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https://www.readbyqxmd.com/read/28530876/research-continuous-surveillance-of-sleep-apnea-patients-in-a-medical-surgical-unit
#1
Dana Supe, Leah Baron, Tom Decker, Kyle Parker, Jeanne Venella, Sarah Williams, Kari Beaton, John Zaleski
This report consists of two separate studies on the use of continuous capnography monitoring conducted in an effort to improve patient safety at Virtua Health System. The desire for improved patient safety is motivating continuous monitoring and improved surveillance in clinical areas not traditionally equipped for such monitoring. We explored the use of remote monitoring of capnography, using enterprise middleware, in patients recovering from surgery in a medical-surgical unit. Continuous monitoring traditionally has been used in higher-acuity settings, such as intensive care units...
May 2017: Biomedical Instrumentation & Technology
https://www.readbyqxmd.com/read/28526048/men-s-and-women-s-response-to-treatment-and-perceptions-of-outcomes-in-a-randomized-controlled-trial-of-injectable-opioid-assisted-treatment-for-severe-opioid-use-disorder
#2
Heather Palis, Kirsten Marchand, Daphne Guh, Suzanne Brissette, Kurt Lock, Scott MacDonald, Scott Harrison, Aslam H Anis, Michael Krausz, David C Marsh, Martin T Schechter, Eugenia Oviedo-Joekes
BACKGROUND: To test whether there are gender differences in treatment outcomes among patients receiving injectable opioids for the treatment of long-term opioid-dependence. The study additionally explores whether men and women have different perceptions of treatment effectiveness. METHODS: This study is a secondary analysis from SALOME, a double-blind, phase III, randomized controlled trial testing the non-inferiorirty of injectable hydromorphone to injectable diacetylmorphine among 202 long-term street opioid injectors in Vancouver (Canada)...
May 19, 2017: Substance Abuse Treatment, Prevention, and Policy
https://www.readbyqxmd.com/read/28521199/safety-profile-of-injectable-hydromorphone-and-diacetylmorphine-for-long-term-severe-opioid-use-disorder
#3
Eugenia Oviedo-Joekes, Suzanne Brissette, Scott MacDonald, Daphne Guh, Kirsten Marchand, Salima Jutha, Scott Harrison, Amin Janmohamed, Derek Z Zhang, Aslam H Anis, Michael Krausz, David C Marsh, Martin T Schechter
AIMS: To review the safety profile of injectable hydromorphone and diacetylmorphine and explore if adverse events (AEs) or serious adverse events (SAEs) were associated with dose and patterns of attendance. METHODS: This was a non-inferiority randomized double-blind controlled trial (Vancouver, Canada) testing hydromorphone (n=100) and diacetylmorphine (n=102) for the treatment of severe opioid use disorder. Medications were delivered under the supervision of trained Registered Nurses up to three times daily...
May 10, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28500651/predictors-of-response-in-emergency-department-patients-receiving-intravenous-opioids-for-severe-pain
#4
Jacob A Radcliff, Rachel M Rafeq, Jane F Bowen, Laura Pontiggia, Sanchita Sen
OBJECTIVE: The primary objective of this study was to identify significant environmental and patient characteristics of emergency department (ED) patients who responded to intravenous (IV) hydromorphone and IV morphine for severe pain. Secondary objectives were to 1) investigate the individual effect of the significant environmental and patient characteristics of responders and 2) assess the nature and strength of the correlation of initial dose and change in pain score from arrival to pre-administration...
May 13, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28481682/acute-impairing-effects-of-morphine-related-to-driving-a-systematic-review-of-experimental-studies-to-define-blood-morphine-concentrations-related-to-impairment-in-opioid-na%C3%A3-ve-subjects
#5
Maren Cecilie Strand, Marianne Arnestad, Bente Fjeld, Jørg Mørland
OBJECTIVE: To look for dose- and concentration-effect relationships in experimental studies on single-dose administration of morphine on traffic relevant behavioral tests by a systematic literature review, and possibly to see if a dose/concentration could be defined, below which few or no tests would be affected. METHODS: Searches for corresponding literature were conducted using MEDLINE, EMBASE, and PsycINFO, throughout March of 2016. The search strategy consisted of words colligated to cognitive- and psychomotor functions of relevance to driving, in relation to morphine administration...
May 8, 2017: Traffic Injury Prevention
https://www.readbyqxmd.com/read/28479415/off-label-medication-use-in-the-inpatient-palliative-care-unit
#6
Jung Hye Kwon, Min Ji Kim, Sebastian Bruera, Minjeong Park, Eduardo Bruera, David Hui
CONTEXT: Although off-label medications are frequently prescribed in palliative care, there are no published studies examining their use in the United States. OBJECTIVES: We examined the frequency of off-label medication use in cancer patients admitted to an acute palliative care unit (APCU). METHODS: This prospective observational study enrolled consecutive patients with advanced cancer admitted to the APCU of a tertiary care cancer center...
May 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28420386/sedation-levels-in-dogs-a-validation-study
#7
Marika C Wagner, Kent G Hecker, Daniel S J Pang
BACKGROUND: The aim of this study was to assess validation evidence for a sedation scale for dogs. We hypothesized that the chosen sedation scale would be unreliable when used by different raters and show poor discrimination between sedation protocols. A sedation scale (range 0-21) was used to score 62 dogs scheduled to receive sedation at two veterinary clinics in a prospective trial. Scores recorded by a single observer were used to assess internal consistency and construct validity of the scores...
April 18, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/28418966/clinical-effectiveness-and-safety-of-intraoperative-methadone-in-patients-undergoing-posterior-spinal-fusion-surgery-a-randomized-double-blinded-controlled-trial
#8
RANDOMIZED CONTROLLED TRIAL
Glenn S Murphy, Joseph W Szokol, Michael J Avram, Steven B Greenberg, Torin D Shear, Mark A Deshur, Jeffery S Vender, Jessica Benson, Rebecca L Newmark
BACKGROUND: Patients undergoing spinal fusion surgery often experience severe pain during the first three postoperative days. The aim of this parallel-group randomized trial was to assess the effect of the long-duration opioid methadone on postoperative analgesic requirements, pain scores, and patient satisfaction after complex spine surgery. METHODS: One hundred twenty patients were randomized to receive either methadone 0.2 mg/kg at the start of surgery or hydromorphone 2 mg at surgical closure...
May 2017: Anesthesiology
https://www.readbyqxmd.com/read/28405945/the-comparative-risk-of-delirium-with-different-opioids-a-systematic-review
#9
REVIEW
Lieke M Swart, Vera van der Zanden, Petra E Spies, Sophia E de Rooij, Barbara C van Munster
OBJECTIVE: There is substantial evidence that the use of opioids increases the risk of adverse outcomes such as delirium, but whether this risk differs between the various opioids remains controversial. In this systematic review, we evaluate and discuss possible differences in the risk of delirium from the use of various types of opioids in older patients. METHODS: We performed a search in MEDLINE by combining search terms on delirium and opioids. A specific search filter for use in geriatric medicine was used...
April 12, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28401133/fatal-overdoses-involving-hydromorphone-and-morphine-among-inpatients-a-case-series
#10
Amanda Lowe, Michael Hamilton, Julie Greenall BScPhm MHSc, Jessica Ma, Irfan Dhalla, Nav Persaud
BACKGROUND: Opioids have narrow therapeutic windows, and errors in ordering or administration can be fatal. The purpose of this study was to describe deaths involving hydromorphone and morphine, which have similar-sounding names, but different potencies. METHODS: In this case series, we describe deaths of patients admitted to hospital or residents of long-term care facilities that involved hydromorphone and morphine. We searched for deaths referred to the Patient Safety Review Committee of the Office of the Chief Coroner for Ontario between 2007 and 2012, and subsequently reviewed by 2014...
January 2017: CMAJ Open
https://www.readbyqxmd.com/read/28394703/comparative-analysis-of-opioid-queries-on-erowid-org-an-opportunity-to-advance-harm-reduction
#11
Rachel S Wightman, Jeanmarie Perrone, Fire Erowid, Earth Erowid, Zachary F Meisel, Lewis S Nelson
BACKGROUND: Many individuals who use opioids turn to online resources to gather information on effects, availability, and safety. OBJECTIVE: Describe opioid index page views on Erowid.org to assess trends in public interest in particular opioids. METHODS: Retrospective analysis of Erowid.org site traffic was performed to identify unique average daily visits to opioid pages. All data was normalized to that of visits to the heroin index page...
April 10, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28392133/patients-at-risk-large-opioid-prescriptions-after-total-knee-arthroplasty
#12
Nicholas M Hernandez, Joshua A Parry, Michael J Taunton
BACKGROUND: Opioids are an effective, and often necessary, treatment of postoperative pain after total knee arthroplasty (TKA). However, it is often difficult to know how much medication patients will need after discharge. The purpose of this study was to determine if patients discharged with greater quantities of opioids after TKA are more likely to request refills. METHODS: This is a retrospective review of 105 primary TKAs performed with at least 1 year of follow-up...
March 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28358229/intractable-acute-pain-related-to-fluoroquinolone-induced-peripheral-neuropathy
#13
Matthew Dukewich, Arash Danesh, Chiemeka Onyima, Anita Gupta
Fluoroquinolones are widely prescribed antibiotics, used for various infectious etiologies. These antibiotics carry the possibility of the serious adverse effect of peripheral neuropathy, with a true incidence not known owing to its rare existence. Recently, the Food and Drug Administration (FDA) has required alterations to drug labels to highlight this adverse effect of fluoroquinolones. This is a case report of a single patient at an inpatient neurology service at an urban academic medical center in the United States...
March 30, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28345745/in-vitro-and-in-vivo-assessment-of-the-abuse-potential-of-pf614-a-novel-bio-md%C3%A2-prodrug-of-oxycodone
#14
D Lynn Kirkpatrick, William K Schmidt, Ricardo Morales, John Cremin, Julie Seroogy, Craig Husfeld, Thomas Jenkins
OBJECTIVE: The need for pain medication which will not lead to abuse is well recognized. Ensysce has designed prodrug analogs of the commonly used pain medications including hydromorphone, oxycodone (OC), hydrocodone, and morphine that limit their use to oral delivery, two of which are in clinical development. This study was undertaken to demonstrate that PF614, an extended-release prodrug of OC, allows the release of OC as designed when delivered orally, yet it resists ex vivo extraction with household chemicals and is pharmacologically inactive when administered by nonoral routes (nasal and parenteral), thereby substantially reducing its intravenous (IV) and intranasal abuse potential...
January 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/28337083/continuous-infusion-etomidate-in-a-patient-receiving-extracorporeal-membrane-oxygenation
#15
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/28321141/adjunct-analgesic-use-for-acute-pain-in-the-emergency-department
#16
James Priano, Brian Faley, Gabrielle Procopio, Kevin Hewitt, Joseph Feldman
Purpose: Multimodal analgesia is common practice in the postoperative setting, but the utility of adjunctive analgesia in the emergency department (ED) is less understood. The primary objective of this study was to analyze ED prescriber ordering habits for adjunct nonopioid pain medication for opioid-naïve patients who require intravenous (IV) morphine or hydromorphone for acute pain. Secondary objectives were to assess initial and total opioid consumption in morphine equivalent units (MEU), pain scores, and ED length of stay (LOS) between groups...
February 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28287363/nebulized-fentanyl-for-dyspnea-in-a-hospice-patient-with-true-allergy-to-morphine-and-hydromorphone
#17
Robert G Wahler, David B Smith, Kimberly B Mulcahy
An 86-year-old white female was admitted to hospice care with lung cancer. Even with optimal medical management, she suffered from dyspnea and required opioid therapy. However, the patient had a true morphine and hydromorphone allergy. She was administered nebulized fentanyl for symptomatic relief of dyspnea with good effect and she did not experience any allergic response.
March 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28287353/new-online-tool-for-exploring-global-opioid-consumption-data
#18
Martha A Maurer
Each year for nearly two decades, the Pain & Policy Studies Group (PPSG) has received from the International Narcotics Control Board, the global monitoring body for the implementation of the United Nations international drug control conventions, consumption data for six principal opioids used to treat moderate and severe pain: fentanyl, hydromorphone, methadone, morphine, oxycodone, and pethidine. To provide these statistics to a wider audience, PPSG developed an extensive section of its Web site featuring these data in the form of global, regional, and individual country graphs...
March 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28259526/review-of-intranasally-administered-medications-for-use-in-the-emergency-department
#19
Abby M Bailey, Regan A Baum, Karolyn Horn, Tameka Lewis, Kate Morizio, Amy Schultz, Kyle Weant, Stephanie N Justice
BACKGROUND: Intranasal (IN) medication delivery is a viable alternative to other routes of administration, including intravenous (IV) and intramuscular (IM) administration. The IN route bypasses the risk of needle-stick injuries and alleviates the emotional trauma that may arise from the insertion of an IV catheter. OBJECTIVE: This review aims to evaluate published literature on medications administered via the IN route that are applicable to practice in emergency medicine...
March 1, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28237682/the-influence-of-demeanor-on-scores-from-two-validated-feline-pain-assessment-scales-during-the-perioperative-period
#20
Mandy Buisman, Michelle M M Hasiuk, Marta Gunn, Daniel S J Pang
OBJECTIVE: To evaluate the effects of demeanor on validated pain assessment scales. STUDY DESIGN: Prospective, blind, clinical trial. ANIMAL POPULATION: Thirty three adult domestic cats scheduled for orchiectomy. METHODS: Cats were assessed for pain pre (baseline) and 1, 2, 4 hours postoperatively using two validated pain scales [Composite Measures Pain Scale-Feline (rCMPS-F) and UNESP-Botucatu multidimensional composite pain scale (psychomotor and pain expression subscales; U-B MCPS-psych and -painex)], and a demeanor scale...
January 8, 2017: Veterinary Anaesthesia and Analgesia
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