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https://www.readbyqxmd.com/read/29913015/comparison-of-safety-and-efficacy-of-methadone-vs-morphine-for-treatment-of-neonatal-abstinence-syndrome-a-randomized-clinical-trial
#1
Jonathan M Davis, Jeffrey Shenberger, Norma Terrin, Janis L Breeze, Mark Hudak, Elisha M Wachman, Peter Marro, Erica L Oliveira, Karen Harvey-Wilkes, Adam Czynski, Barbara Engelhardt, Karen D'Apolito, Debra Bogen, Barry Lester
Importance: Although opioids are used to treat neonatal abstinence syndrome (NAS), the best pharmacologic treatment has not been established. Objective: To compare the safety and efficacy of methadone and morphine in NAS. Design, Setting, and Participants: In this randomized, double-blind, intention-to-treat trial, term infants from 8 US newborn units whose mothers received buprenorphine, methadone, or opioids for pain control during pregnancy were eligible...
June 18, 2018: JAMA Pediatrics
https://www.readbyqxmd.com/read/29897589/efficacy-of-lubiprostone-for-the-treatment-of-opioid-induced-constipation-analyzed-by-opioid-class
#2
Lynn R Webster, Randall P Brewer, Peter Lichtlen, Taryn Losch-Beridon, Shadreck Mareya, Martin Wang
Objectives: To examine the efficacy and safety of lubiprostone for the treatment of opioid-induced constipation (OIC) in patients by opioid class received. Design: Data were pooled from three phase III, randomized, double-blind, placebo-controlled studies. Subjects/Setting: Adults with chronic noncancer pain receiving opioid therapy for 30 or more days and diagnosed with OIC. Methods: Overall mean change from baseline in spontaneous bowel movement (SBM) frequency, overall treatment response (≥1 SBM/week improvement over baseline SBM frequency in all treatment weeks with available data and ≥3 SBMs/week for ≥9 of the 12 weeks of treatment), and OIC-related symptoms were examined in patients taking opioids...
June 1, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29893627/practices-attitudes-and-beliefs-of-palliative-care-physicians-regarding-the-use-of-methadone-and-other-long-acting-opioids-in-children-with-advanced-cancer
#3
Kevin Madden, Minjeong Park, Diane Liu, Eduardo Bruera
BACKGROUND: Palliative care physicians often assist with pain management in children with cancer, but little is known about how they use long-acting opioids for chronic pain with these patients. OBJECTIVE: To determine the practices, attitudes, and beliefs of palliative care physicians toward the use of long-acting opioids in children with advanced cancer. DESIGN: An electronic survey was sent to all members of The American Academy of Pediatrics (AAP) Section of Hospice and Palliative Medicine (SOHPM) and those identified as physicians who provide palliative care to children on the AAP SOHPM LISTSERV® ...
June 12, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29851451/the-role-of-managed-care-professionals-and-pharmacists-in-combating-opioid-abuse
#4
Kirk Moberg
Substance misuse is a critical and costly public health problem in the United States. Data as of 2016 show 11,517 cases of opioid analgesic misuse, with the majority (6924 cases) related to hydrocodone misuse. Substance misuse impacts our society significantly with high costs related to healthcare, crime, and lost productivity. Opioid analgesic pain relievers are one of the most prescribed classes of medications and are among the most common drugs related to misuse. Increases in emergency department visits of over 200% have been associated with a dramatic surge in written prescriptions for opioid pain relievers...
May 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29847389/opioid-use-disorders-perioperative-management-of-a-special-population
#5
Emine Nalan Ward, Aurora Naa-Afoley Quaye, Timothy E Wilens
Opioid-related overdose deaths have reached epidemic levels within the last decade. The efforts to prevent, identify, and treat opioid use disorders (OUDs) mostly focus on the outpatient setting. Despite their frequent overrepresentation, less is known about the inpatient management of patients with OUDs. Specifically, the perioperative phase is a very vulnerable time for patients with OUDs, and little has been studied on the optimal management of acute pain in these patients. The preoperative evaluation should aim to identify those with OUDs and assess factors that may interfere with OUD treatment and pain management...
May 25, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29847382/intraoperative-methadone-in-same-day-ambulatory-surgery-a-randomized-double-blinded-dose-finding-pilot-study
#6
Helga Komen, L Michael Brunt, Elena Deych, Jane Blood, Evan D Kharasch
BACKGROUND: Approximately 50 million US patients undergo ambulatory surgery annually. Postoperative opioid overprescribing is problematic, yet many patients report inadequate pain relief. In major inpatient surgery, intraoperative single-dose methadone produces better analgesia and reduces opioid use compared with conventional repeated dosing of short-duration opioids. This investigation tested the hypothesis that in same-day ambulatory surgery, intraoperative methadone, compared with short-duration opioids, reduces opioid consumption and pain, and determined an effective intraoperative induction dose of methadone for same-day ambulatory surgery...
May 25, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29796025/relationship-between-serum-methadone-concentration-and-cold-pressor-pain-sensitivity-in-patients-undergoing-methadone-maintenance-therapy
#7
Zalina Zahari, Chee Siong Lee, Muslih Abdulkarim Ibrahim, Nurfadhlina Musa, Mohd Azhar Mohd Yasin, Yeong Yeh Lee, Soo Choon Tan, Nasir Mohamad, Rusli Ismail
Hyperalgesia is a common clinical phenomenon among opioid dependent patients on methadone maintenance therapy (MMT) and it may be associated with undertreated pain and/or therapeutic failure. This study aimed to investigate association between serum methadone concentration (SMC) and cold pressor pain responses. Cold pressor pain responses in 147 opioid dependent patients on MMT were assessed using cold pressor test (CPT) at 0 h and at 2, 4, 8, 12, and 24 h after the dose intake. Blood samples were collected at 24 h after the dose...
2018: Iranian Journal of Pharmaceutical Research: IJPR
https://www.readbyqxmd.com/read/29781530/a-comparison-between-methadone-and-buprenorphine-for-perioperative-analgesia-in-dogs-undergoing-ovariohysterectomy
#8
M D Shah, D Yates, J Hunt, J C Murrell
OBJECTIVE: To investigate whether preoperative methadone provides superior perioperative analgesia compared to buprenorphine in dogs undergoing ovariohysterectomy. METHODS: Eighty female dogs were recruited to an assessor-blinded, randomised, clinical trial. Dogs received a premedication dose of 0·05 mg/kg acepromazine or 10 μg/kg medetomidine combined with either 0·3 mg/kg methadone or 20 μg/kg buprenorphine intramuscularly. Anaesthesia was induced with propofol and maintained with isoflurane...
May 21, 2018: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29764265/use-of-methadone-to-reverse-opioid-escalation-in-a-patient-with-surgical-pain
#9
Muhammad Jaffar, Gwin Cunningham, Michael Chandler, Thomas Webb
Acute pain is a prevalent issue for patients recovering from surgical procedures. Methadone has been recognized as a unique option for treatment of surgical pain due to its multiple mechanisms of analgesia and its potential to decrease tolerance to other opioids. Studies of methadone use in postoperative settings are sparse in part due to safety concerns, such as complex pharmacokinetics, risk of respiratory depression, and association with arrhythmias. In this case study of a 70-year-old male with postsurgical abdominal pain, methadone utilization over a period of 9 days resulted in patient-reported analgesia and aided in de-escalating overall opioid use...
May 15, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/29762767/concerns-and-help-seeking-among-patients-using-opioids-for-management-of-chronic-noncancer-pain
#10
Briony Larance, Gabrielle Campbell, Teleri Moore, Suzanne Nielsen, Raimondo Bruno, Nicholas Lintzeris, Milton Cohen, Wayne Hall, Richard Mattick, Courtney O'Donnell, Louisa Degenhardt
Background: The safety and efficacy of long-term opioid treatment for chronic noncancer pain (CNCP) remains controversial. This study examined whether patients who report problematic opioid use sought help and/or perceived barriers to help-seeking. Methods: Data were collected from 1,086 people prescribed opioids for CNCP via a large prospective cohort called the Pain and Opioids IN Treatment (POINT) study. Patients' characteristics and help-seeking were examined according to scores on the Prescribed Opioids Difficulties Scale (PODS)...
May 11, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29749702/management-of-severe-chronic-pain-with-methadone-in-pediatric-patients-with-sickle-cell-disease
#11
Zachary LeBlanc, Chris Vance, Jason Payne, Jie Zhang, Lee Hilliard, Jeffrey D Lebensburger, Thomas H Howard
Vasocclusive pain crises are common among pediatric patients with sickle cell disease (SCD). Some patients with repeated pain crises develop chronic pain. We performed a retrospective cohort study of pediatric patients with SCD with chronic pain treated with methadone. We identified a significant reduction in pain hospitalizations following methadone treatment (0.35 ± 0.19 vs. 0.19 ± 0.17 hospitalizations/month, P = 0.016). In addition, we did not observe overt organ toxicity nor symptoms of opioid withdrawal during methadone wean...
May 11, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29733095/assessment-of-outcomes-following-high-dose-opioid-tapering-in-a-veterans-healthcare-system
#12
Lauren Hundley, Shelley Spradley, Scott Donelenko
OBJECTIVE: To assess the impact of tapering of chronic high dose opioid therapy in veterans prompted by the implementation of the Opioid Safety Initiative in 2013. DESIGN: IRB and VA Office of Research and Development-approved retrospective, observational chart review. SETTING: North Florida/South Georgia Veterans Health System Patients: Veterans on high dose opioid therapy (≥300 mg of morphine equivalents per day) for chronic non-cancer pain as of 1/1/2012 with an opioid agreement discontinuation note documented in the medical record were included...
March 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29729777/methadone-maximizing-safety-and-efficacy-for-pain-control-in-patients-with-cancer
#13
REVIEW
Mary Lynn McPherson, Ryan C Costantino, Alexandra L McPherson
Methadone is a valuable opioid in the management of patients who have cancer with pain. Methadone is a mu-, kappa-, and delta-opioid agonist, and an N-methyl-D-aspartate receptor antagonist. These mechanisms of action make methadone an attractive option for complex pain syndromes. It is critically important that providers consider a patient's risk status before beginning methadone. Careful consideration must be given to dosing methadone in both opioid-naïve and opioid-tolerant patients, with vigilant monitoring for therapeutic effectiveness and potential toxicity until the patient achieves steady state...
June 2018: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/29726847/opioid-induced-hyperalgesia-in-the-nonsurgical-setting-a-systematic-review
#14
David Z Yang, Billy Sin, Joshua Beckhusen, Dawei Xia, Rebecca Khaimova, Ilia Iliev
BACKGROUND: Opioid-induced hyperalgesia (OIH) is a phenomenon that causes an increased pain sensitization and perception of pain to noxious stimuli secondary to opioid exposure. While this clinical effect has been described in the surgical setting, it is unclear if OIH occurs in the nonsurgical setting. STUDY QUESTION: To review the available literature which evaluated OIH in nonsurgical settings. DATA SOURCES: A comprehensive literature search was performed using PubMed (January 1946-July 2017) using a variety of keywords for OIH...
January 31, 2018: American Journal of Therapeutics
https://www.readbyqxmd.com/read/29700030/yonder-chronic-pain-asthma-obstructive-sleep-apnoea-and-methadone-prescribing
#15
Ahmed Rashid
No abstract text is available yet for this article.
May 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29694467/continuous-dentoalveolar-neuropathic-pain-response-to-repeated-intravenous-ketamine-infusions-a-case-report
#16
Isabel Moreno-Hay, John Lindroth
This article describes a case of continuous dentoalveolar neuropathic pain in which relief was obtained following repeated administration of intravenous infusions of a subanesthetic dose of ketamine. A 50-year-old female presented in 2006 with a 1-year history of constant sharp pain in the gingiva surrounding the maxillary left second premolar and second molar rated as 10/10 on a pain intensity scale. After multiple systemic medications failed to adequately manage the patient's pain, partial pain reduction was obtained (4/10) with daily use of methadone 50 mg in combination with application of a topical compound including lidocaine, amitriptyline, and carbamazepine to the affected area as needed...
April 2018: Journal of Oral & Facial Pain and Headache
https://www.readbyqxmd.com/read/29671504/buprenorphine-therapy-for-opioid-use-disorder
#17
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/29665978/outpatient-intravenous-multimodal-elastomeric-pump-with-methadone-in-ambulatory-surgery
#18
L Gómez-López, X Sala-Blanch, P L Gambús Cerrillo, A López Gutiérrez, M Agustí Lasús, M T Anglada Casas
BACKGROUND AND OBJECTIVE: Analgesia in Ambulatory Surgery (AS) needs to evolve in parallel with surgical complexity. We designed a study to try to improve analgesia in painful surgery using an intravenous elastomeric pump. As a novelty, methadone was included. PATIENTS AND METHODS: An observational study, physical status ASA I-II, underwent ambulatory surgeries with moderate-severe postoperative pain. Analgesia was administered for 48h by an intravenous multimodal elastomeric pump (methadone, tramadol, dexketoprofen and ondansetron at low doses)...
June 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29664690/methadone-as-the-initial-long-acting-opioid-in-children-with-advanced-cancer
#19
Kevin Madden, Sarah Mills, Seyedeh Dibaj, Janet L Williams, Diane Liu, Eduardo Bruera
BACKGROUND: Methadone is an attractive medication for treating children with advanced cancer with pain as it is the only long-acting opioid available as a liquid. However, it is not frequently used due to concerns about potential toxicities and side effects. OBJECTIVE: Evaluate the efficacy and safety of methadone as the first long-acting opioid in children with advanced cancer. DESIGN: Retrospective chart review of 52 consecutive patients referred to Pediatric Supportive Care for pain management started on methadone as their first long-acting opioid...
April 17, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29627201/perioperative-analgesic-effects-of-an-ultrasound-guided-transversus-abdominis-plane-block-with-a-mixture-of-bupivacaine-and-lidocaine-in-cats-undergoing-ovariectomy
#20
Despoina Skouropoulou, Luca Lacitignola, Paola Centonze, Angela Simone, Alberto M Crovace, Francesco Staffieri
OBJECTIVE: To evaluate the perioperative analgesic effects of a transversus abdominis plane (TAP) block with a mixture of lidocaine and bupivacaine administered to cats undergoing ovariectomy. STUDY DESIGN: Controlled, randomized, prospective, blinded clinical study. ANIMALS: A group of 20 healthy cats. METHODS: Robenacoxib (2 mg kg-1 ) was administered subcutaneously 0.5 hour before intramuscular (IM) administration of ketamine (5 mg kg-1 ), methadone (0...
May 2018: Veterinary Anaesthesia and Analgesia
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