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Narcotic prescribing

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https://www.readbyqxmd.com/read/27843963/comparative-evaluation-between-two-methods-of-induced-hypotension-with-infusion-of-remifentanil-and-labetalol-during-sinus-endoscopy
#1
Parvin Sajedi, Ali Rahimian, Gholamreza Khalili
OBJECTIVE: This study aimed to compare two methods of controlled hypotension using labetalol and remifentanil in terms of capability to create controlled hypotension and to investigate the obtained complications, and satisfaction rate of surgeon and patient during functional endoscopic sinus surgery. METHODS: In this prospective clinical trial, 62 patients underwent endoscopic sinus surgery in Al-Zahra and Ayatollah Kashani Hospitals of Isfahan were divided into two groups: in the first group, 20 mg bolus dose of labetalol and then infusion of it, at a rate of 0...
October 2016: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/27842790/otolaryngology-concerns-for-illicit-and-prescription-drug-use
#2
REVIEW
Nathan J Gonik, Martin H Bluth
Concern for illicit and restricted drug use in otolaryngology is similar to other surgical specialties with a few notable exceptions. Many illicit drugs are consumed transnasally. Repeated nasal exposure to stimulants or narcotics can cause local tissue destruction that can present as chronic rhinosinusitis or nasoseptal perforation. Further, the Food and Drug Administration has taken a stance against codeine for pediatric patients undergoing adenotonsillectomy. They have identified an increased risk of death postoperatively with these medications...
December 2016: Clinics in Laboratory Medicine
https://www.readbyqxmd.com/read/27670911/erratum-to-prescription-reporting-with-immediate-medication-utilization-mapping-primum-development-of-an-alert-to-improve-narcotic-prescribing
#3
Rachel B Seymour, Daniel Leas, Meghan K Wally, Joseph R Hsu
No abstract text is available yet for this article.
2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27600629/primary-caregiver-perception-of-pain-control-following-pediatric-adenotonsillectomy-a-cross-sectional-survey
#4
Justin C Sowder, Craig M Gale, Jacob L Henrichsen, Kristy Veale, Katie B Liljestrand, Barbara C Ostlund, Aaron Sherwood, Austin Smith, Griffin H Olsen, Mark Ott, Jeremy D Meier
OBJECTIVES: To (1) review pain medications prescribed following pediatric adenotonsillectomy (T&A), (2) identify pain medications reported to be helpful, and (3) compare parent-reported outcomes among various combinations of pain medications. STUDY DESIGN: Case series with planned data collection. SETTING: Multihospital network. SUBJECTS AND METHODS: The primary caregivers of children aged 1 to 18 years who underwent isolated T&A from June to December 2014 were contacted 14 to 21 days after surgery...
September 6, 2016: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/27578606/review-of-drug-utilization-patterns-in-nicus-worldwide
#5
N Krzyżaniak, I Pawłowska, B Bajorek
WHAT IS KNOWN AND OBJECTIVES: When considering acute care settings, such as the neonatal intensive care unit (NICU), the inappropriate use of medicines poses a great risk to vulnerable babies at the start of their lives. However, there is limited published literature that explores the current medication management practices in NICUs and where the main misuse issues lie. Therefore, the purpose of this review was to give an overview of medicine use in NICUs worldwide and identify therapeutic areas requiring more targeted pharmaceutical care...
August 31, 2016: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/27549364/prescription-reporting-with-immediate-medication-utilization-mapping-primum-development-of-an-alert-to-improve-narcotic-prescribing
#6
Rachel B Seymour, Daniel Leas, Meghan K Wally, Joseph R Hsu
BACKGROUND: Prescription narcotic overdoses and abuse have reached alarming numbers. To address this epidemic, integrated clinical decision support within the electronic medical record (EMR) to impact prescribing behavior was developed and tested. METHODS: A multidisciplinary Expert Panel identified risk factors for misuse, abuse, or diversion of opioids or benzodiazepines through literature reviews and consensus building for inclusion in a rule within the EMR. We ran the rule "silently" to test the rule and collect baseline data...
August 22, 2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27486534/a-retrospective-snapshot-of-patients-prescribed-acute-versus-chronic-narcotic-therapy-in-a-resident-provider-internal-medicine-outpatient-clinic
#7
Melissa M Butler, Randy A Sansone, Charles Opperman
No abstract text is available yet for this article.
2016: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/27459620/-the-specific-features-of-pain-syndrome-in-patients-with-hemophilia
#8
O K Levchenko, E M Shulutko, V Yu Zorenko, G M Galstyan
AIM: to study the nature of pain in hemophilic arthropathy and its prevention ways used by patients with hemophilia. SUBJECTS AND METHODS: A prospective, multicenter, cross-sectional study was conducted to interview 136 patients with hemophilia A or B. The survey included 32 points, including questions about drug and nondrug pain treatment, as well as questionnaires to assess the severity of pain and its impact on daily life (Brief Pain Inventory) and those to identify a neuropathic pain component (PainDetect questionnaire)...
2016: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/27403756/outpatient-narcotic-use-after-minimally-invasive-urogynecologic-surgery
#9
Carolyn W Swenson, Angela S Kelley, Dee E Fenner, Mitchell B Berger
OBJECTIVES: To quantify outpatient narcotic use in the first 2 weeks after urogynecologic surgery. METHODS: Using a convenience sample, women who underwent minimally invasive urogynecologic surgery between May and October 2014 were contacted by telephone 2 weeks postoperatively and given a questionnaire regarding their postoperative pain experience. To quantify narcotic use, patients were asked to count the tablets remaining from their discharge narcotic prescription...
September 2016: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/27365868/change-in-prescription-habits-after-federal-rescheduling-of-hydrocodone-combination-products
#10
Susan Seago, Adam Hayek, Jessica Pruszynski, Megan Greene Newman
Nationally, health care providers wrote 259 million prescriptions for narcotic analgesics in 2012, or roughly one bottle of narcotics per US adult (1). In an effort to combat this ever-growing problem, the Drug Enforcement Administration changed the schedule of hydrocodone combination products from schedule III to schedule II on October 6, 2014. Fourteen Baylor Scott & White pharmacies encompassing a 200-mile radius in Central Texas were queried for prescription information on hydrocodone/acetaminophen, morphine, codeine/acetaminophen, and tramadol before and after the rescheduling to evaluate trends in prescription drug usage...
July 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27323522/the-opioid-epidemic-and-the-minnesota-board-of-medical-practice
#11
Steven J Waisbren
America is suffering from an epidemic of opioid misuse that has been attributed to the narcotic prescribing practices of physicians. This article focuses on the State of Minnesota and the role that its Board of Medical Practice (BMP) played in this crisis. It presents a review of guidelines issued by the BMP over the last 30 years, showing that it followed national trends in emphasizing increased prescribing of narcotics for pain up until last year, when a much more cautious and nuanced approach to opioid prescribing was advised...
May 2016: Minnesota Medicine
https://www.readbyqxmd.com/read/27316667/psychosocial-risk-factors-for-postoperative-pain-in-ankle-and-hindfoot-reconstruction
#12
Ryan P Mulligan, Kevin J McCarthy, Benjamin J Grear, David R Richardson, Susan N Ishikawa, G Andrew Murphy
BACKGROUND: The purpose of this study was to examine factors associated with pain after elective ankle and hindfoot reconstruction. METHODS: Patients who underwent major ankle or hindfoot reconstruction over a 3-year period were identified. Retrospective chart review determined patient demographics, comorbidities, surgeries, tobacco, alcohol, and narcotic use, chronic pain, and mood disorders. Primary outcomes were cumulative amount of narcotic prescribed (morphine milligram equivalent dose) in the initial 90-day postoperative period, beyond 90 days, and visual analog pain score (VAS) at a minimum of 1-year follow-up...
June 16, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27262002/using-cognitive-behavior-therapy-and-mindfulness-techniques-in-the-management-of-chronic-pain-in-primary-care
#13
REVIEW
Norah Baker
Chronic pain and its associated syndrome have become increasingly prevalent in primary care. With the increase in narcotic use and subsequent adverse events, primary care physicians often seek safer alternatives to treating this condition. Prescribing narcotics necessitates using methods to screen for high abuse risk and protect against misuse. With the understanding of how chronic pain is related to mental illnesses such as depression and posttraumatic stress disorder, mindfulness techniques and behavioral therapy can be used to help decrease the dependence on dangerous opioid medications and help patients understand, accept, and cope with their chronic pain...
June 2016: Primary Care
https://www.readbyqxmd.com/read/27131463/narcotic-use-and-postoperative-doctor-shopping-by-patients-with-nephrolithiasis-requiring-operative-intervention-implications-for-patient-safety
#14
Stephen F Kappa, Elizabeth A Green, Nicole L Miller, Stanley D Herrell, Christopher R Mitchell, Hassan R Mir, Matthew J Resnick
PURPOSE: We sought to determine perioperative patterns of narcotic use and the prevalence of postoperative doctor shopping among patients with nephrolithiasis requiring operative management. MATERIALS AND METHODS: We retrospectively reviewed the records of consecutive patients residing in Tennessee who required ureteroscopy with laser lithotripsy for nephrolithiasis at a single institution from January to December 2013. Using the Tennessee CSMD (Controlled Substances Medication Database) patients were categorized by the number of postoperative narcotic providers...
September 2016: Journal of Urology
https://www.readbyqxmd.com/read/27121026/general-practitioners-attitudes-towards-electronic-prescribing-and-the-use-of-the-national-prescription-centre
#15
Eija Kivekäs, Hannes Enlund, Elizabeth Borycki, Kaija Saranto
RATIONALE, AIMS AND OBJECTIVES: The purpose of this study was to assess general practitioners' (GP) experience of an electronic prescription (e-prescription) system and the use of a national prescription centre. METHODS: A web-based survey with 29 structured questions and 8 open-ended questions was used. The technology acceptance model was used to explain first users' use of e-prescribing technology. GPs (n = 269) in two different primary health care organizations, which implemented the e-prescribing module as the first of its kind in Finland...
October 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27103812/safe-medication-management-and-use-of-narcotics-in-a-joint-commission-international-accredited-academic-medical-center-hospital-in-the-people-s-republic-of-china
#16
Xu Fang, Ling-Ling Zhu, Sheng-Dong Pan, Ping Xia, Meng Chen, Quan Zhou
Safe medication management and use of high-alert narcotics should arouse concern. Risk management experiences in this respect in a large-scale Joint Commission International (JCI)-accredited academic medical center hospital in the People's Republic of China during 2011-2015, focusing on organizational, educational, motivational, and information technological measures in storage, prescribing, preparing, dispensing, administration, and monitoring of medication are summarized. The intensity of use of meperidine in hospitalized patients in 2015 was one-fourth that in 2011...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/26884362/implementation-of-a-pediatric-posttonsillectomy-pain-protocol-in-a-large-group-practice
#17
Lauren J Luk, David Mosen, Carol J MacArthur, Anna H Grosz
OBJECTIVE: In response to the increased risk of respiratory failure and death after tonsillectomy related to codeine use, Kaiser Permanente Northwest restricted use of opioids in patients <7 years old via electronic health record (EHR). However, opioids could be prescribed at physician discretion by overriding the EHR. This study aims to examine protocol compliance in a large group practice using EHR order sets and complication rates as compared with historical data. STUDY DESIGN: Case series with chart review...
April 2016: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/26856978/use-of-diagnosis-codes-for-detection-of-clinically-significant-opioid-poisoning-in-the-emergency-department-a-retrospective-analysis-of-a-surveillance-case-definition
#18
Joseph M Reardon, Katherine J Harmon, Genevieve C Schult, Catherine A Staton, Anna E Waller
BACKGROUND: Although fatal opioid poisonings tripled from 1999 to 2008, data describing nonfatal poisonings are rare. Public health authorities are in need of tools to track opioid poisonings in near real time. METHODS: We determined the utility of ICD-9-CM diagnosis codes for identifying clinically significant opioid poisonings in a state-wide emergency department (ED) surveillance system. We sampled visits from four hospitals from July 2009 to June 2012 with diagnosis codes of 965...
2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/26682022/characteristics-of-urinary-retention-in-female-inpatients-managed-with-medical-treatments
#19
Chang Yong Lee, Chul Sung Kim, Won Jin Cho
PURPOSE: We aimed to analyze the characteristics of urinary retention (UR) in female inpatients managed with medical treatments. MATERIALS AND METHODS: We retrospectively analyzed the medical records of female inpatients referred to the department of urology for UR at our institution from January 2009, to December 2014. UR was defined as a difficulty in self-voiding despite a sufficient urine volume or >300-mL postvoid residual. The data included patients' age, body mass index (BMI), ambulatory status, medical and surgical history, classes of taking drugs, and urinary tract infection...
December 2015: Korean Journal of Urology
https://www.readbyqxmd.com/read/26537773/primary-care-provider-perspectives-on-electronic-medication-refill-history
#20
Dominique Comer, Elizabeth Mearns, Lindsey Olivere, Daniel J Elliott
Improvements in health information technology have made aggregate multipayer pharmacy claims data increasingly available through the electronic health record (EHR). The objective of this study was to assess the current awareness, utilization, and impact of pharmacy history data available in the EHR on primary care provider (PCP) decision making. A 14-question survey was distributed to all PCPs in a large medical practice. Of the 55/72 responding PCPs, 47 (85.5%) were aware of the EHR medication history function, and 36 (65...
November 4, 2015: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
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