keyword
MENU ▼
Read by QxMD icon Read
search

Opioid titration

keyword
https://www.readbyqxmd.com/read/29769132/toots-tastes-and-tester-shots-user-accounts-of-drug-sampling-methods-for-gauging-heroin-potency
#1
Sarah G Mars, Jeff Ondocsin, Daniel Ciccarone
BACKGROUND: Internationally, overdose is the primary cause of death among people injecting drugs. However, since 2001, heroin-related overdose deaths in the United States (US) have risen sixfold, paralleled by a rise in the death rate attributed to synthetic opioids, particularly the fentanyls. This paper considers the adaptations some US heroin injectors are making to protect themselves from these risks. METHODS: Between 2015 and 2016, a team of ethnographers collected data through semi-structured interviews and observation captured in field notes and video recording of heroin preparation/consumption...
May 16, 2018: Harm Reduction Journal
https://www.readbyqxmd.com/read/29725865/post-operative-weaning-of-opioids-after-ambulatory-surgery-the-importance-of-physician-stewardship
#2
REVIEW
Brandon Roth, Adjoa Boateng, Allison Berken, Daniel Carlyle, Nalini Vadivelu
PURPOSE OF REVIEW: We performed a systematic review to elucidate the current guidelines on weaning patients from opioids in the post-operative ambulatory surgery setting, and how pain management intraoperatively can impact this process. DESIGN: The review highlights the most up-to-date research from clinical trials, patient reports, and retrospective studies regarding both the current guidelines and weaning of opioid analgesia in ambulatory surgery setting. RECENT FINDINGS: A striking paucity of convincing evidence exists on ambulatory postoperative pain management discontinuation or weaning of pain medications...
May 3, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29721765/a-survey-of-perceptions-attitudes-knowledge-and-practices-of-medical-oncologists-about-cancer-pain-management-in-spain
#3
Jesús García-Mata, Cecilio Álamo, Javier de Castro, Jorge Contreras, Rafael Gálvez, Carlos Jara, Antonio Llombart, Concepción Pérez, Pedro Sánchez, Susana Traseira, Juan-Jesús Cruz
PURPOSE: To monitor oncologists' perspective on cancer pain management. METHODS: An anonymized survey was conducted in two waves. First, over a convenience sample of oncologists known to be particularly concerned with the management of pain. Second, using a random sample of oncologists. RESULTS: In total, 73 and 82 oncologists participated in the first and second wave, respectively. Many oncologists reported to have good knowledge of analgesic drugs (95...
May 2, 2018: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/29700664/halving-the-volume-of-anaconda-initial-clinical-experience-with-a-new-small-volume-anaesthetic-reflector-in-critically-ill-patients-a-quality-improvement-project
#4
Hagen Bomberg, Franziska Meiser, Sarah Zimmer, Martin Bellgardt, Thomas Volk, Daniel I Sessler, Heinrich V Groesdonk, Andreas Meiser
AnaConDa-100 ml (ACD-100, Sedana Medical, Uppsala, Sweden) is well established for inhalation sedation in the intensive care unit. But because of its large dead space, the system can retain carbon dioxide (CO2 ) and increase ventilatory demands. We therefore evaluated whether AnaConDa-50 ml (ACD-50), a device with half the internal volume, reduces CO2 retention and ventilatory demands during sedation of invasively ventilated, critically ill patients. Ten patients participated in this cross-over protocol. After sedation with isoflurane via ACD-100 for 24 h, the 5-h observation period started...
April 26, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29679696/effect-of-neuromonitor-guided-titrated-care-on-brain-tissue-hypoxia-after-opioid-overdose-cardiac-arrest
#5
Jonathan Elmer, Katharyn L Flickinger, Maighdlin W Anderson, Allison Koller, Matthew Sundermann, Cameron Dezfulian, David O Okonkwo, Lori A Shutter, David Salcido, Clifton W Callaway, James J Menegazzi
INTRODUCTION: Brain tissue hypoxia may contribute to preventable secondary brain injury after cardiac arrest. We developed a porcine model of opioid overdose cardiac arrest and post-arrest care including invasive, multimodal neurological monitoring of regional brain physiology. We hypothesized brain tissue hypoxia is common with usual post-arrest care and can be prevented by modifying mean arterial pressure (MAP) and arterial oxygen concentration (PaO2 ). METHODS: We induced opioid overdose and cardiac arrest in sixteen swine, attempted resuscitation after 9 minutes of apnea, and randomized resuscitated animals to three alternating 6-hour blocks of standard or titrated care...
April 18, 2018: Resuscitation
https://www.readbyqxmd.com/read/29617066/the-mixed-opioid-receptor-antagonist-naltrexone-mitigates-stimulant-induced-euphoria-a-double-blind-placebo-controlled-trial-of-naltrexone
#6
Thomas J Spencer, Pradeep Bhide, Jinmin Zhu, Stephen V Faraone, Maura Fitzgerald, Amy M Yule, Mai Uchida, Andrea E Spencer, Anna M Hall, Ariana J Koster, Leah Feinberg, Sarah Kassabian, Barbara Storch, Joseph Biederman
OBJECTIVE: Supratherapeutic doses of methylphenidate activate μ-opioid receptors, which are linked to euphoria. This study assessed whether naltrexone, a mixed μ-opioid antagonist, may attenuate the euphoric effects of stimulants, thereby minimizing their abuse potential in subjects with attention-deficit/hyperactivity disorder (ADHD). METHODS: We conducted a 6-week, double-blind, placebo-controlled, randomized clinical trial of naltrexone in adults with DSM-IV ADHD receiving open treatment with a long-acting formulation of methylphenidate (January 2013 to June 2015)...
March 13, 2018: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/29498534/low-dose-nocturnal-dexmedetomidine-prevents-icu-delirium-a-randomized-placebo-controlled-trial
#7
Yoanna Skrobik, Matthew S Duprey, Nicholas S Hill, John W Devlin
RATIONALE: Dexmedetomidine is associated with less delirium than benzodiazepines and better sleep architecture than either benzodiazepines or propofol; its effect on delirium and sleep when administered at night to patients requiring sedation remains unclear. OBJECTIVES: To determine if nocturnal dexmedetomidine prevents delirium and improves sleep in critically ill adults. METHODS: This two-center, double-blind, placebo-controlled trial randomized 100 delirium-free critically ill adults receiving sedatives to receive nocturnal (9:30 p...
May 1, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29478355/treating-breakthrough-pain-in-oncology
#8
Sebastiano Mercadante
Breakthrough cancer pain (BTcP) is an episode of severe intensity in patients receiving an adequate treatment with opioids able to provide at least mild analgesia. BTcP is a heterogeneous condition as episodes vary between individuals. The aim of this article is to review the pharmacologic options for the management of BTcP. Areas covered: Recent reviews revealed that transmucosal preparations of fentanyl provided superior and more rapid pain relief as compared to placebo and oral morphine within the first 30 min after dosing...
May 2018: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/29474345/opioid-related-genetic-polymorphisms-do-not-influence-postoperative-opioid-requirement-a-prospective-observational-study
#9
Frédéric Aubrun, Noël Zahr, Olivier Langeron, Nicolas Boccheciampe, Nathalie Cozic, Lisa Belin, Jean-Sebastien Hulot, Frederic Khiami, Bruno Riou
BACKGROUND: Among the various factors that may influence the pharmacological response to opioids, genetic polymorphisms [single nucleotide polymorphisms (SNP)] have generated some interest. OBJECTIVES: To examine the influence on morphine dose requirements and adverse events in the postoperative period of four SNP [opioid receptor mu1 (OPRM1), ATP-binding cassette subfamily B, member 1 (ABCB1) ex-21 and ex-26, catechol-o-methyltransferase (COMT)] in candidate genes involved in morphine pharmacodynamics and pharmacokinetics...
February 22, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29442160/peri-articular-injection-of-an-analgesic-mixture-in-primary-total-hip-arthroplasty-an-effective-strategy-for-pain-control-during-the-first-post-operative-day
#10
Maria Bautista, Meilyn Muskus, Adolfo Llinás, Guillermo Bonilla, Carlos Guerrero, Jairo Moyano
BACKGROUND: Previous studies of soft tissue infiltration in hip arthroplasty present variable results. The purpose of this study is to identify whether injection of an analgesic mixture improves pain management during the immediate post-operative period. MATERIALS AND METHODS: This cohort study compared 129 patients that received peri-articular soft tissue injection with 20 ml of 0.25% bupivacaine and 2 ml of ketorolac (30 mg/1 ml) in 28 ml of saline solution, with 71 patients who did not received injections...
February 13, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29379313/a-prospective-longitudinal-study-to-evaluate-the-clinical-utility-of-a-predictive-algorithm-that-detects-risk-of-opioid-use-disorder
#11
Ashley Brenton, Chee Lee, Katrina Lewis, Maneesh Sharma, Svetlana Kantorovich, Gregory A Smith, Brian Meshkin
Purpose: The purpose of this study was to determine the clinical utility of an algorithm-based decision tool designed to assess risk associated with opioid use. Specifically, we sought to assess how physicians were using the profile in patient care and how its use affected patient outcomes. Patients and methods: A prospective, longitudinal study was conducted to assess the utility of precision medicine testing in 5,397 patients across 100 clinics in the USA. Using a patent-protected, validated algorithm combining specific genetic risk factors with phenotypic traits, patients were categorized into low-, moderate-, and high-risk patients for opioid abuse...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29372020/pain-medication-and-long-qt-syndrome
#12
REVIEW
Christoph Klivinyi, Helmar Bornemann-Cimenti
Long QT syndrome is a cardiac repolarization disorder and is associated with an increased risk of torsades de pointes. The acquired form is most often attributable to administration of specific medications and/or electrolyte imbalance. This review provides insights into the risk for QT prolongation associated with drugs frequently used in the treatment of chronic pain. In the field of pain medicine all the major drug classes (i.e. NSAIDs, opioids, anticonvulsive and antidepressant drugs, cannabinoids, muscle relaxants) contain agents that increase the risk of QT prolongation...
January 2018: Korean Journal of Pain
https://www.readbyqxmd.com/read/29307505/practical-considerations-in-medical-cannabis-administration-and-dosing
#13
REVIEW
Caroline A MacCallum, Ethan B Russo
Cannabis has been employed medicinally throughout history, but its recent legal prohibition, biochemical complexity and variability, quality control issues, previous dearth of appropriately powered randomised controlled trials, and lack of pertinent education have conspired to leave clinicians in the dark as to how to advise patients pursuing such treatment. With the advent of pharmaceutical cannabis-based medicines (Sativex/nabiximols and Epidiolex), and liberalisation of access in certain nations, this ignorance of cannabis pharmacology and therapeutics has become untenable...
March 2018: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29278818/ondansetron-does-not-prevent-physical-dependence-in-patients-taking-opioid-medications-chronically-for-pain-control
#14
Larry F Chu, Tom Rico, Erika Cornell, Hannah Obasi, Ellen M Encisco, Haley Vertelney, Jamison G Gamble, Clayton W Crawford, John Sun, Anna Clemenson, Matthew J Erlendson, Robin Okada, Ian Carroll, J David Clark
OBJECTIVES: In this study, we investigated the co-administration of ondansetron with morphine, and whether it could prevent the development of physical dependence in patients taking opioids for the treatment of chronic pain. METHODS: A total of 48 chronic back pain patients (N = 48) participated in this double-blinded, placebo-controlled, randomized study. Patients were titrated onto sustained-release oral morphine and randomized to take 8 mg ondansetron or placebo three times daily concurrently with morphine during the 30-day titration...
February 1, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29231146/comparison-of-two-naloxone-regimens-in-addicted-methadone-overdosed-patients-a-clinical-trial-study
#15
Navid Khosravi, Nasim Zamani, Hossein Hassanian-Moghaddam, Ali Ostadi, Mitra Rahimi, Ali Kabir
BACKGROUND: Methadone toxicity is one of the major causes of death in opioid dependent individuals. OBJECTIVE: We aimed to compare two different protocols for naloxone in terms of reversal of overdose and frequency of complications in opioid-dependent methadone-intoxicated patients. METHODS: One-hundred opioid-dependent patients with signs/symptoms of methadone overdose were included. The patients were consecutively assigned into Tintinalli (group 1) or Goldfrank regimen protocol (group 2) of naloxone administration...
December 11, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/29229211/the-use-of-rapid-onset-fentanyl-in-children-and-young-people-for-breakthrough-cancer-pain
#16
Lucy Coombes, Kimberley Burke, Anna-Karenia Anderson
BACKGROUND AND AIMS: No published studies have looked at the dosing and use of rapid onset fentanyl preparations in children. The primary aim of this study was to assess whether there is a correlation between effective dose of rapid onset fentanyl and background oral morphine equivalent analgesia in children less than 18 years old. Secondary objectives included establishing whether there is a correlation between effective dose of rapid onset fentanyl and age and weight. Reported side effects were also reviewed...
October 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29183228/recommendations-for-buprenorphine-and-methadone-therapy-in-opioid-use-disorder-a-european-consensus
#17
Maurice Dematteis, Marc Auriacombe, Oscar D'Agnone, Lorenzo Somaini, Néstor Szerman, Richard Littlewood, Farrukh Alam, Hannu Alho, Amine Benyamina, Julio Bobes, Jean Pierre Daulouede, Claudio Leonardi, Icro Maremmani, Marta Torrens, Stephan Walcher, Michael Soyka
Management of patients with opioid use disorder (OUD) commonly includes opioid agonist therapy (OAT) as a part of an integrated treatment plan. These interventions are associated with proven benefits to the individual and society. Areas covered: The use of methadone and buprenorphine within an integrated treatment plan in the management of patients with OUD: this work provides consensus recommendation on pharmacotherapy in OUD to assist clinicians with practical decision making in this field. Expert opinion: Pharmacotherapy is recommended as part of an integrated OUD treatment approach with psychosocial interventions, with the goal of reducing risks of illicit opioid use, overdose mortality, infection with HIV or HCV, improving health, psychological and social outcomes...
December 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29122828/referrals-to-a-perinatal-specialist-palliative-care-consult-service-in-ireland-2012-2015
#18
Des L McMahon, Marie Twomey, Maeve O'Reilly, Mary Devins
OBJECTIVE: To analyse the referral patterns of perinatal patients referred to a specialist palliative care service (SPCS), their demographics, diagnoses, duration of illness, place of death and symptom profile. DESIGN: A retrospective chart review of all perinatal referrals over a 4-year period to the end of 2015. SETTING: A consultant-led paediatric SPCS at Our Lady's Children's Hospital, Crumlin, Dublin, and the Coombe Women & Infants University Hospital, Dublin...
November 9, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29120929/risk-factors-for-opioid-induced-respiratory-depression-and-failure-to-rescue-a-review
#19
Kapil Gupta, Arun Prasad, Mahesh Nagappa, Jean Wong, Lusine Abrahamyan, Frances F Chung
PURPOSE OF REVIEW: The primary objective of this review is to identify the risk factors for opioid-induced respiratory depression (OIRD) in the postoperative period. RECENT FINDINGS: In the postoperative period, OIRD has often been reported resulting in morbidity and mortality. The risk factors which predispose surgical patients to increased risk of OIRD are not clearly defined. A literature search was performed for adult surgical patients who were prescribed opioids during their hospital stay and any available reports on postoperative respiratory depression/respiratory events...
February 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29094098/managing-pain-in-patients-with-cancer-the-chinese-good-pain-management-experience
#20
REVIEW
Shi-Ying Yu, Jie-Jun Wang, Yu-Guang Huang, Bing Hu, Kun Wang, Ping Ping Li, Yi-Long Wu, He-Long Zhang, Li Zhang, Qing-Yuan Zhang, Shu-Kui Qin
Purpose: The number of cancer cases in China has increased rapidly from 2.1 million in 2000 to 4.3 million in 2015. As a consequence, pain management as an integral part of cancer treatment became an important health care issue. In March 2011, the Good Pain Management (GPM) program was launched to standardize the treatment of cancer pain and improve the quality of life for patients with cancer. With this work, we will describe the GPM program, its implementation experience, and highlight key lessons that can improve pain management for patients with cancer...
October 2017: Journal of Global Oncology
keyword
keyword
4492
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"