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Hydromorphon

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https://www.readbyqxmd.com/read/29351102/fatal-sickling-triggered-by-massive-foreign-particle-embolism-a-case-report-of-unrecognized-indwelling-venous-catheter-drug-abuse-in-sickle-cell-disease
#1
Christopher A Febres-Aldana, Lydia Hernandez Howard
Sickle cell disease (SCD) manifests itself with vaso-occlusive episodes leading to infarction. Placement of intravascular catheters provides a useful route for management of pain crises as well as other complications. However, catheter misuse is a commonly unrecognized problem, which can have lethal consequences. We present a case of fatal splenic sequestration/hyperhemolysis secondary to foreign body pulmonary and systemic embolization due to intravenous administration of hydromorphone pills in a young woman with SCD...
January 18, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29346227/refractory-pain-management-in-amyloid-associated-peripheral-neuropathy
#2
Nafisseh S Warner, James C Watson, Markus A Bendel, Susan M Moeschler
OBJECTIVE: Systemic amyloidosis is a disease that often involves multiple organ systems, including the peripheral nervous system. Patients may present with severe, refractory neuropathic pain; however, the optimal treatment approach for pain for these patients remains unclear. CASE REPORT: A man with severe, refractory neuropathic pain in his bilateral upper and lower extremities and the trunk secondary to amyloid neuropathy is presented. Multiple medication trials, including neuropathic and opioid agents, produced considerable adverse effects and minimal relief...
January 17, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29300708/medial-open-transversus-abdominis-plane-motap-catheters-reduce-opioid-requirements-and-improve-pain-control-following-open-liver-resection-a-multicenter-blinded-randomized-controlled-trial
#3
Paul Jack Karanicolas, Sean Cleary, Paul McHardy, Alex Kiss, Jason Sawyer, Ramy Behman, Salima Ladak, Stuart A McCluskey, Coimbatore Srinivas, Joel Katz, Natalie Coburn, Calvin Law, Alice C Wei, Paul Greig, Julie Hallet, Hance Clarke
OBJECTIVE: Conventional management of pain following open liver resection involves intravenous, patient-controlled analgesia (IV PCA) or epidural analgesia. The objective of this trial was to assess the efficacy of a regional technique called Medial Open Transversus Abdominis Plane (MOTAP) catheter analgesia compared with IV PCA. METHODS: This was a blinded, randomized, controlled parallel-arm trial conducted at 2 high-volume centers. Patients undergoing liver resection through a subcostal incision were enrolled...
January 3, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29298186/evaluation-of-the-relative-abuse-of-an-oros%C3%A2-extended-release-hydromorphone-hci-product-results-from-three-post-market-surveillance-studies
#4
Stephen F Butler, Emily C McNaughton, Ryan A Black, Theresa A Cassidy
OBJECTIVE: Formulating prescription opioids to limit abuse remains a priority. OROS® extended-release (ER) hydromorphone HCl (EXALGO®) may have low abuse potential. Three post-marketing studies of the relative abuse liability of OROS hydromorphone ER were conducted. METHODS: Estimates of abuse, unadjusted and adjusted for prescription volume, were generated for OROS hydromorphone ER and comparators from Q2 2010 through Q2 2014 for a high-risk, substance abuse treatment population and the general population using poison control center data...
January 2, 2018: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29279930/prochlorperazine-superior-to-hydromorphone-for-migraine
#5
Anita Slomski
No abstract text is available yet for this article.
December 26, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29274731/simultaneous-analysis-of-opioid-analgesics-and-their-metabolites-in-municipal-wastewaters-and-river-water-by-liquid-chromatography-tandem-mass-spectrometry
#6
Ivona Krizman-Matasic, Petra Kostanjevecki, Marijan Ahel, Senka Terzic
Although published literature provides a clear demonstration of widespread occurrence of opioid analgesics (OAs) in the aquatic environment, analytical methods suitable for a systematic study of this pharmaceutical class, which would include a broad spectrum of opioid analgesics and their metabolites, are still missing. In this work, a comprehensive multiresidue method for quantitative analysis of 27 opioid analgesics and their metabolites, including 2 morphine glucuronide conjugates, was developed and validated for three matrices: raw wastewater (RW), secondary effluent (SE) and river water...
December 11, 2017: Journal of Chromatography. A
https://www.readbyqxmd.com/read/29236495/a-stable-heroin-analog-that-can-serve-as-a-vaccine-hapten-to-induce-antibodies-that-block-the-effects-of-heroin-and-its-metabolites-in-rodents-and-that-cross-react-immunologically-with-related-drugs-of-abuse
#7
Agnieszka Sulima, Rashmi Jalah, Joshua F G Antoline, Oscar B Torres, Gregory H Imler, Jeffrey R Deschamps, Zoltan Beck, Carl R Alving, Arthur E Jacobson, Kenner C Rice, Gary R Matyas
An improved synthesis of a haptenic heroin surrogate 1 (6-AmHap) is reported. The intermediate needed for the preparation of 1 was described in the route in the synthesis of 2 (DiAmHap). A scalable procedure was developed to install the C-3 amido group. Using the Boc protectng group in 18 allowed preparation of 1 in an overall yield of 53% from 4 and eliminated the necessity of preparing the diamide 13. Hapten 1 was conjugated to tetanus toxoid and mixed with liposomes containing monophosphoryl lipid A as an adjuvant...
December 13, 2017: Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/29227577/management-of-pain-in-end-stage-renal-disease-patients-short-review
#8
REVIEW
Rupesh Raina, Vinod Krishnappa, Mona Gupta
Pain management in end stage renal disease (ESRD) patients is a complex and challenging task to accomplish, and effective pain and symptom control improves quality of life. Pain is prevalent in more than 50% of hemodialysis patients and up to 75% of these patients are treated ineffectively due to its poor recognition by providers. A good history for PQRST factors and intensity assessment using visual analog scale are the initial steps in the management of pain followed by involvement of palliative care, patient and family counseling, discussion of treatment options, and correction of reversible causes...
December 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29224919/assessment-of-tapentadol-api-abuse-liability-with-the-researched-abuse-diversion-and-addiction-related-surveillance-radars-system
#9
Suzanne K Vosburg, S Geoffrey Severtson, Richard C Dart, Theodore J Cicero, Steven P Kurtz, Mark W Parrino, Jody L Green
Tapentadol, a Schedule II opioid with a combination of µ-opioid activity and norepinephrine reuptake inhibition, is used for the management of moderate to severe acute and chronic pain. Its dual-mechanism of action is thought to reduce opioid-related side effects that can complicate pain management. Since approval, tapentadol has been tracked across multiple outcomes suggesting abuse liability, and a pattern of relatively low, although not absent, abuse liability has been found. This retrospective cohort study further details the abuse liability of tapentadol as an Active Pharmaceutical Ingredient (API) when both immediate-release and extended-release formulations were on the market together (4Q2011 to 2Q2016)...
December 7, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29222361/evaluation-of-opioid-prescribing-after-rescheduling-of-hydrocodone-containing-products
#10
M Brooke Bernhardt, Ruston S Taylor, Joseph L Hagan, Nihar Patel, Corrie E Chumpitazi, Karin A Fox, Chris Glover
PURPOSE: Institutional prescribing trends of hydrocodone-containing products (HCPs) before and after the Drug Enforcement Administration's rescheduling of HCPs were evaluated. METHODS: A retrospective evaluation was performed on 6 oral opioid analgesics on the hospital formulary that were prescribed to patients treated at Texas Children's Hospital and Pavilion for Women for the 6 months before and after the rescheduling of HCPs on October 6, 2014. Patients were eligible for inclusion if they were prescribed any of the following oral agents: HCPs (e...
December 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29210063/opioid-induced-inhibition-of-the-human-serotonin-and-norepinephrine-transporters-in-vitro-link-to-clinical-reports-of-serotonin-syndrome
#11
Anna Rickli, Evangelia Liakoni, Marius C Hoener, Matthias E Liechti
BACKGROUND AND PURPOSE: Opioids may inhibit the serotonin and norepinephrine transporters (SERT and NET, respectively). NET inhibition may contribute to analgesia, and SERT inhibition or interactions with serotonin receptors may cause serotonergic toxicity. However, the effects of different opioids on the human SERT, NET, and serotonin receptors have not been sufficiently studied. EXPERIMENTAL APPROACH: We determined the potencies of different opioids to inhibit the SERT and NET in vitro using human transporter-transfected cells...
December 6, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/29206315/intrathecal-trialing-of-continuous-infusion-combination-therapy-with-hydromorphone-and-bupivacaine-in-failed-back-surgery-patients
#12
Ryan J Galica, Salim M Hayek, Elias Veizi, Matthew T McEwan, Sivakanth Katta, Omar Ali, Nida Aziz, Nidhi Sondhi
OBJECTIVES: Intrathecal (IT) trial is a prognostic interventional pain management procedure employed to determine the potential success of treating intractable pain with an implantable infusion device system. There is a dearth of data regarding trials with continuous infusion of combination therapy (e.g. opioid combined with local anesthetic). The objective of the this study was to determine the overall outcomes of continuous infusion IT trials and factors influencing long-term success of IT therapy in patients with chronic intractable pain post-laminectomy...
December 5, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29199397/opioid-tolerance-and-urine-drug-testing-among-initiates-of-extended-release-or-long-acting-opioids-in-food-and-drug-administration-s-sentinel-system
#13
Marc R Larochelle, Noelle M Cocoros, Jennifer Popovic, Elizabeth C Dee, Cynthia Kornegay, Jing Ju, Judith A Racoosin
OBJECTIVE: A risk evaluation and mitigation strategy for extended-release and long-acting (ER/LA) opioid analgesics was approved by the Food and Drug Administration in 2012. Our objective was to assess frequency of opioid tolerance and urine drug testing for individuals initiating ER/LA opioid analgesics. DESIGN: Retrospective cohort study. SETTING: Sentinel, a distributed database with electronic healthcare data on >190 million predominantly commercially insured members...
September 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/29186453/detection-and-quantification-of-codeine-6-glucuronide-hydromorphone-3-glucuronide-oxymorphone-3-glucuronide-morphine-3-glucuronide-and-morphine-6-glucuronide-in-human-hair-from-opioid-users-by-lc-ms-ms
#14
Megan Grabenauer, Nichole D Bynum, Katherine N Moore, Robert M White, John M Mitchell, Eugene D Hayes, Ronald Flegel
Current hair testing methods that rely solely on quantification of parent drug compounds are unable to definitively distinguish between drug use and external contamination. One possible solution to this problem is to confirm the presence of unique drug metabolites that cannot be present through contamination, such as phase II glucuronide conjugates. This work demonstrates for the first time that codeine-6-glucuronide, hydromorphone-3-glucuronide, oxymorphone-3-glucuronide, morphine-3-glucuronide and morphine-6-glucuronide are present at sufficient concentrations to be quantifiable in hair of opioid users and that their concentrations generally increase as the concentrations of the corresponding parent compounds increase...
November 24, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/29182997/bioanalytical-methods-for-the-quantification-of-hydromorphone-fentanyl-norfentanyl-morphine-morphine-3%C3%A3-glucuronide-and-morphine-6%C3%A3-glucuronide-in-human-plasma
#15
Peter de Bruijn, Evelien J M Kuip, Mei-Ho Lam, Ron H J Mathijssen, Stijn L W Koolen
The aim of this study was to develop an assay for the quantification of hydromorphone, morphine, fentanyl and the metabolites norfentanyl, morphine-3ß-glucuronide and morphine-6ß-glucuronide in human plasma to support pharmacokinetic studies investigating the large interpatient variability in response to opioid treatment. For the quantitation of hydromorphone, morphine, fentanyl and its metabolite norfentanyl aliquots of 200μL human potassium EDTA plasma were deproteinized with deuterated internal standards in a mixture of acetonitrile and acetone, followed by a liquid-liquid extraction with 4% ammonium hydroxide and ethyl acetate...
November 17, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/29169696/efficacy-and-feasibility-of-opioids-for-burn-analgesia-an-evidence-based-qualitative-review-of-randomized-controlled-trials
#16
REVIEW
Chao Yang, Xiao-Min Xu, Guang-Zhao He
Opioids are commonly used for burn analgesia, but no comprehensive reviews have been published on such use. We aimed to assess the literature regarding the effectiveness and side effects of opioids both in adult and pediatric burn patients. We conducted a systematic search of the PubMed, Embase, Cochrane, and Web of Science databases. Information on study characteristics, results, and interventions was extracted. The review identified nine studies that satisfied the inclusion criteria. Burn sizes of patients ranged from 1% to 62% of the body...
November 20, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29167237/changes-in-the-dispensing-of-opioid-medications-in-canada-following-the-introduction-of-a-tamper-deterrent-formulation-of-long-acting-oxycodone-a-time-series-analysis
#17
Tara Gomes, Andrea Mastorakos, J Michael Paterson, Ingrid Sketris, Patricia Caetano, Simon Greaves, David Henry
BACKGROUND: In February 2012, a reformulated tamper-deterrent form of long-acting oxycodone, OxyNeo, was introduced in Canada. We investigated the impact of the introduction of OxyNeo on patterns of opioid prescribing. METHODS: We conducted population-based, cross-sectional analyses of opioid dispensing in Canada between 2008 and 2016. We estimated monthly community pharmacy dispensing of oral formulations of codeine, morphine, hydromorphone and oxycodone, and a transdermal formulation of fentanyl, and converted quantities to milligrams of morphine equivalents (MMEs) per 1000 population...
November 22, 2017: CMAJ Open
https://www.readbyqxmd.com/read/29154933/opioid-prescription-and-patient-use-following-gynecologic-procedures-a-survey-of-patients-and-providers
#18
Kendall C Griffith, Nisse V Clark, Andrea L Zuckerman, Tanaz R Ferzandi, Kelly N Wright
STUDY OBJECTIVE: To describe opioid distribution and patient use following gynecologic procedures. DESIGN: This is a survey study of physicians and patients composed of two parts: 1) a physician survey on opioid prescribing practices following gynecologic procedures, and 2) a patient survey on opioid consumption following hysterectomy. DESIGN CLASSIFICATION: III SETTING: An urban academic tertiary care hospital. SUBJECTS: 96 gynecologists in the Boston-area...
November 14, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29141373/-a-concentration-response-observation-of-hydromorphone-combined-with-ropivacaine-in-labor-analgesia
#19
Y Y Lu, H Huang, W L Mao, R H Liu, M J Hu, L X Shao, M P Hu, J Li
Objective: To investigate the median effective dose (ED(50)) of hydromorphone and the appropriate concentration of ropivacaine combined with hydromorphone in epidural labor analgesia. Methods: One hundred and forty nulliparous women undergoing labor selected for delivery with epidural analgesia were enrolled in our hospital from January to June 2016. The first of top 50 women received 0.12% ropivacaine plus 20 μg/ml hydromorphone complex solution, then sequential women were used the modified sequential method to determine the ED(50) and ED(95) of hydromorphone...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29099518/diffuse-skin-rash-altered-mental-status-%C3%A2-dx
#20
Caitlyn T Reed, Allison R Cruse, Jeremy D Jackson
A 74-YEAR-OLD CAUCASIAN MAN presented to the hospital with intractable back and chest pain, a diffuse skin rash, and altered mental status. He said that 2 days ago, he'd gone to a different local hospital for treatment of back pain and a headache that had begun 3 days earlier. He was treated with intravenous hydromorphone and sent home with a prescription for meperidine. He said that several hours after being treated with the hydromorphone, the rash developed on his head and then spread to his trunk and upper extremities...
November 2017: Journal of Family Practice
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