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Opioid dose ranges

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https://www.readbyqxmd.com/read/28195856/pharmacoepidemiologic-analyses-of-opioid-use-among-oef-oif-ond-veterans
#1
Teresa J Hudson, Jacob T Painter, Brad Martin, Mark A Austen, James S Williams, John Fortney, Mark D Sullivan, Mark E Edlund
There is a great deal of concern about opioid use in Veterans, particularly those that served in Afghanistan (OEF) and Iraq (OIF and OND). The current study provides a detailed pharmacoepidemiologic analysis of opioid use among OEF/OIF/OND Veterans from FY09 to FY12. Data from three data repositories from the Veterans Health Administration (VHA) were used to describe demographic, clinical, and medication characteristics associated with opioid use among OEF/OIF/OND Veterans and among those with TBI. Logistic regression models were used to identify risks associated with chronic opioid use in FY12...
February 11, 2017: Pain
https://www.readbyqxmd.com/read/28182128/co-prescription-of-opioids-with-benzodiazepine-and-other-co-medications-among-opioid-users-differential-in-opioid-doses
#2
Che Suraya Zin, Fadhilah Ismail
PURPOSE: This study investigated the patterns of opioid co-prescription with benzodiazepine and other concomitant medications among opioid users. Opioid dose in each type of co-prescription was also examined. PATIENTS AND METHODS: This cross-sectional study was conducted among opioid users receiving concomitant medications at an outpatient tertiary hospital setting in Malaysia. Opioid prescriptions (morphine, fentanyl, oxycodone, dihydrocodeine and tramadol) that were co-prescribed with other medications (opioid + benzodiazepines, opioid + antidepressants, opioid + anticonvulsants, opioid + antipsychotics and opioid + hypnotics) dispensed from January 2013 to December 2014 were identified...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28170358/influence-of-ethanol-on-oxycodone-induced-respiratory-depression-a-dose-escalating-study-in-young-and-elderly-individuals
#3
Rutger van der Schrier, Margot Roozekrans, Erik Olofsen, Leon Aarts, Monique van Velzen, Merijn de Jong, Albert Dahan, Marieke Niesters
BACKGROUND: Respiratory depression is a potentially fatal complication of opioid use, which may be exacerbated by simultaneous ethanol intake. In this three-way sequential crossover dose-escalating study, the influence of coadministration of oral oxycodone and intravenous ethanol was assessed on resting ventilation, apneic events and the hypercapnic ventilatory response in healthy young and older volunteers. METHODS: Twelve young (21 to 28 yr) and 12 elderly (66 to 77 yr) opioid-naive participants ingested one 20 mg oxycodone tablet combined with an intravenous infusion of 0, 0...
March 2017: Anesthesiology
https://www.readbyqxmd.com/read/28163987/mirror-therapy-for-phantom-limb-pain-at-a-pediatric-oncology-institution
#4
Doralina L Anghelescu, Cassandra N Kelly, Brenda D Steen, Jianrong Wu, Huiyun Wu, Brian M DeFeo, Kristin Scobey, Laura Burgoyne
BACKGROUND AND PURPOSE/OBJECTIVE: Mirror therapy has not been reported for phantom limb pain (PLP) in pediatric oncology. Our aims are to describe the incidence and duration of PLP post-amputation, the duration of follow-up, pain scores and pain medications, and the differences between a group that received mirror therapy (MT) in addition to the standard treatment and a group that received only the standard treatment (non-MT). METHODS: A retrospective review of patients' medical records from June 2009 to March 2015 was completed...
July 2016: Rehabilitation Oncology
https://www.readbyqxmd.com/read/28156445/evaluation-of-the-japanese-opioid-conversion-ratio-for-switching-to-methadone-for-cancer-pain-control
#5
Sachiko Okayama, Yoshito Yoshikawa, Yoshio Kobayashi
: 196 Background: In Japan, oral administration of methadone was approved for patients with cancer pain in March 2013. As methadone exhibits complex pharmacokinetics with individual differences and rare but serious adverse effects, methadone is only prescribed as a fourth-line drug by cancer pain specialists, who must start methadone according to the following table and must not increase methadone dose within 7 days. AIMS: To assess the validity of the Japanese opioid conversion ratio...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156444/the-conversion-ratio-from-intravenous-iv-hydromorphone-to-oral-po-opioids-in-patients-with-cancer
#6
Sara Dost, Marieberta Vidal, Saneese Stephen, Karen Baumgartner, Jimin Wu, Diane D Liu, Sriram Yennu, Eduardo Bruera
: 197 Background: Inpatients with cancer frequently undergo conversions from IV to PO hydromorphone (HM) or opioid rotation (OR) from IV HM to another PO opioid prior to discharge. Currently used conversion ratios (CR) between IV and PO HM range from 2-5 and opioid rotation ratios (ORR) between IV HM and oral morphine equivalent daily dose (MEDD) range from 10-20. This large variation in ratios may lead to uncontrolled pain or overdosing. Our aim was to determine the accurate CR from IV to PO HM and ORR from IV HM to PO morphine and oxycodone (measured as MEDD)...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28146271/liposomal-bupivacaine-infiltration-at-the-surgical-site-for-the-management-of-postoperative-pain
#7
REVIEW
Thomas W Hamilton, Vassilis Athanassoglou, Stephen Mellon, Louise H Strickland, Marialena Trivella, David Murray, Hemant G Pandit
BACKGROUND: Despite multi-modal analgesic techniques, acute postoperative pain remains an unmet health need, with up to three quarters of people undergoing surgery reporting significant pain. Liposomal bupivacaine is an analgesic consisting of bupivacaine hydrochloride encapsulated within multiple, non-concentric lipid bi-layers offering a novel method of sustained-release analgesia. OBJECTIVES: To assess the analgesic efficacy and adverse effects of liposomal bupivacaine infiltration at the surgical site for the management of postoperative pain...
February 1, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28144823/abuse-and-misuse-of-pregabalin-and-gabapentin
#8
REVIEW
Kirk E Evoy, Megan D Morrison, Stephen R Saklad
BACKGROUND: Gabapentinoid (pregabalin and gabapentin) abuse is increasingly being reported. OBJECTIVE: To assess the extent of gabapentinoid abuse, characteristics of typical abusers, patterns of abuse, and potential harms in order to bring this trend to providers' attention. METHODS: A systematic review of MEDLINE, Cochrane Library, ClinicalTrials.gov, and US FDA data, indexed through 28 July 2016, utilizing the following searches: pregabalin OR gabapentin OR gabapentinoid AND one of the following: abuse, misuse, overdose, or substance-related disorders[MESH], was conducted...
February 1, 2017: Drugs
https://www.readbyqxmd.com/read/28127938/an-open-label-randomized-bioavailability-study-of-alternative-methods-of-oral-administration-of-naloxegol-in-healthy-subjects
#9
Khanh Bui, Bruce Birmingham, Ulysses Diva, Bruce Berger
Naloxegol is a peripherally acting μ-opioid receptor antagonist approved as an orally administered tablet for the treatment of opioid-induced constipation. Patients with swallowing difficulties may benefit from alternative approaches to the oral administration of the whole-tablet formulation of naloxegol. This open-label, randomized, 4-period, 4-treatment, crossover, single-dose study (NCT02446171) evaluated the pharmacokinetic (PK) characteristics of crushed naloxegol 25-mg tablets (suspended in water) administered orally or by nasogastric tube and a naloxegol solution compared with the commercially available 25-mg tablet formulation in healthy volunteers...
January 27, 2017: Clinical Pharmacology in Drug Development
https://www.readbyqxmd.com/read/28111431/initial-titration-with-200-%C3%AE-g-fentanyl-buccal-tablets-a-retrospective-safety-analysis-in-korean-cancer-patients
#10
Mi-Young Kwon, Ha-Na Cho, Dong-Hoe Koo, Yun-Gyoo Lee, Sukjoong Oh, Seung-Sei Lee
Background/Aims: Managing breakthrough pain (BTP) is important for many cancer patients because of the rapid onset and unpredictable nature of the pain episodes. Fentanyl buccal tablets (FBTs) are a rapid-onset opioid indicated for BTP management. However, FBT titration is needed to optimize BTP management. In this study, we aimed to evaluate the safety and efficacy of initiating 200 μg FBTs in Korean cancer patients. Methods: A retrospective analysis of medical records was performed on all advanced cancer patients treated with FBTs for BTP between October 2014 and July 2015...
January 24, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28107783/lorcaserin-suppresses-oxycodone-self-administration-and-relapse-vulnerability-in-rats
#11
Harshini Neelakantan, Erica D Holliday, Robert G Fox, Sonja J Stutz, Sandra D Comer, Margaret Haney, Noelle C Anastasio, Frederick Gerard Moeller, Kathryn A Cunningham
Opioid use disorder (OUD) is a major public health problem. High relapse rates and poor treatment retention continue to pose major challenges in OUD treatment. Of the abused opioids, oxycodone is well described to maintain self-administration and evoke the durable conditioned responses ("cue reactivity") that result from pairing of opioid-related stimuli (e.g., paraphernalia) with repeated abuse. Serotonin (5-HT) neurotransmission, particularly through the 5-HT2C receptor (5-HT2CR), regulates psychostimulant reward and cue reactivity, and in the present experiments, we investigated the hypothesis that the selective 5-HT2CR agonist lorcaserin, which is FDA-approved for the treatment of obesity, will suppress oxycodone self-administration and oxycodone-associated cue reactivity in rats...
January 20, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/28106611/time-course-of-copeptin-during-a-model-of-experimental-pain-and-hyperalgesia-a-randomised-volunteer-crossover-trial
#12
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
#13
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/28089187/effect-of-periarticular-morphine-injection-for-total-knee-arthroplasty-a-randomized-double-blind-trial
#14
Kentaro Iwakiri, Yoshito Minami, Yoichi Ohta, Akio Kobayashi
BACKGROUND: The periarticular multimodal cocktail injection including morphine is currently commonly used to treat postoperative pain after total knee arthroplasty (TKA). Despite its analgesic effect, it is frequently reported to cause nausea and vomiting, which are adverse effects of opioids. This study aimed to assess the efficacy of morphine as a component of a multimodal cocktail injection for providing postoperative analgesia and alleviating swelling in patients who underwent TKA...
December 27, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28088507/patient-reported-outcomes-and-opioid-use-in-outpatients-with-chronic-pain
#15
Lisa R Witkin, David Zylberger, Neel Mehta, Madeleine Hindenlang, Christopher Johnson, Jacob Kean, Susan D Horn, Charles E Inturrisi
: The Weill Cornell Medical College (WCMC) Pain Registry database contains patient characteristics, treatments, and outcomes for a prospective cohort of 1159 chronic pain patients who were seen at the WCMC Pain Medicine outpatient clinic from 7/08/2011 to 12/10/2014. Patients aged 45-64 comprised 43% followed by age >=65 at 37%. Fifty-eight percent were female. Average pain intensity (Brief Pain Inventory) was reported as mild by 22.3% of patients, moderate by 34.7%, and severe by 43...
January 11, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28073687/adverse-event-detection-using-the-fda-post-marketing-drug-safety-surveillance-system-cardiotoxicity-associated-with-loperamide-abuse-and-misuse
#16
Kimberley A Swank, Eileen Wu, Cindy Kortepeter, Jana McAninch, Robert L Levin
OBJECTIVE: The purpose of this investigation was to identify and characterize post-marketing reports of cardiotoxicity, including torsades de pointes (TdP), associated with loperamide use. METHODS: We searched the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) database for post-marketing reports of serious cardiac adverse events associated with loperamide use from December 28, 1976 (U.S. drug approval date), through December 14, 2015. We also conducted a Pubmed and Google Scholar search to identify additional published reports of cardiotoxicity associated with loperamide in the medical literature through February 11, 2016...
January 7, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28063863/correlation-between-observational-scales-of-sedation-and-comfort-and-bispectral-index-scores-bis
#17
Michael Barbato, Greg Barclay, Jan Potter, Wilf Yeo, Joseph Chung
CONTEXT: When palliative care patients enter the phase of unconsciousness preceding death it is standard practice to initiate or continue a subcutaneous infusion of an opioid plus or minus a sedative. The doses are determined somewhat empirically and adjustments are based on clinical assessment and observational measures of sedation and comfort. Following reports that these observational measures could be misleading, this study assesses their validity by comparing them with an objective measure of sedation, the Bispectral Index score (BIS)...
January 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28053591/potentially-inappropriate-medications-prescribed-for-elderly-patients-through-family-physicians
#18
Abdulaziz Al Odhayani, Ayla Tourkmani, Mohammed Alshehri, Hala Alqahtani, Adel Mishriky
The elderly population is increasing throughout the globe, resulting in higher healthcare costs. Potential inappropriate medication (PIM) prescriptions are a major health problem affecting the elderly persons. Due to limited studies in PIM use in primary care and home healthcare in Saudi Arabia, we aim to examine the extent of PIM prescription for and use by elderly patients. This study was carried out with 798 elderly patients, arbitrarily selected from Prince Sultan Medical Military City through the patient register...
January 2017: Saudi Journal of Biological Sciences
https://www.readbyqxmd.com/read/28049031/the-efficacy-of-dynorphin-fragments-at-the-%C3%AE%C2%BA-%C3%AE-and-%C3%AE-opioid-receptor-in-transfected-hek-cells-and-in-an-animal-model-of-unilateral-peripheral-inflammation
#19
M Morgan, A Heffernan, F Benhabib, S Wagner, A K Hewavitharana, P N Shaw, P J Cabot
Dynorphin 1-17 is an endogenous peptide that is released at sites of inflammation by leukocytes, binding preferentially to κ-opioid receptors (KOP) to mediate nociception. We have previously shown that dynorphin 1-17 is rapidly biotransformed to smaller peptide fragments in inflamed tissue homogenate. This study aimed to determine the efficacy and potency of selected dynorphin fragments produced in an inflamed environment at the KOP, μ and δ-opioid receptors (MOP and DOP respectively) and in a model of inflammatory pain...
December 31, 2016: Peptides
https://www.readbyqxmd.com/read/28035588/clinical-pharmacokinetics-and-pharmacodynamics-of-naloxegol-a-peripherally-acting-%C3%A2%C2%B5-opioid-receptor-antagonist
#20
REVIEW
Khanh Bui, Diansong Zhou, Hongmei Xu, Eike Floettmann, Nidal Al-Huniti
Naloxegol is a peripherally acting µ-opioid receptor antagonist approved for use as an orally administered tablet (therapeutic doses of 12.5 and 25 mg) for the treatment of opioid-induced constipation. Over a wide dose range (i.e. single supratherapeutic doses up to 1000 mg in healthy volunteers), the pharmacokinetic properties of naloxegol appear to be time- and dose-independent. Naloxegol is rapidly absorbed, with mean time to maximum plasma concentration of <2 h. Following once-daily administration, steady state is achieved within 2-3 days and minimal accumulation is observed...
December 29, 2016: Clinical Pharmacokinetics
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