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Fentanyl Transdermal

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https://www.readbyqxmd.com/read/28156677/insurer-pre-authorization-and-copayment-for-palliative-patients-with-cancer-receiving-opioids-other-than-morphine
#1
Akhila Sunkepally Reddy, Eden Mae Rodriguez, Eduardo Bruera
: 217 Background: Uncontrolled pain is one of the main fears for patients with cancer and their families. Opioid analgesics are highly effective agents, but the choice of type, route, and dose needs to be personalized. The highly cost of some of them can make it difficult for patients to received adequate pain control without appropriate insurance coverage. There is a lack of information regarding the frequency of denials or heavy copayments by insurers. METHODS: We evaluated 143 continuous opioid test claims for prescriptions by our palliative care providers for opioids other than morphine, including transdermal fentanyl, extended release oxycodone, hydromorphone and oxymorphone...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28118835/pilot-evaluation-of-a-novel-unilateral-onychectomy-model-and-efficacy-of-an-extended-release-buprenorphine-product
#2
RANDOMIZED CONTROLLED TRIAL
Masataka Enomoto, Patricia D Kigin, David Bledsoe, Robyn Slone, Jonathan Hash, Charles E Smith, B Duncan X Lascelles
BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs), transdermal fentanyl patches, and transmucosal buprenorphine are probably the most commonly used options for providing post-operative analgesia in the early at-home period. However, these require daily administration or are associated with abuse concerns. One of the significant unmet needs in veterinary surgery and pain management is for longer acting opioids for cats to effectively bridge the gap between the in-hospital and at-home recovery periods...
January 24, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/28106611/time-course-of-copeptin-during-a-model-of-experimental-pain-and-hyperalgesia-a-randomised-volunteer-crossover-trial
#3
Eckhard Mauermann, Claudine A Blum, Giovanna Lurati Buse, Oliver Bandschapp, Wilhelm Ruppen
BACKGROUND: A reliable biomarker for quantifying pain or hyperalgesia has yet to be found. A surrogate marker of arginine vasopressin, copeptin, is elevated in a number of states of physiological and psychological stress and may have a role in quantifying pain and/or hyperalgesia. OBJECTIVES: To evaluate copeptin as a biomarker for pain or hyperalgesia developing after 120 min of sustained electrical stimulation. DESIGN: Secondary analysis of a randomised, double-blinded, crossover trial...
January 19, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28101968/defined-daily-doses-ddd-do-not-accurately-reflect-opioid-doses-used-in-contemporary-chronic-pain-treatment
#4
Suzanne Nielsen, Natasa Gisev, Raimondo Bruno, Wayne Hall, Milton Cohen, Briony Larance, Gabrielle Campbell, Marian Shanahan, Fiona Blyth, Nicholas Lintzeris, Sallie Pearson, Richard Mattick, Louisa Degenhardt
OBJECTIVE: To assess how well the defined daily dose (DDD) metric reflects opioid utilisation among chronic non-cancer pain patients. DESIGN: Descriptive, cross-sectional study, utilising a 7-day medication diary. SETTING: Community-based treatment settings, Australia. SUBJECTS: A sample of 1101 people prescribed opioids for chronic non-cancer pain. METHODS: Opioid dose data was collected via a self-completed 7-day medication diary capturing names, strengths and doses of each medication taken in the past week...
January 19, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28096225/not-so-patchy-story-of-attempted-suicide%C3%A2-leading-to-24%C3%A2-hours-of-deep-sleep-and-survival
#5
Adam Joseph Trist, Hardeep Sahota, Lucy Williams
Here, we present a somewhat unusual suicide attempt where, despite an unbelievable overdose with transdermal fentanyl patches, the patient survived. The patient-a woman aged 70 years, who has suffered from chronic back pain despite starting transdermal fentanyl patches in 2007. The unconventional method of attempted suicide was based on online research into deaths from fentanyl patch toxicity. She had gradually accumulated 100 µg fentanyl patches from repeat prescriptions, applying 14 patches with fatal intent, alongside 2 45 mg mirtazapine tablets, and concurrent therapeutic doses of tramadol and morphine sulfate oral solution...
January 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28004310/high-body-mass-index-and-use-of-fentanyl-iontophoretic-transdermal-system-in-postoperative-pain-management-results-of-a-pooled-analysis-of-six-phase-3-3b-trials
#6
Eugene R Viscusi, Li Ding, J Bradley Phipps, Loretta M Itri, Philip R Schauer
INTRODUCTION: Postoperative pain management can be challenging in patients with a high body mass index (BMI) especially as a result of poor venous access and delayed ambulation that can result in serious complications. Fentanyl iontophoretic transdermal system (ITS) is a needle-free, patient-controlled analgesic method available for use in acute postoperative pain. The primary objective of these analyses was to determine if there were any differences between patients with high BMI (>40 kg/m(2)) and lower BMIs (<30 kg/m(2) and 35-40 kg/m(2)) in terms of efficacy or safety...
December 21, 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27973601/high-dose-opioid-prescribing-and-opioid-related-hospitalization-a-population-based-study
#7
Kimberly Fernandes, Diana Martins, David Juurlink, Muhammad Mamdani, J Michael Paterson, Luke Spooner, Samantha Singh, Tara Gomes
AIMS: To examine the impact of national clinical practice guidelines and provincial drug policy interventions on prevalence of high-dose opioid prescribing and rates of hospitalization for opioid toxicity. DESIGN: Interventional time-series analysis. SETTING: Ontario, Canada, from 2003 to 2014. PARTICIPANTS: Ontario Drug Benefit (ODB) beneficiaries aged 15 to 64 years from 2003 to 2014. INTERVENTIONS: Publication of Canadian clinical practice guidelines for use of opioids in chronic non-cancer pain (May 2010) and implementation of Ontario's Narcotics Safety and Awareness Act (NSAA; November 2011)...
2016: PloS One
https://www.readbyqxmd.com/read/27971698/economic-impact-of-fentanyl-hcl-iontophoretic-transdermal-system-versus-iv-pca-in-acute-pain-management-following-surgery-in-the-united-kingdom-germany-and-sweden
#8
J Abraham, C Edwards, L Feeney, M Gavaghan, R Beaton
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27922764/comparison-of-abuse-suspected-suicidal-intent-and-fatalities-related-to-the-7-day-buprenorphine-transdermal-patch-versus-other-opioid-analgesics-in-the-national-poison-data-system
#9
COMPARATIVE STUDY
Paul M Coplan, Nelson E Sessler, Venkatesh Harikrishnan, Richa Singh, Charles Perkel
OBJECTIVE: Prescription opioid related abuse, suicide and death are significant public health problems. This study compares rates of poison center calls categorized as intentional abuse, suspected suicidal intent or fatality for the 7-day buprenorphine transdermal system/patch (BTDS) with other extended-release and long-acting (ER/LA) opioids indicated for chronic pain. METHODS: Retrospective 24-month cohort study using National Poison Data System data from July 2012 through June 2014...
January 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/27904731/clinical-usefulness-of-long-term-application-of-fentanyl-matrix-in-chronic-non-cancer-pain-improvement-of-pain-and-physical-and-emotional-functions
#10
Jaewon Lee, Joon Shik Yoon, Jae Hyup Lee, So-Hak Chung, Kyu-Yeol Lee, Young Yul Kim, Jong Moon Kim, Min Ho Kong, Ung Gu Kang, Ye-Soo Park
BACKGROUND: Opioids are recently recommended for those who do not gain adequate pain relief from the use of acetaminophen or nonsteroidal anti-inflammatory drugs. Medical opioids are administered in various routes, and transdermal opioid products that can make up for the weaknesses of the oral or intravenous products have been developed. This study is to evaluate the clinical usefulness of fentanyl matrix in terms of the long-term improvement in pain and physical and mental functions...
December 2016: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/27886163/alghedon-fentanyl-transdermal-system
#11
Patrizia Romualdi, Patrizia Santi, Sanzio Candeletti
The efficacy of transdermal fentanyl for cancer pain and chronic non-cancer pain (chronic lower back pain, rheumatoid arthritis, osteoarthritis, neuropathic pain) is well established. Several formulations of fentanyl transdermal systems have been developed to improve the drug delivery and prevent misuse of the active principle. The addition of a rate controlling membrane to the matrix system represented an important advance. The design and functional features of Alghedon patch are compared with other approved generic fentanyl transdermal systems, emphasizing the distinctiveness of Alghedon patch...
April 2017: Minerva Medica
https://www.readbyqxmd.com/read/27877065/poor-adhesion-of-fentanyl-transdermal-patches-may-mimic-end-of-dosage-failure-after-48-hours-and-prompt-early-patch-replacement-in-hospitalized-cancer-pain-patients
#12
Isabelle Arnet, Sabrina Schacher, Eva Balmer, Dieter Koeberle, Kurt E Hersberger
CONTEXT: Renewal of fentanyl transdermal patch (transdermal therapeutic system [TTS]) should occur every 3 days (72 hours) according to manufacturer's guidelines. Some studies mentioned patients reporting end-of-dose failure, and thus, some authors recommend shortening the interval of application to 2 days (48 hours). However, reasons for early replacement are mostly unknown. OBJECTIVES: The objectives of this study were to assess the prevalence of early replacement of fentanyl TTS in a cancer center in Basel, Switzerland, and to assess the reasons for early replacement in stationary patients...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27867509/comparison-of-fentanyl-iontophoretic-transdermal-system-and-routine-care-with-morphine-intravenous-patient-controlled-analgesia-in-the-management-of-early-postoperative-mobilisation-results-from-a-randomised-study
#13
Richard M Langford, Kuang-Yi Chang, Li Ding, Jeffrey Abraham
INTRODUCTION: Fentanyl iontophoretic transdermal system (ITS) (IONSYS(®), The Medicines Company, Parsippany, NJ, USA) and morphine intravenous (IV) patient-controlled analgesia (PCA) have demonstrated equivalent pain control in several published studies. The primary objective of the current study was to compare fentanyl ITS with morphine IV PCA with regard to the patient's ability to mobilise with acute postoperative pain. METHODS: In this multicentre, open-label, randomised, active-controlled, prospective phase IV study, postoperative patients initially received IV morphine and were titrated to pain score ⩽ 4out of 10 on a Numeric Rating Scale (NRS) and then received fentanyl ITS (up to 240 µg (6 doses)/hour; up to a maximum of 3...
November 2016: British Journal of Pain
https://www.readbyqxmd.com/read/27817153/use-of-fentanyl-iontophoretic-transdermal-system-its-ionsys-%C3%A2-in-the-management-of-patients-with-acute-postoperative-pain-a-case-series
#14
Steven Poplawski, Matthew Johnson, Philip Philips, Leopold H J Eberhart, Tilo Koch, Loretta M Itri
Fentanyl iontophoretic transdermal system (ITS) [IONSYS(®), The Medicines Company, Parsippany, NJ, USA] is a needle-free, patient-controlled, postoperative opioid pain management treatment. It is indicated for the short-term management of acute postoperative pain in adults requiring opioid analgesia in the hospital. The safety and effectiveness of fentanyl ITS for acute postoperative pain management has been demonstrated in a range of surgery and patient types studied in seven phase 3 trials (three placebo-controlled trials and four active-comparator trials)...
December 2016: Pain and Therapy
https://www.readbyqxmd.com/read/27785733/the-efficacy-and-safety-of-the-fentanyl-iontophoretic-transdermal-system-ionsys-%C3%A2-in-the-geriatric-population-results-of-a-meta-analysis-of-phase%C3%A2-iii-and-iiib-trials
#15
Eugene R Viscusi, Li Ding, Loretta M Itri
BACKGROUND AND OBJECTIVES: Acute postoperative pain management in the geriatric patient can be challenging, including their response to medications. The purpose of this analysis was to evaluate whether the efficacy and safety profile of fentanyl iontophoretic transdermal system (ITS) (IONSYS(®)) was similar in geriatric (≥65 years) and non-geriatric (<65 years) patients. METHODS: Efficacy and safety data from three randomized, double-blind, placebo-controlled trials and four randomized, open-label, active-comparator trials were utilized for this analysis...
December 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27771783/accessibility-of-opioid-analgesics-and-barriers-to-optimal-chronic-pain-treatment-in-poland-in-2000-2015
#16
Tomasz Dzierżanowski, Aleksandra Ciałkowska-Rysz
PURPOSE: Based on the international reports, consumption of opioid analgesics in Poland is relatively low. There is limited information on possible impediments to optimal opioid use. This study was aimed to identify possible barriers to access to opioid analgesics and causes of failure to comply with current clinical guidelines. METHODS: Consumption data per capita in 2000-2015 were analyzed in terms of oral morphine equivalents in total, per prescription type, per reimbursement status, to identify the impact of regulations specific for Poland...
March 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/27727431/fentanyl-for-neuropathic-pain-in-adults
#17
REVIEW
Sheena Derry, Cathy Stannard, Peter Cole, Philip J Wiffen, Roger Knaggs, Dominic Aldington, R Andrew Moore
BACKGROUND: Opioid drugs, including fentanyl, are commonly used to treat neuropathic pain, and are considered effective by some professionals. Most reviews have examined all opioids together. This review sought evidence specifically for fentanyl, at any dose, and by any route of administration. Other opioids are considered in separate reviews. OBJECTIVES: To assess the analgesic efficacy of fentanyl for chronic neuropathic pain in adults, and the adverse events associated with its use in clinical trials...
October 11, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27720662/inappropriate-fentanyl-prescribing-among-nursing-home-residents-in-the-united-states
#18
Kevin M Fain, Carlos Castillo-Salgado, David D Dore, Jodi B Segal, Andrew R Zullo, G Caleb Alexander
OBJECTIVE: We quantified transdermal fentanyl prescribing in elderly nursing home residents without prior opioid use or persistent pain, and the association of individual and facility traits with opioid-naïve prescribing. DESIGN: Cross-sectional study. SETTING: Linked Minimum Data Set (MDS) assessments; Online Survey, Certification and Reporting (OSCAR) records; and Medicare Part D claims. PARTICIPANTS: From a cross-section of all long-stay US nursing home residents in 2008 with an MDS assessment and Medicare Part D enrollment, we identified individuals (≥65 years old) who initiated transdermal fentanyl, excluding those with Alzheimer disease, severe cognitive impairment, cancer, or receipt of hospice care...
February 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/27688989/comparison-of-pain-scores-in-postoperative-patients-intravenous-morphine-patient-controlled-analgesia-vs-iontophoretic-transdermal-fentanyl
#19
REVIEW
Gabriel D Glaun, Anthony M Caram, Nirav Patel, Hayden M Sandler
Postoperative management of pain has traditionally utilized intravenous (IV) morphine for pain control. An alternative approach to the invasive patient-controlled analgesia (PCA) system is the administration of transdermal analgesics, such as fentanyl. In 2006 the Food and Drug Administration (FDA) approved the fentanyl hydrochloride (fentanyl HCl) iontophoretic transdermal system (ITS), which utilizes iontophoretic technology to produce a controlled electrical current that propels ionized fentanyl molecules into the systemic vasculature...
August 26, 2016: Curēus
https://www.readbyqxmd.com/read/27607410/foetal-fentanyl-exposure-and-ion-trapping-after-intravenous-and-transdermal-administration-to-the-ewe
#20
Emma M Heikkinen, Hannu Kokki, Aki Heikkinen, Veli-Pekka Ranta, Juha Räsänen, Hanna-Marja Voipio, Merja Kokki
Opioids given to pregnant and parturient women are relatively freely transferred across the placenta. Spinal, epidural and intravenous fentanyl has been studied in pregnant women and neonates, but foetal safety of fentanyl dosing with transdermal patch during pregnancy and labour is not sufficiently studied. Foetal pH is physiologically lower than maternal pH, and thus, opioids, which are weak bases, are ionized and may cumulate to foetus. Foetal asphyxia may further worsen acidosis, and ion trapping induced by low pH is assumed to increase the foetal exposure to opioids...
September 8, 2016: Basic & Clinical Pharmacology & Toxicology
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