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https://www.readbyqxmd.com/read/29446449/opioid-prescribing-patterns-among-otolaryngologists-crucial-insights-among-the-medicare-population
#1
Peter F Svider, Khashayar Arianpour, Eric Guo, Elana Folbe, Giancarlo Zuliani, Hosheng Lin, Jean Anderson Eloy, Adam J Folbe
OBJECTIVES/HYPOTHESIS: There has been growing recognition of the roles prescription drug misuse and diversion play in facilitating the ongoing opioid epidemic. Our objective was to evaluate opioid prescription patterns among practicing otolaryngologists. STUDY DESIGN: Retrospective review of a CMS database. METHODS: Medicare Part D beneficiary data (2015) were accessed for a list of otolaryngologists. Opioid prescription rates, amount, and supply were calculated...
February 15, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29419590/extended-release-liposomal-bupivacaine-injection-exparel-for-early-postoperative-pain-control-following-pharyngoplasty
#2
Kristopher M Day, Narayanan M Nair, Devan Griner, Larry A Sargent
BACKGROUND: Liposomal bupivacaine (LB, Exparel) is a long-acting local anesthetic reported to decrease postoperative. The authors demonstrate the first safe use of LB in pediatric patients with improved pain control following pharyngoplasty. METHODS: Retrospective case-control of all the patients who underwent pharyngoplasty at a tertiary craniofacial center from March 2010 to June 2016. Treatment group (TG) administered 1.3% LB and 0.5% bupivacaine and 1:200,000 epinephrine...
February 6, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29378623/patient-perspectives-of-transitioning-from-prescription-opioids-to-heroin-and-the-role-of-route-of-administration
#3
Laura B Monico, Shannon Gwin Mitchell
BACKGROUND: As the availability of prescription opioids decreases and the availability of heroin increases, some prescription opioid users are transitioning to heroin. This study seeks to explore factors associated with respondents' transition from prescription opioid use to heroin. METHODS: In-depth, semi-structured qualitative interviews (n = 20) were conducted with buprenorphine patients in an opioid treatment program. Respondents were predominantly White (n = 13) and male (n = 13), with a range of treatment tenure (4 days to 2 years)...
January 29, 2018: Substance Abuse Treatment, Prevention, and Policy
https://www.readbyqxmd.com/read/29322813/opioid-drug-poisonings-in-ohio-adolescents-and-young-adults-2002-2014
#4
Sarah Caupp, Janine Steffan, Junxin Shi, Krista K Wheeler, Henry A Spiller, Marcel J Casavant, Henry Xiang
CONTEXT: Opioids represent a drug class that adolescents and young adults intentionally misuse and abuse. When taken on their own or with other substances in this manner, opioids pose an increased risk of overdose and potential death. OBJECTIVE: To determine trends of opioid drug poisonings among adolescents and young adults in Ohio from 2002 to 2014 using Poison Control Center (PCC) data. METHODS: Data were obtained from Ohio PCCs from 2002 to 2014 for opioid drug poisonings amongst 10-29 year olds...
January 11, 2018: Clinical Toxicology
https://www.readbyqxmd.com/read/29308593/application-of-hot-melt-extrusion-technology-in-immediate-release-abuse-deterrent-formulations
#5
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/29308584/do-abuse-deterrent-opioid-formulations-work
#6
Richard C Dart, Janetta L Iwanicki, Nabarun Dasgupta, Theodore J Cicero, Sidney H Schnoll
OBJECTIVE: We performed a systematic review to answer the question, "Does the introduction of an opioid analgesic with abuse deterrent properties result in reduced overall abuse of the drug in the community?" DESIGN: We included opioid analgesics with abuse deterrent properties (hydrocodone, morphine, oxycodone) with results restricted to the metasearch term "delayed onset," English language, use in humans, and publication years 2009-2016. All articles that contained data evaluating misuse, abuse, overdose, addiction, and death were included...
November 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/29304922/the-appropriate-use-of-opioids-in-the-treatment-of-refractory-restless-legs-syndrome
#7
Michael H Silber, Philip M Becker, Mark J Buchfuhrer, Christopher J Earley, William G Ondo, Arthur S Walters, John W Winkelman
Restless legs syndrome (RLS) is a distinct disorder, differing from chronic pain in many ways. Refractory RLS is characterized by unresponsiveness to dopamine agonists or alpha-2-delta ligands due to inadequate efficacy, augmentation, or adverse effects. This may result in severely impaired quality of life, profound insomnia, and suicidal depression. Opioid therapy is a mainstay in the management of these patients. This article summarizes the basic science and clinical evidence in support of their use, including the positive result of a large controlled multicenter study of 306 subjects, and outlines an approach to their use in clinical practice...
January 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29274731/simultaneous-analysis-of-opioid-analgesics-and-their-metabolites-in-municipal-wastewaters-and-river-water-by-liquid-chromatography-tandem-mass-spectrometry
#8
Ivona Krizman-Matasic, Petra Kostanjevecki, Marijan Ahel, Senka Terzic
Although published literature provides a clear demonstration of widespread occurrence of opioid analgesics (OAs) in the aquatic environment, analytical methods suitable for a systematic study of this pharmaceutical class, which would include a broad spectrum of opioid analgesics and their metabolites, are still missing. In this work, a comprehensive multiresidue method for quantitative analysis of 27 opioid analgesics and their metabolites, including 2 morphine glucuronide conjugates, was developed and validated for three matrices: raw wastewater (RW), secondary effluent (SE) and river water...
December 11, 2017: Journal of Chromatography. A
https://www.readbyqxmd.com/read/29274661/perioperative-celecoxib-and-postoperative-opioid-use-in-hand-surgery-a-prospective-cohort-study
#9
Jeffrey G Stepan, Daniel A London, Daniel A Osei, Martin I Boyer, Agnes Z Dardas, Ryan P Calfee
PURPOSE: Prescription opioid abuse is an epidemic in the United States; multimodal analgesia has been suggested as a potential solution to decrease postoperative opioid use. The primary aim of this study was to determine the effect of perioperative celecoxib on opioid intake. Secondary goals were to determine whether perioperative administration of celecoxib decreased postoperative patient-reported pain and whether patient demographic characteristics could predict postoperative pain and opioid intake...
December 21, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29248605/pain-treatment-practices-of-community-dwelling-black-older-adults
#10
Sheria G Robinson-Lane, April Hazard Vallerand
Black older adults often experience disparities in pain treatment that results in unmet pain needs. The aims of this study were to assess the pain management experiences of a group of community dwelling Black older adults and identify gaps in clinical practice. A qualitative, descriptive design was employed using the methodology of ethnography. The setting was an urban, low-income, community elderly housing high-rise facility. Participants included facility residents (n = 106); of these, 20 completed structured qualitative interviews...
December 13, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29236495/a-stable-heroin-analog-that-can-serve-as-a-vaccine-hapten-to-induce-antibodies-that-block-the-effects-of-heroin-and-its-metabolites-in-rodents-and-that-cross-react-immunologically-with-related-drugs-of-abuse
#11
Agnieszka Sulima, Rashmi Jalah, Joshua F G Antoline, Oscar B Torres, Gregory H Imler, Jeffrey R Deschamps, Zoltan Beck, Carl R Alving, Arthur E Jacobson, Kenner C Rice, Gary R Matyas
An improved synthesis of a haptenic heroin surrogate 1 (6-AmHap) is reported. The intermediate needed for the preparation of 1 was described in the route in the synthesis of 2 (DiAmHap). A scalable procedure was developed to install the C-3 amido group. Using the Boc protectng group in 18 allowed preparation of 1 in an overall yield of 53% from 4 and eliminated the necessity of preparing the diamide 13. Hapten 1 was conjugated to tetanus toxoid and mixed with liposomes containing monophosphoryl lipid A as an adjuvant...
December 13, 2017: Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/29224919/assessment-of-tapentadol-api-abuse-liability-with-the-researched-abuse-diversion-and-addiction-related-surveillance-radars-system
#12
Suzanne K Vosburg, S Geoffrey Severtson, Richard C Dart, Theodore J Cicero, Steven P Kurtz, Mark W Parrino, Jody L Green
Tapentadol, a Schedule II opioid with a combination of µ-opioid activity and norepinephrine reuptake inhibition, is used for the management of moderate to severe acute and chronic pain. Its dual-mechanism of action is thought to reduce opioid-related side effects that can complicate pain management. Since approval, tapentadol has been tracked across multiple outcomes suggesting abuse liability, and a pattern of relatively low, although not absent, abuse liability has been found. This retrospective cohort study further details the abuse liability of tapentadol as an Active Pharmaceutical Ingredient (API) when both immediate-release and extended-release formulations were on the market together (4Q2011 to 2Q2016)...
December 7, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29224770/pain-control-following-tonsillectomy-in-children-a-survey-of-patients
#13
Philip R Persino, Lena Saleh, David L Walner
OBJECTIVE: This prospective study aimed to survey pediatric patients and their parents after tonsillectomy to assess their pain management utilization and satisfaction. INTRODUCTION: Tonsillectomy is the second most common surgical procedure performed in pediatric patients. Postoperative recovery is often associated with high levels of pain and severe functional limitations. There is currently no consensus on pain control regimens. Additionally, a recent FDA Black Box Warning on narcotic use has caused more uncertainty in appropriate pain control regimens...
December 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29222361/evaluation-of-opioid-prescribing-after-rescheduling-of-hydrocodone-containing-products
#14
M Brooke Bernhardt, Ruston S Taylor, Joseph L Hagan, Nihar Patel, Corrie E Chumpitazi, Karin A Fox, Chris Glover
PURPOSE: Institutional prescribing trends of hydrocodone-containing products (HCPs) before and after the Drug Enforcement Administration's rescheduling of HCPs were evaluated. METHODS: A retrospective evaluation was performed on 6 oral opioid analgesics on the hospital formulary that were prescribed to patients treated at Texas Children's Hospital and Pavilion for Women for the 6 months before and after the rescheduling of HCPs on October 6, 2014. Patients were eligible for inclusion if they were prescribed any of the following oral agents: HCPs (e...
December 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29210063/opioid-induced-inhibition-of-the-human-serotonin-and-norepinephrine-transporters-in-vitro-link-to-clinical-reports-of-serotonin-syndrome
#15
Anna Rickli, Evangelia Liakoni, Marius C Hoener, Matthias E Liechti
BACKGROUND AND PURPOSE: Opioids may inhibit the serotonin and norepinephrine transporters (SERT and NET, respectively). NET inhibition may contribute to analgesia, and SERT inhibition or interactions with serotonin receptors may cause serotonergic toxicity. However, the effects of different opioids on the human SERT, NET, and serotonin receptors have not been sufficiently studied. EXPERIMENTAL APPROACH: We determined the potencies of different opioids to inhibit the SERT and NET in vitro using human transporter-transfected cells...
December 6, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/29186453/detection-and-quantification-of-codeine-6-glucuronide-hydromorphone-3-glucuronide-oxymorphone-3-glucuronide-morphine-3-glucuronide-and-morphine-6-glucuronide-in-human-hair-from-opioid-users-by-lc-ms-ms
#16
Megan Grabenauer, Nichole D Bynum, Katherine N Moore, Robert M White, John M Mitchell, Eugene D Hayes, Ronald Flegel
Current hair testing methods that rely solely on quantification of parent drug compounds are unable to definitively distinguish between drug use and external contamination. One possible solution to this problem is to confirm the presence of unique drug metabolites that cannot be present through contamination, such as phase II glucuronide conjugates. This work demonstrates for the first time that codeine-6-glucuronide, hydromorphone-3-glucuronide, oxymorphone-3-glucuronide, morphine-3-glucuronide and morphine-6-glucuronide are present at sufficient concentrations to be quantifiable in hair of opioid users and that their concentrations generally increase as the concentrations of the corresponding parent compounds increase...
November 24, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/29148351/opioid-prescribing-by-nurse-practitioners-in-medicare-part-d-impact-of-state-scope-of-practice-legislation
#17
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/29146621/effect-of-fda-investigation-on-opioid-prescribing-to-children-after-tonsillectomy-adenoidectomy
#18
MULTICENTER STUDY
Kao-Ping Chua, Mark G Shrime, Rena M Conti
BACKGROUND: In August 2012, the Food and Drug Administration investigated the safety of codeine use by children after tonsillectomy and/or adenoidectomy, culminating in a black box warning in February 2013. The objective of this study was to evaluate the association between the investigation and opioid prescribing to children undergoing these surgeries. METHODS: We identified 362 992 privately insured children in the 2010-2015 Truven MarketScan Commercial Claims and Encounters database who underwent tonsillectomy and/or adenoidectomy...
December 2017: Pediatrics
https://www.readbyqxmd.com/read/29121158/opioid-use-by-patients-after-rhinoplasty
#19
Sagar Patel, Angela Sturm, Michael Bobian, Peter F Svider, Giancarlo Zuliani, Russell Kridel
Importance: Given the increase in opioid addiction and overdose in the United States, reasoned opioid use after outpatient surgery may affect prescription medication abuse. Objectives: To examine patient use of opioids after rhinoplasty and establish an optimal postrhinoplasty pain management regimen. Design, Setting, and Participants: In this case series, opioid use was evaluated in 62 patients who underwent rhinoplasty performed by 3 fellowship-trained facial plastic surgeons, 2 in private practice in Texas and 1 in an academic setting in Michigan, from February 2016 to September 2016...
November 9, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/29120973/acute-intoxications-and-fatalities-from-illicit-fentanyl-and-analogues-an-update
#20
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...
February 2018: Therapeutic Drug Monitoring
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