedation for pain management. The N2O/O2 group received up to 70:30 ratio during the procedure and placebo pills preprocedure; the oral group received inhaled oxygen during the procedure and oral hydrocodone/acetaminophen 5 mg/325 mg and lorazepam 1 mg preprocedure...
August 2017: Contraception
https://www.readbyqxmd.com/read/28596010/silica-hydride-based-phases-for-small-molecule-separations-using-automated-liquid-chromatography-mass-spectrometry-method-development
#10
Dananjaya K Appulage, Kevin A Schug
Silica hydride, or Type C silica, has been developed as an alternative chromatographic support material for liquid chromatography. There are various bonded phases available with this new support. For four such phases (Cholesterol, Bidentate C18, Diamond Hydride, and Diol), retention and selectivity behavior were investigated using liquid chromatography coupled with triple quadrupole mass spectrometry. A set of small molecules from several chemical classes of interest, and varying in their physicochemical properties, were chromatographed under both reversed-phase and aqueous normal phase modes...
June 3, 2017: Journal of Chromatography. A
https://www.readbyqxmd.com/read/28593907/opioid-induced-hyponatremia-in-a-patient-with-central-diabetes-insipidus-independence-from-adh
#11
Nandini Bhat, Erjola Balliu, Jennifer Osipoff, Andrew Lane, Thomas Wilson
Hyponatremia can be a complication of opioid therapy, which has been postulated to occur secondary to inappropriate antidiuretic hormone secretion (syndrome of inappropriate antidiuretic hormone secretion [SIADH]). We report severe hyponatremia following wisdom teeth extraction with opioid analgesia in a 19-year-old female with diabetes insipidus (DI) and acquired panhypopituitarism that challenges this theory. As this patient has DI, we believe opioid treatment caused severe hyponatremia by the following mechanisms: (1) Opioids have a direct antidiuretic effect independent of changes in ADH, as demonstrated in Brattleboro rats with central DI...
May 24, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28582659/increased-use-of-heroin-as-an-initiating-opioid-of-abuse
#12
Theodore J Cicero, Matthew S Ellis, Zachary A Kasper
INTRODUCTION: Given the relatively recent growth in access to heroin and a more permissive atmosphere surrounding its use, we hypothesized that an increasing number of persons with limited experience and tolerance to opioids would experiment with heroin as their first opioid rather than more common prescription opioid analgesics. METHODS: Individuals entering substance abuse treatment for an opioid use disorder in the period 2010-2016 (N=5885) were asked about the specific opioid they first regularly used to get high...
May 23, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28579823/use-of-immediate-release-opioids-as-supplemental-analgesia-during-management-of-moderate-to-severe-chronic-pain-with-buprenorphine-transdermal-system
#13
Sanford Silverman, Robert B Raffa, Marc J Cataldo, Monica Kwarcinski, Steven R Ripa
BACKGROUND: The buprenorphine transdermal system (BTDS) is approved in the US for the management of chronic pain. Due to its high affinity for μ-opioid receptors with a slow dissociation profile, buprenorphine may potentially displace or prevent the binding of competing μ-opioid-receptor agonists, including immediate-release (IR) opioids, in a dose-dependent manner. Health care professionals may assume that the use of IR opioids for supplemental analgesia during BTDS therapy is not acceptable...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28579821/opioid-analgesics-related-pharmacokinetic-drug-interactions-from-the-perspectives-of-evidence-based-on-randomized-controlled-trials-and-clinical-risk-management
#14
REVIEW
Xiu-Qin Feng, Ling-Ling Zhu, Quan Zhou
BACKGROUND: Multimorbidity results in complex polypharmacy which may bear a risk of drug interactions. A better understanding of opioid analgesics combination therapy used for pain management could help warrant medication safety, efficacy, and economic relevance. Until now there has been no review summarizing the opioid analgesics-related pharmacokinetic drug interactions from the perspective of evidence based on randomized controlled trials (RCTs). METHOD: A literature search was performed using PubMed, MEDLINE, and the Cochrane Library, using a PRISMA flowchart...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28574523/neuropathic-pain-treatment-provides-unexpected-benefit
#15
Adam D Keesling, Meg Wilson, Robert Wilkins
A 57-year-old African American woman was being treated at our clinic for neurogenic urinary incontinence (UI). The UI, which occurred day and night, began 2 years earlier following a laminectomy of vertebrae C3 to C6 with spinal fusion of C3 to C7 for cervical spinal stenosis. The UI persisted despite physical therapy and trials of oxybutynin and imipramine. Since the surgery, the patient had also been experiencing chronic (debilitating) neuropathic pain in both legs, and the sensation of incomplete bladder emptying...
June 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28551445/decreasing-postoperative-narcotics-in-reconstructive-pelvic-surgery-a%C3%A2-randomized-controlled-trial
#16
Krista M L Reagan, David M O'Sullivan, Richard Gannon, Adam C Steinberg
BACKGROUND: Postoperative pain control is crucial to any successful recovery plan. Many currently used medication regimens are narcotic-focused. OBJECTIVE: The objective of our study was to evaluate the efficacy of a multimodal pain regimen after pelvic reconstructive surgery. STUDY DESIGN: The primary outcome measure was narcotic use. Secondary outcomes included pain, nausea, and constipation. Patients were randomized to either usual care postoperative treatment or multimodal pain regimen...
May 25, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28549620/the-effect-of-opioid-prescribing-guidelines-on-prescriptions-by-emergency-physicians-in-ohio
#17
Scott G Weiner, Olesya Baker, Sabrina J Poon, Ann F Rodgers, Chad Garner, Lewis S Nelson, Jeremiah D Schuur
STUDY OBJECTIVE: The objective of our study is to evaluate the association between Ohio's April 2012 emergency physician guidelines aimed at reducing inappropriate opioid prescribing and the number and type of opioid prescriptions dispensed by emergency physicians. METHODS: We used Ohio's prescription drug monitoring program data from January 1, 2010, to December 31, 2014, and included the 5 most commonly prescribed opioids (hydrocodone, oxycodone, tramadol, codeine, and hydromorphone)...
May 20, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28479220/electronic-medication-complete-communication-strategy-for-opioid-prescriptions-in-the-emergency-department-rationale-and-design-for-a-three-arm-provider-randomized-trial
#18
Danielle M McCarthy, D Mark Courtney, Patrick M Lank, Kenzie A Cameron, Andrea M Russell, Laura M Curtis, Kwang-Youn A Kim, Surrey M Walton, Enid Montague, Abbie L Lyden, Stephanie J Gravenor, Michael S Wolf
BACKGROUND: Thousands of people die annually from prescription opioid overdoses; however there are few strategies to ensure patients receive medication risk information at the time of prescribing. OBJECTIVES: To compare the effectiveness of the Emergency Department (ED) Electronic Medication Complete Communication (EMC(2)) Opioid Strategy (with and without text messaging) to promote safe medication use and improved patient knowledge as compared to usual care. METHODS: The ED EMC(2) Opioid Strategy consists of 5 automated components to promote safe medication use: 1) physician reminder to counsel, 2) inbox message sent on to the patient's primary care physician, 3) pharmacist message on the prescription to counsel, 4) MedSheet supporting prescription information, and 5) patient-centered Take-Wait-Stop wording of prescription instructions...
May 4, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28448772/the-effect-of-a-federal-controlled-substance-act-schedule-change-on-hydrocodone-combination-products-claims-in-a-medicaid-population
#19
Stephanie Tran, Pavel Lavitas, Karen Stevens, Bonnie C Greenwood, Karen Clements, Caroline J Alper, Kimberly Lenz, Mylissa Price, Tasmina Hydery, Jennifer L Arnold, Mito Takeshita, Rachel Bacon, Justin P Peristere, Paul L Jeffrey
BACKGROUND: In 2012, hydrocodone combination products (HCPs) were the most prescribed medications in the United States. Under the Controlled Substance Act of 1970, hydrocodone alone was classified as a Schedule II drug, while HCPs were classified as Schedule III, indicating a lower risk for abuse and misuse. However, according to a Drug Enforcement Agency analysis, the addition of nonopioids has not been shown to diminish abuse potential of hydrocodone. In response to concerns for drug abuse and overdose, the Drug Enforcement Agency rescheduled HCPs to Schedule II in October 2014, with the intent of limiting overprescribing and increasing awareness of their abuse potential...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28442580/ethanol-reversal-of-tolerance-to-the-antinociceptive-effects-of-oxycodone-and-hydrocodone
#20
Joanna C Jacob, Justin L Poklis, Hamid I Akbarali, Graeme Henderson, William L Dewey
This study compared the development of tolerance to two orally bioavailable prescription opioids, oxycodone and hydrocodone, to that of morphine, and the reversal of this tolerance by ethanol. Oxycodone (s.c.) was significantly more potent in the mouse tail-withdrawal assay than either morphine or hydrocodone. Oxycodone was also significantly more potent in this assay than hydrocodone when administered orally. Tolerance was seen following chronic subcutaneous administration of each of the three drugs and by the chronic administration of oral oxycodone, but not following the chronic oral administration of hydrocodone...
July 2017: Journal of Pharmacology and Experimental Therapeutics
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