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https://www.readbyqxmd.com/read/28343821/use-of-chronic-methadone-before-total-knee-arthroplasty
#1
Ferdinand J Chan, Andrew M Schwartz, Jason Wong, Cynthia Chen, Bharat Tiwari, Sun Jin Kim
BACKGROUND: A subset of patients who undergo total knee arthroplasty (TKA) are on methadone maintenance. They require more and often unpredictable quantities of opioids to function as effective painkillers. This study aims to compare the opioid requirements and the immediate postoperative course for patients on methadone maintenance with those who are not, after a TKA. METHODS: A retrospective, case-control study was performed. From 2005 to 2010, 36 patients, who underwent a unilateral TKA, on chronic methadone maintenance were identified...
February 28, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28343774/immunogenicity-and-safety-of-a-high-dose-hepatitis-b-vaccine-among-patients-receiving-methadone-maintenance-treatment-a-randomized-double-blinded-parallel-controlled-trial
#2
Jing Shi, Yongliang Feng, Linying Gao, Dan Feng, Tian Yao, Shan Shi, Yawei Zhang, Xiaofeng Liang, Suping Wang
BACKGROUND AND AIMS: To explore whether the immunization with high-dose (60μg) hepatitis B vaccines in patients receiving methadone maintenance treatment (MMT) could yield a superior protection against hepatitis B infection than did the standard dose (20μg). METHODS: We conducted a randomized, double-blinded, parallel-controlled trial in MMT patients. Patients with serologically negative hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (anti-HBs) were randomized in a ratio of 1:1 to receive three intramuscular injections of 20μg or 60μg recombinant hepatitis B vaccine at months 0, 1, and 6...
March 23, 2017: Vaccine
https://www.readbyqxmd.com/read/28339433/management-of-neuropathic-chronic-pain-with-methadone-combined-with-ketamine-a-randomized-double-blind-active-controlled-clinical-trial
#3
Flavia Karine Rigo, Gabriela Trevisan, Maria C Godoy, Mateus Fortes Rossato, Gerusa D Dalmolin, Mariane A Silva, Mirian S Menezes, Wolnei Caumo, Juliano Ferreira
BACKGROUND: Methadone and ketamine are used in neuropathic pain management. However, the benefits of both drugs association are uncertain in the treatment of neuropathic pain. OBJECTIVE: Our primary objective was test the hypothesis that oral methadone combined with oral ketamine is more effective than oral methadone or ketamine alone in reducing neuropathic pain. STUDY DESIGN: We conducted a randomized, double blind, active-controlled parallel-group clinical trial...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28337083/continuous-infusion-etomidate-in-a-patient-receiving-extracorporeal-membrane-oxygenation
#4
Joseph M LaRochelle, Bonnie Desselle, Janet L Rossi
We describe a 16-year-old, 65-kg male deployed on extracorporeal membrane oxygenation (ECMO) for refractory respiratory failure secondary to ingestion of multiple substances. During his ECMO course, standard sedative and analgesic strategies failed and alternative medications were used. The patient received various dosages of fentanyl, morphine, hydromorphone, clonidine patches, dexmedetomidine, lorazepam, methadone, pentobarbital, olanzapine, and propofol. Despite administration of multiple agents, on day 29 of ECMO the patient experienced elevated blood pressures due to agitation, and continuous infusion etomidate was started...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28315808/benzodiazepine-z-drug-and-pregabalin-prescriptions-and-mortality-among-patients-in-opioid-maintenance-treatment-a-nation-wide-register-based-open-cohort-study
#5
Tove Abrahamsson, Jonas Berge, Agneta Öjehagen, Anders Håkansson
BACKGROUND: Use of sedatives may increase risk of death in opioid users. The aim of the study was to assess whether prescription of sedatives may be associated with mortality in patients in opioid maintenance treatment. METHODS: This retrospective register-based open cohort study included nation-wide register data including all individuals who were dispensed methadone or buprenorphine as opioid maintenance treatment for opioid dependence between July, 2005 and December, 2012 (N=4501)...
February 28, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28314286/safety-and-tolerance-of-d-l-methadone-in-combination-with-chemotherapy-in-patients-with-glioma
#6
Julia Onken, Claudia Friesen, Peter Vajkoczy, Martin Misch
BACKGROUND/AIM: D,L-Methadone increases sensitivity toward chemotherapy of different tumor cell populations. We evaluated the safety and tolerance of additional use of D,L-methadone in patients with glioma in combination with chemotherapy. PATIENTS AND METHODS: The dosage, duration of therapy and side-effects related to D,L-methadone were recorded in 27 patients. Toxicity was assessed accordingly to the Common Toxicity Criteria (CTC) of the National Cancer Institute...
March 2017: Anticancer Research
https://www.readbyqxmd.com/read/28292505/unintentional-methadone-and-buprenorphine-exposures-in-children-developing-prevention-messages
#7
Lauren Schwartz, Maria Mercurio-Zappala, Mary Ann Howland, Robert S Hoffman, Mark K Su
OBJECTIVES: To develop key messages for methadone and buprenorphine safety education material based on an analysis of calls to the NYC Poison Control Center (NYC PCC) and designed for distribution to caregivers of young children. METHODS: Retrospective review of all calls for children 5 years of age and younger involving methadone or buprenorphine from January 1, 2000, to June 15, 2014. A data abstraction form was completed for each case to capture patient demographics, exposure and caller sites, caller relation to patient, qualitative information regarding the exposure scenario, the product information, if naloxone was given, and the medical outcome of the case...
March 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28243315/acceleration-of-cardiovascular-biological-age-by-amphetamine-exposure-is-a-power-function-of-chronological-age
#8
Albert Stuart Reece, Amanda Norman, Gary Kenneth Hulse
BACKGROUND: Amphetamine abuse is becoming more widespread internationally. The possibility that its many cardiovascular complications are associated with a prematurely aged cardiovascular system, and indeed biological organism systemically, has not been addressed. METHODS: Radial arterial pulse tonometry was performed using the SphygmoCor system (Sydney). 55 amphetamine exposed patients were compared with 107 tobacco smokers, 483 non-smokers and 68 methadone patients (total=713 patients) from 2006 to 2011...
2017: Heart Asia
https://www.readbyqxmd.com/read/28226332/responsible-safe-and-effective-prescription-of-opioids-for-chronic-non-cancer-pain-american-society-of-interventional-pain-physicians-asipp-guidelines
#9
Laxmaiah Manchikanti, Adam M Kaye, Nebojsa Nick Knezevic, Heath McAnally, Konstantin Slavin, Andrea M Trescot, Susan Blank, Vidyasagar Pampati, Salahadin Abdi, Jay S Grider, Alan D Kaye, Kavita N Manchikanti, Harold Cordner, Christopher G Gharibo, Michael E Harned, Sheri L Albers, Sairam Atluri, Steve M Aydin, Sanjay Bakshi, Robert L Barkin, Ramsin M Benyamin, Mark V Boswell, Ricardo M Buenaventura, Aaron K Calodney, David L Cedeno, Sukdeb Datta, Timothy R Deer, Bert Fellows, Vincent Galan, Vahid Grami, Hans Hansen, Standiford Helm Ii, Rafael Justiz, Dhanalakshmi Koyyalagunta, Yogesh Malla, Annu Navani, Kent H Nouri, Ramarao Pasupuleti, Nalini Sehgal, Sanford M Silverman, Thomas T Simopoulos, Vijay Singh, Daneshvari R Solanki, Peter S Staats, Ricardo Vallejo, Bradley W Wargo, Arthur Watanabe, Joshua A Hirsch
BACKGROUND: Opioid use, abuse, and adverse consequences, including death, have escalated at an alarming rate since the 1990s. In an attempt to control opioid abuse, numerous regulations and guidelines for responsible opioid prescribing have been developed by various organizations. However, the US opioid epidemic is continuing and drug dose deaths tripled during 1999 to 2015. Recent data show a continuing increase in deaths due to natural and semisynthetic opioids, a decline in methadone deaths, and an explosive increase in the rates of deaths involving other opioids, specifically heroin and illicit synthetic fentanyl...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28220474/buprenorphine-for-managing-opioid-withdrawal
#10
REVIEW
Linda Gowing, Robert Ali, Jason M White, Dalitso Mbewe
BACKGROUND: Managed withdrawal is a necessary step prior to drug-free treatment or as the endpoint of substitution treatment. OBJECTIVES: To assess the effects of buprenorphine versus tapered doses of methadone, alpha2-adrenergic agonists, symptomatic medications or placebo, or different buprenorphine regimens for managing opioid withdrawal, in terms of the intensity of the withdrawal syndrome experienced, duration and completion of treatment, and adverse effects...
February 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28213673/individual-placement-and-support-ips-for-methadone-maintenance-therapy-patients-a-pilot-randomized-controlled-trial
#11
Carrie E Lones, Gary R Bond, Mark P McGovern, Kathryn Carr, Teresa Leckron-Myers, Tim Hartnett, Deborah R Becker
Individual Placement and Support (IPS) is an evidence-based employment model for people with severe mental illness, but it has not been evaluated for clients enrolled in substance abuse treatment programs. This study evaluated the effectiveness of IPS for people with opioid use disorders enrolled in an opioid treatment program. Within a randomized controlled experiment, 45 patients receiving methadone maintenance therapy were assigned to either IPS or a 6-month waitlist. The waitlist group received IPS after 6 months...
February 17, 2017: Administration and Policy in Mental Health
https://www.readbyqxmd.com/read/28186837/methadone-and-corrected-qt-prolongation-in-pain-and-palliative-care-patients-a-case-control-study
#12
Katherine M Juba, Tina M Khadem, David J Hutchinson, Jack E Brown
BACKGROUND: Methadone (ME) is commonly used in pain and palliative care (PPC) patients with refractory pain or intolerable opioid adverse effects (AEs). A unique ME AE is its corrected QT (QTc) interval prolongation risk, but most evidence exists in methadone maintenance therapy patients. OBJECTIVE: Our goal was to identify QTc interval prolongation risk factors in PPC patients receiving ME and other medications known to prolong the QTc interval and develop a risk stratification tool...
February 10, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28177515/methadone-for-cancer-pain
#13
REVIEW
Alexander B Nicholson, Graeme R Watson, Sheena Derry, Philip J Wiffen
BACKGROUND: This is an updated review originally published in 2004 and first updated in 2007. This version includes substantial changes to bring it in line with current methodological requirements. Methadone is a synthetic opioid that presents some challenges in dose titration and is recognised to cause potentially fatal arrhythmias in some patients. It does have a place in therapy for people who cannot tolerate other opioids but should be initiated only by experienced practitioners. This review is one of a suite of reviews on opioids for cancer pain...
February 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28156619/a-randomized-controlled-trial-rct-of-2-dose-ratios-for-conversion-from-parenteral-to-oral-methadone-in-patients-with-cancer-pain
#14
Josep Porta-Sales, Maria Nabal-Vicuña, Leyre Diez-Porres, Jaume Canal, Alberto Alonso-Babarro, Yolanda Vilches, Silvia Llorens, Mireia Sanllorente, Silvia Perez-Pujol, Eduardo Bruera
206 Background: Methadone (M) is frequently used for severe cancer pain using the parenteral and oral route. The most commonly used dose ratio (DR) parenteral: oral is 1:2. However, methadone is highly bioavailable and a lower ratio might result in similar analgesia with less toxicity. The main objective of this RCT is to compare success and side effects with 2 ratios of parenteral to oral M: 1:2 vs 1:1.2 in hospitalized patients with cancer pain. METHODS: Inpatients with cancer pain well controlled with parenteral M requiring rotation to the oral route...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156445/evaluation-of-the-japanese-opioid-conversion-ratio-for-switching-to-methadone-for-cancer-pain-control
#15
Sachiko Okayama, Yoshito Yoshikawa, Yoshio Kobayashi
196 Background: In Japan, oral administration of methadone was approved for patients with cancer pain in March 2013. As methadone exhibits complex pharmacokinetics with individual differences and rare but serious adverse effects, methadone is only prescribed as a fourth-line drug by cancer pain specialists, who must start methadone according to the following table and must not increase methadone dose within 7 days. AIMS: To assess the validity of the Japanese opioid conversion ratio. METHODS: The clinical characteristics of 60 patients who were prescribed oral methadone between April 2013 and March 2016 were analyzed...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28063398/brain-derived-neurotrophic-factor-bdnf-and-oxidative-stress-in-heroin-dependent-male-patients-undergoing-methadone-maintenance-treatment
#16
Meng-Chang Tsai, Tiao-Lai Huang
Brain-derived neurotrophic factor (BDNF) and oxidative stress may play a role in patients with heroin dependence. The aim of this study was to investigate the serum levels and activities of BDNF and oxidative stress markers, such as superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), thiobarbituric acid reactive substances (TBARS), protein carbonyl content (PCC), and 8-hydroxy 2'-deoxyguanosine (8-OHdG), in heroin-dependent patients undergoing methadone maintenance treatment (MMT). 60 heroin-dependent male MMT patients and 30 healthy males were recruited for this study...
March 2017: Psychiatry Research
https://www.readbyqxmd.com/read/27927519/a-rapid-recovery-pathway-for-adolescent-idiopathic-scoliosis-that-improves-pain-control-and-reduces-time-to-inpatient-recovery-after-posterior-spinal-fusion
#17
Alex L Gornitzky, John M Flynn, Wallis T Muhly, Wudbhav N Sankar
STUDY DESIGN: Retrospective comparative cohort. OBJECTIVES: To determine if a standardized multimodal analgesic and rehabilitation protocol (rapid recovery pathway [RRP]) in adolescent idiopathic scoliosis (AIS) patients undergoing posterior spinal fusion (PSF) could improve pain control, reduce opioid-related complications, and expedite early mobilization. BACKGROUND: Several reports have described postoperative recovery pathways for AIS patients undergoing PSF that shorten length of stay (LOS) without reporting the impact such pathways might have on patients' pain or quality of recovery...
July 2016: Spine Deformity
https://www.readbyqxmd.com/read/27870477/ascending-single-dose-double-blind-placebo-controlled-safety-study-of-noribogaine-in-opioid-dependent-patients
#18
Paul Glue, Gavin Cape, Donna Tunnicliff, Michelle Lockhart, Fred Lam, Noelyn Hung, C Tak Hung, Sarah Harland, Jane Devane, R S Crockett, John Howes, Borje Darpo, Meijian Zhou, Holger Weis, Lawrence Friedhoff
Ibogaine is a psychoactive substance that may reduce opioid withdrawal symptoms. This was the first clinical trial of noribogaine, ibogaine's active metabolite, in patients established on methadone opioid substitution therapy (OST). In this randomized, double-blind, placebo-controlled single ascending-dose study, we evaluated the safety, tolerability, and pharmacokinetics of noribogaine in 27 patients seeking to discontinue methadone OST who had been switched to morphine during the previous week. Noribogaine doses were 60, 120, or 180 mg (n = 6/dose level) or matching placebo (n = 3/dose level)...
November 2016: Clinical Pharmacology in Drug Development
https://www.readbyqxmd.com/read/27821595/cannabis-exposure-as-an-interactive-cardiovascular-risk-factor-and-accelerant-of-organismal-ageing-a-longitudinal-study
#19
Albert Stuart Reece, Amanda Norman, Gary Kenneth Hulse
OBJECTIVES: Many reports exist of the cardiovascular toxicity of smoked cannabis but none of arterial stiffness measures or vascular age (VA). In view of its diverse toxicology, the possibility that cannabis-exposed patients may be ageing more quickly requires investigation. DESIGN: Cross-sectional and longitudinal, observational. Prospective. SETTING: Single primary care addiction clinic in Brisbane, Australia. PARTICIPANTS: 11 cannabis-only smokers, 504 tobacco-only smokers, 114 tobacco and cannabis smokers and 534 non-smokers...
November 7, 2016: BMJ Open
https://www.readbyqxmd.com/read/27809831/tailoring-a-brief-intervention-for-illicit-drug-use-and-alcohol-use-in-irish-methadone-maintained-opiate-dependent-patients-a-qualitative-process
#20
Catherine Darker, Brion Sweeney, Eamon Keenan, Lucy Whiston, Rolande Anderson, Joe Barry
BACKGROUND: The World Health Organization (WHO) recommend the tailoring of a brief intervention (BI) programme of research to ensure that it is both culturally and contextually appropriate for the country and the environment in which it is being tested. The majority of BI research has been conducted with non-opioid dependent participants. The current study developed a tailored BI for illicit drug use and alcohol use to a methadone maintained opioid dependent polydrug using cohort of patients...
November 3, 2016: BMC Psychiatry
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