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https://www.readbyqxmd.com/read/29683378/pharmacokinetic-properties-of-intranasal-and-injectable-formulations-of-naloxone-for-community-use-a-systematic-review
#1
Shawn A Ryan, Robert B Dunne
AIM: To assess the pharmacokinetic properties of community-use formulations of naloxone for emergency treatment of opioid overdose. METHODS: Systematic literature review based on searches of established databases and congress archives. RESULTS: Seven studies met inclusion criteria: two of US FDA-approved intramuscular (im.)/subcutaneous (sc.) auto-injectors, one of an FDA-approved intranasal spray, two of unapproved intranasal kits (syringe with atomizer attachment) and two of intranasal products in development...
April 23, 2018: Pain Management
https://www.readbyqxmd.com/read/29680374/-temporary-approval-for-intranasal-naloxone-setting-up-in-a-french-addiction-center
#2
Thomas Barré, Florence Vorspan, Maeva Fortias, Marc Veyrier, Pauline Cavagna, Julien Azuar, Louise Nicolas, François Naccache, Hélène Barreteau, Franck Bellivier, Vanessa Bloch
Intranasal naloxone aims at preventing opioid overdose related deaths in active drug users. In France, it has been available since July 2016 through a temporary approval which requires a hospital-based pharmacy and a nominative registration of each patient. We present the characteristics of the first patients who could receive this prescription in our hospital-based addiction center and how they used naloxone during follow-up. Results favor a larger dispensing of naloxone. Patients' as well as peers' and families' education is needed...
March 29, 2018: Thérapie
https://www.readbyqxmd.com/read/29680097/cost-effectiveness-of-take-home-naloxone-for-the-prevention-of-overdose-fatalities-among-heroin-users-in-the-united-kingdom
#3
Sue Langham, Antony Wright, James Kenworthy, Richard Grieve, William C N Dunlop
BACKGROUND: Heroin overdose is a major cause of premature death. Naloxone is an opioid antagonist that is effective for the reversal of heroin overdose in emergency situations and can be used by nonmedical responders. OBJECTIVE: Our aim was to assess the cost-effectiveness of distributing naloxone to adults at risk of heroin overdose for use by nonmedical responders compared with no naloxone distribution in a European healthcare setting (United Kingdom). METHODS: A Markov model with an integrated decision tree was developed based on an existing model, using UK data where available...
April 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/29679881/ventrolateral-orbital-cortex-oxytocin-attenuates-neuropathic-pain-through-periaqueductal-gray-opioid-receptor
#4
Mina Taati, Esmaeal Tamaddonfard
BACKGROUND: Oxytocin plays an important role in supraspinal modulation of pain. In the present study, we investigated the effects of ventrolateral orbital cortex (VLOC) microinjection of oxytocin on neuropathic pain after blockade of opioid receptors in this area and ventrolateral periaqueductal gray (vlPAG). METHODS: Neuropathic pain was induced by complete transcection of preoneal and tibial branches of sciatic nerve. The VLOC and vlPAG were unilaterally (contralateral to the sciatic nerve-injured side) and bilaterally implanted with guide cannulas, respectively...
December 21, 2017: Pharmacological Reports: PR
https://www.readbyqxmd.com/read/29678561/distribution-of-take-home-opioid-antagonist-kits-during-a-synthetic-opioid-epidemic-in-british-columbia-canada-a-modelling-study
#5
Michael A Irvine, Jane A Buxton, Michael Otterstatter, Robert Balshaw, Reka Gustafson, Mark Tyndall, Perry Kendall, Thomas Kerr, Mark Gilbert, Daniel Coombs
BACKGROUND: Illicit use of high-potency synthetic opioids has become a global issue over the past decade. This misuse is particularly pronounced in British Columbia, Canada, where a rapid increase in availability of fentanyl and other synthetic opioids in the local illicit drug supply during 2016 led to a substantial increase in overdoses and deaths. In response, distribution of take-home naloxone (THN) overdose prevention kits was scaled up (6·4-fold increase) throughout the province...
April 17, 2018: Lancet. Public Health
https://www.readbyqxmd.com/read/29678560/take-home-naloxone-while-good-it-is-far-from-good-enough
#6
Catherine Maria Comiskey
No abstract text is available yet for this article.
April 17, 2018: Lancet. Public Health
https://www.readbyqxmd.com/read/29677413/survey-assessing-medical-student-and-physician-knowledge-and-attitudes-regarding-the-opioid-crisis
#7
Skyler Chouinard, Aman Prasad, Randall Brown
BACKGROUND: There is a national opioid misuse and overdose crisis. Consensus guidelines seek to inform practice and reduce risk; however, effect on clinician attitudes and knowledge remains unclear. METHODS: We surveyed 228 medical students and physicians in Wisconsin to assess their knowledge regarding at-risk patients, alternatives to opioids, and best treatment practices for opioid addiction. We also assessed attitudes about prescribing naloxone, relapse likelihood, and responsibility for the crisis...
March 2018: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29674251/outpatient-transition-to-extended-release-injectable-naltrexone-for-patients-with-opioid-use-disorder-a-phase-3-randomized-trial
#8
Adam Bisaga, Paolo Mannelli, Miao Yu, Narinder Nangia, Christine E Graham, D Andrew Tompkins, Thomas R Kosten, Sarah C Akerman, Bernard L Silverman, Maria A Sullivan
BACKGROUND: Injectable extended-release naltrexone (XR-NTX), approved to prevent relapse to opioid dependence, requires initial abstinence. This multisite outpatient clinical trial examined the efficacy and safety of low-dose oral naltrexone (NTX), combined with a brief buprenorphine (BUP) taper and standing ancillary medications, for detoxification and induction onto XR-NTX. METHODS: Patients (N = 378) were randomized, stratified by primary short-acting opioid-of-use, to one of three regimens: NTX + BUP; NTX + placebo BUP (PBO-B); placebo NTX (PBO-N) + PBO-B...
April 10, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29673329/comparison-of-electroencephalographic-changes-in-response-to-acute-electrical-and-thermal-stimuli-with-the-tail-flick-and-hot-plate-test-in-rats-administered-with-opiorphin
#9
Preet Singh, Kavitha Kongara, David Harding, Neil Ward, Venkata Sayoji Rao Dukkipati, Craig Johnson, Paul Chambers
BACKGROUND: The objective of this study was to compare the changes in the electroencephalogram (EEG) in response to noxious stimuli with tail flick and hot plate responses of rats administered opiorphin. METHODS: Female Sprague -Dawley rats (n = 8 per group) randomly received intravenous (IV) injection of morphine (1 mg/kg,) or opiorphin (2 mg/kg,) or saline (0.5 ml,) in each of the three testing methods (EEG, tail flick and hot plate). Each type of test (n = 24 per test) was conducted in different population of rats on separate occasions...
April 19, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29672167/sex-differences-in-opioid-use-and-medical-issues-during-buprenorphine-naloxone-treatment
#10
Celestina Barbosa-Leiker, Sterling McPherson, Matthew E Layton, Ekaterina Burduli, John M Roll, Walter Ling
BACKGROUND: There are sex differences in buprenorphine/naloxone clinical trials for opioid use. While women have fewer opioid-positive urine samples, relative to men, a significant decrease in opioid-positive samples was found during treatment for men, but not women. In order to inform sex-based approaches to improve treatment outcomes, research is needed to determine if opioid use, and predictors of opioid use, differs between men and women during treatment. OBJECTIVES: To test for sex differences in opioid use during a buprenorphine/naloxone clinical trial and determine if sex differences exist in the associations between addiction-related problem areas and opioid use over the course of the trial...
April 19, 2018: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/29671681/sexual-dysfunctions-are-predicted-by-childhood-sexual-abuse-in-women-with-opioid-use-disorder
#11
Ruken Ağaçhanlı, İzgi Alnıak, Cuneyt Evren
BACKGROUND: Studies on sexual functioning of populations with substance use disorders (SUDs) are mostly conducted with male substance users. We have very limited information about the sexuality and related factors in women with opioid use disorder (OUD). OBJECTIVES: We aimed to evaluate the relationship between childhood traumatic experiences (CTEs) and sexual dysfunctions (SDs) of women with OUD and to compare it with a sample of women who do not have SUD. METHODS: Participants included 51 outpatient women with OUD who were on opioid maintenance treatment (OMT) with Buprenorphine/Naloxone and 48 women without SUD...
April 19, 2018: Substance Use & Misuse
https://www.readbyqxmd.com/read/29671504/buprenorphine-therapy-for-opioid-use-disorder
#12
Roger Zoorob, Alicia Kowalchuk, Maria Mejia de Grubb
Opioid misuse, including the use of heroin and the overprescribing, misuse, and diversion of opioid pain medications, has reached epidemic proportions in the United States. As a result, there has been a dramatic increase in opioid use disorder and associated overdoses and deaths. Addiction is a chronic brain disease with a genetic component that affects motivation, inhibition, and cognition. Patient characteristics associated with successful buprenorphine maintenance treatment include stable or controlled medical or psychiatric comorbidities and a safe, substance-free environment...
March 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29668645/coverage-of-medications-that-treat-opioid-use-disorder-and-opioids-for-pain-management-in-marketplace-plans-2017
#13
Haiden A Huskamp, Lauren E Riedel, Colleen L Barry, Alisa B Busch
BACKGROUND: Efficacious medications to treat opioid use disorders (OUDs) have been slow to diffuse into practice, and insurance coverage limits may be one important barrier. OBJECTIVES: To compare coverage for medications used to treat OUDs and opioids commonly prescribed for pain management in plans offered on the 2017 Health Insurance Marketplace exchanges. RESEARCH DESIGN: We identified a sample of 100 plans offered in urban and in rural counties on the 2017 Marketplaces, weighting by population...
April 17, 2018: Medical Care
https://www.readbyqxmd.com/read/29667859/prescribing-naloxone-for-opioid-overdose-intervention
#14
Robert B Dunne
To provide an update on prescription of naloxone as a harm-reduction strategy, PubMed was searched to identify publications relevant to naloxone prescribing for reversal of opioid overdose. Opportunities now exist to expand naloxone use, although evidence suggests these are often missed or underexploited. The US FDA has approved an intranasal naloxone spray and an autoinjector naloxone formulation for community use. Effective use of naloxone in community settings requires screening to identify patients at risk of opioid overdose, discussing naloxone use with patients and their relatives, and providing appropriate training...
April 18, 2018: Pain Management
https://www.readbyqxmd.com/read/29667452/the-feasibility-of-employing-a-home-healthcare-model-for-education-and-treatment-of-opioid-overdose-using-a-naloxone-auto-injector-in-a-private-practice-pain-medicine-clinic
#15
Anthony Dragovich, Fred Brason, Thomas Beltran, Amy McCoart, Anthony R Plunkett
OBJECTIVES: The purpose of this study was to determine if employing a home healthcare model for education and treatment of opioid overdose using Evzio® (Naloxone)* auto-injector in a private practice pain clinic. METHODS: A prospective survey was used to determine the feasibility of integrating a naloxone auto-injector within the patient's home with a home care training model. Twenty moderate or high-risk patients were enrolled from our chronic pain clinic. Patients who were moderate or high risk completed an evaluation survey...
April 18, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29665651/3-hydroxy-piperidinyl-n-benzyl-acyl-arylhydrazone-derivatives-reduce-neuropathic-pain-and-increase-thermal-threshold-mediated-by-opioid-system
#16
Nathália M Dos Santos, Nayara C Pereira, Angélica P S de Albuquerque, Flávia P Dias Viegas, Clarice Veloso, Fabiana C Vilela, Alexandre Giusti-Paiva, Marcelo L da Silva, Josie R T da Silva, Claudio Viegas
Here in, we report the preparation and evaluation of four 3-hydroxy-piperidine-N-benzyl-aryl-acylhydrazone derivatives (6a-d) for their potential antinociceptive activity. In the tail flick test, compounds 6a and 6d exhibited a significant increase in the latency time of the animals, in comparison to the control group. These two compounds also showed a significant increase in the nociceptive threshold from 1 to 6 h after treatment in the CCI neuropathic pain model. In both cases, the antinociceptive activity was blocked by naloxone, suggesting an opioid mechanism of action, but without sedative or motor coordination effects...
March 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/29664203/trends-and-patterns-of-opioid-analgesic-prescribing-regional-and-rural-urban-variations-in-kentucky-from-2012-to-2015
#17
Huong Luu, Svetla Slavova, Patricia R Freeman, Michelle Lofwall, Steven Browning, Heather Bush
PURPOSE: Increased opioid analgesic prescribing (OAP) has been associated with increased risk of prescription opioid diversion, misuse, and abuse. We studied regional and rural-urban variations in OAP trends in Kentucky, from 2012 to 2015, and examined potential county-level risk and protective factors. METHODS: This study used prescription drug monitoring data. Marginal models employing generalized estimating equations were used to model repeated counts of residents with opioid analgesic prescriptions within county-quarter, 2012-2015, with offset for resident population, by rural-urban classification exposure, and adjusting for time-varying socioeconomic and relevant health status measures...
April 17, 2018: Journal of Rural Health
https://www.readbyqxmd.com/read/29663018/effects-of-acute-morphine-withdrawal-on-ultrasonic-vocalizations-in-adult-rats-unchanged-50-khz-call-rate-and-altered-subtype-profile
#18
YiQi C Lin, Leah L Zhao, Paul B S Clarke
RATIONALE: Adult rat 22- and 50-kHz ultrasonic vocalizations (USVs) are commonly considered as indices of negative and positive affect, respectively. More specifically, we have proposed that positive affective states are revealed by a predominance of trill over flat 50-kHz call subtypes. However, the 50-kHz call subtypes emitted during aversive drug states remain largely uninvestigated. OBJECTIVES: To determine whether acute morphine withdrawal affects 50-kHz call rates or alters the relative prevalence of trill and flat calls...
April 16, 2018: Psychopharmacology
https://www.readbyqxmd.com/read/29651781/abuse-deterrent-opioid-formulations-a-key-ingredient-in-the-recipe-to-prevent-opioid-disasters
#19
Aaron J Salwan, Nicholas E Hagemeier, Sam Harirforoosh
The US Food and Drug Administration (FDA) is encouraging the innovation of long-acting opioid formulations that are manipulation-resistant. The purpose of this commentary is to assess the benefits and limitations of abuse-deterrent opioid formulations (ADFs) and discuss their role in mitigating the current opioid epidemic. ADFs have been created with chemical properties that make it difficult for people who non-medically use prescription drugs to crush and dissolve opioid tablets, as well as by combining opioids with antagonists such as naloxone or naltrexone, which are released only when the dosage form has been manipulated or the drug is taken by a non-intended route...
April 12, 2018: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29650444/reviewing-state-mandated-training-requirements-for-naloxone-dispensing-pharmacists
#20
Andrew W Roberts, Delesha M Carpenter, Austin Smith, Kevin A Look
BACKGROUND: Expanding access to naloxone is crucial for mitigating the public health epidemic of opioid overdose deaths in America. Pharmacists now have greater independent authority to dispense naloxone to the public due to a wave of enhanced pharmacy naloxone access laws. It is unknown to what extent pharmacists are required to receive specialized training to serve in this capacity. OBJECTIVES: The goal of this study was to review naloxone training mandates from states with enhanced pharmacy naloxone access laws...
April 5, 2018: Research in Social & Administrative Pharmacy: RSAP
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