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Meghan MacKenzie, Richard Hall
PURPOSE: Knowledge of how alterations in pharmacogenomics and pharmacogenetics may affect drug therapy in the intensive care unit (ICU) has received little study. We review the clinically relevant application of pharmacogenetics and pharmacogenomics to drugs and conditions encountered in the ICU. SOURCE: We selected relevant literature to illustrate the important concepts contained within. PRINCIPAL FINDINGS: Two main approaches have been used to identify genetic abnormalities - the candidate gene approach and the genome-wide approach...
October 17, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Kam Lun Hon, Michael Ho Ming Chan, Ming Him James Ng, Chi Cheung Ho, Yin Ching Kathy Tsang, Wing Hung Tam, Chung Shun Ho
OBJECTIVE: Maternal drug abuse may influence neonatal outcomes. We compared neonatal outcomes of patients with urine screened positive for commonly abused drugs (CAD) versus those who were screened negative, and reviewed the pattern of drugs detected at a university teaching hospital. METHODS: Urine samples collected from babies with suspected illicit drug exposure who were admitted to the neonatal unit were sent for comprehensive drug screen (CDS) performed by liquid chromatography-time-of-flight mass spectrometry (LC-TOF/MS)...
October 10, 2016: Current Clinical Pharmacology
Rakesh Pore, Swati Biswas, Srirupa Das
PURPOSE: The aim of the survey was to understand the prevailing practice pattern for the management of dry cough among primary care physicians in Indian clinical setting. MATERIAL AND METHODS: This single visit, cross-sectional, non-interventional, interview based physician survey was conducted over a period of 3 months where 500 registered physicians with at least 6 months of clinical practice and willing to participate in the survey were interviewed in their clinic or hospital from June to August 2015...
June 2016: Journal of the Association of Physicians of India
Pedram Ramin, Andreas Libonati Brock, Fabio Polesel, Ana Causanilles, Erik Emke, Pim de Voogt, Benedek Gy Plosz
Sewer pipelines, although primarily designed for sewage transport, can also be considered as bioreactors. In-sewer processes may lead to significant variations of chemical loadings from source release points to the treatment plant influent. In this study, we assessed in-sewer utilization of growth substrates (primary metabolic processes) and transformation of illicit drug biomarkers (secondary metabolic processes) by suspended biomass. Sixteen drug biomarkers were targeted, including mephedrone, methadone, cocaine, heroin, codeine and tetrahydrocannabinol (THC) and their major human metabolites...
October 14, 2016: Environmental Science & Technology
Corrie E Chumpitazi, Chris A Rees, Elizabeth A Camp, M Brooke Bernhardt
BACKGROUND: The Drug Enforcement Administration (DEA) changed hydrocodone-containing products (HCPs) from Schedule III to II status on October 6, 2014, making codeine-containing products (CCPs) the only non-Schedule II oral opioid agents. OBJECTIVES: We sought to describe prescribing patterns of oral opioid agents in the pediatric emergency department before and after the 2014 DEA rescheduling of HCPs. METHODS: We performed a cross-sectional study evaluating prescribing patterns in the pediatric emergency department at an urban, academic, quaternary care children's hospital system for 6 months before and 6 months after the DEA rescheduling of HCPs...
October 7, 2016: Journal of Emergency Medicine
G Jeanne, D Purper-Ouakil, H Rigole, N Franc
AIM: There have been significant changes in adolescent consumption habits over the past fifteen years. New molecules have been synthesized, new devices created and a number of products have increased in popularity; and as a result clinicians sometimes lack information. We chose to focus on this population because of its vulnerability, as adolescents show low sensitivity to long-term outcomes of their actions and may be easily influenced by peers as regards experimentation of new drugs...
October 6, 2016: L'Encéphale
Kai-Hsiang Kang, Li-Fen Kuo, I-Chen Cheng, Chih-Shiuh Chang, Wen-Ing Tsay
BACKGROUND/PURPOSE: According to WHO guideline, the consumption of opioids is an important sign of national progress in cancer pain relief. However, precise data on the consumption of opioid analgesics consumption in Taiwan has not been published. We investigate opioid analgesic consumption in Taiwan between 2002 and 2014 compare the results with those in other countries to see what we could learn about other methods of pain management. To find out the different patterns between Taiwan and other country, improves the quality of pain management...
October 4, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
Elizabeth Marrett, Winghan Jacqueline Kwong, Feride Frech, Chunlin Qian
INTRODUCTION: Nausea and vomiting (NV) are common side effects of opioid use and limiting factors in pain management. This study sought to quantify the frequency of antiemetic prescribing and the impact of NV on health care resource utilization and costs in outpatients prescribed opioids for acute pain. The perspective was that of a commercial health plan. METHODS: Medical and pharmacy claims from IMS PharMetrics Plus were used to identify patients initiating opioid therapy with a prescription for an oxycodone-, hydrocodone- or codeine-containing immediate-release product for acute use (≤15-day supply) between October 1, 2013 and September 30, 2014...
October 4, 2016: Pain and Therapy
Pongkwan Sitasuwan, Cathleen Melendez, Margarita Marinova, Kaylee R Mastrianni, Alicia Darragh, Emily Ryan, L Andrew Lee
Drug monitoring laboratories utilize a hydrolysis process to liberate the opiates from their glucuronide conjugates to facilitate their detection by tandem mass spectrometry (MS). Both acid and enzyme hydrolysis have been reported as viable methods, with the former as a more effective process for recovering codeine-6-glucuronide and morphine-6-glucuronide. Here, we report concerns with acid-catalyzed hydrolysis of opioids, including a significant loss of analytes and conversions of oxycodone to oxymorphone, hydrocodone to hydromorphone and codeine to morphine...
October 2016: Journal of Analytical Toxicology
E M O'Sullivan, B Sweeney, E Mitten, C Ryan
Many headache patients self-medicate and choose their preferred analgesic from a range of acute analgesics available on the high-street and from community pharmacies. Little is known about their presenting symptoms, headache diagnosis and their preferred treatments. A questionnaire was distributed to community pharmacies in the Munster region of Ireland and was administered to patients requesting treatment for headache. A total of 1023 completed questionnaires were received, 76.7% (n=765) were female and 51...
2016: Irish Medical Journal
L Garcin, M Le Roch, C-A Agbessi, J-B Lobut, A Lecoeur, G Benoist
"Purple drank" is a dangerous hallucinogenic cocktail commonly used by teenagers, made popular by American rappers and social networks. It combines codeine-based cough syrup, antihistamines such as promethazine, and soda. Unknown by caregivers, it may be responsible for serious neuropsychological complications. We report the effects of this new risky behavior in three patients: a 14-year-old girl and her boyfriend, both found in an initial state of drowsiness, followed by hallucinations and anticholinergic toxidrome; and another teenager whose chronic use led to addiction with increasing doses...
September 23, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Joseph D Tobias, Thomas P Green, Charles J Coté
Codeine has been prescribed to pediatric patients for many decades as both an analgesic and an antitussive agent. Codeine is a prodrug with little inherent pharmacologic activity and must be metabolized in the liver into morphine, which is responsible for codeine's analgesic effects. However, there is substantial genetic variability in the activity of the responsible hepatic enzyme, CYP2D6, and, as a consequence, individual patient response to codeine varies from no effect to high sensitivity. Drug surveillance has documented the occurrence of unanticipated respiratory depression and death after receiving codeine in children, many of whom have been shown to be ultrarapid metabolizers...
September 19, 2016: Pediatrics
Eva L Pijpers, Sanne Kreijkamp-Kaspers, Treasure M McGuire, Laura Deckx, Wendy Brodribb, Mieke L van Driel
BACKGROUND: For many medicines, safe use during pregnancy is not established and adherence is often poor due to safety concerns. Therefore, it is important to identify consumers' medicines information needs during pregnancy. MATERIALS AND METHODS: A retrospective, mixed methods analysis was conducted on eight years of pregnancy-related calls to an Australian national medicines call centre. The call profile of pregnancy and non-pregnancy-related questions were compared...
September 14, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
M Taei, H Salavati, F Hasanpour, S Habibollahi, H Baghlani
Based on incorporating ZnCrFeO4 into multi-walled carbon nanotubes paste matrix (MWCNTs/ZnCrFeO4/CPE), a chemically modified electrode was prepared for the simultaneous determination of ascorbic acid (AA), acetaminophen (AC) and codeine (CO). The prepared electrode, MWCNTs/ZnCrFeO4/CPE, was characterized by scanning electron microscopy (SEM) and electrochemical impedance spectroscopy (EIS). The MWCNTs/ZnCrFeO4/CPE showed an efficient electrocatalytic activity for the oxidation of AA, AC, and CO. The separations of the oxidation peak potentials for AA-AC and AC-CO were about 250mV and 630mV, respectively...
December 1, 2016: Materials Science & Engineering. C, Materials for Biological Applications
Andis Graudins, Robert Meek, Jacqueline Parkinson, Diana Egerton-Warburton, Alastair Meyer
OBJECTIVE: Compare pain relief from non-opioid, codeine and oxycodone analgesic regimens in adults with moderate pain from limb injury. METHOD: Double-blind, randomised, controlled, non-inferiority trial. Three regimens of six tablets, each included 2 × 500 mg paracetamol and 2 × 200 mg ibuprofen with 2 × 100 mg thiamine (non-opioid), 2 × 30 mg codeine (codeine) or 2 × 5 mg oxycodone tablets (oxycodone). PRIMARY OUTCOME: difference in mean visual analogue scale (VAS) change between groups at 30 min, with a limit of inferiority of 13...
September 7, 2016: Emergency Medicine Australasia: EMA
Chouki Chenaf, Jean-Luc Kabore, Jessica Delorme, Bruno Pereira, Aurélien Mulliez, Lucie Roche, Alain Eschalier, Noémie Delage, Nicolas Authier
: Codeine is a widely used opioid analgesic but studies on its misuse in chronic non-cancer pain (CNCP) are still lacking. The aim of this study was to assess the incidence of codeine shopping behavior in CNCP patients and to identify the associated risk factors. This was a population-based retrospective cohort study from the French health insurance claims database from 2004 to 2014. The main outcome was the one-year incidence of codeine shopping behavior defined as ≥1 day of overlapping prescriptions written by ≥2 different prescribers and filled in ≥3 different pharmacies...
September 1, 2016: Journal of Pain: Official Journal of the American Pain Society
Sarah Adelsperger, Cynthia A Prows, Melanie F Myers, Cassandra L Perry, Ariel Chandler, Ingrid A Holm, John A Lynch
Concerns about the ethical and social implications of genetics persist as more applications of genetic and genomic technology have become available. Pediatric testing for genetic influences on response to opioids like codeine is one area of application. We interviewed parents of children enrolled in a mixed-methods study following the communication of actual or hypothetical results for CYP2D6, which impacts opioid response. Forty-one parents of children naive to opioids and 42 parents of children previously exposed to opioids participated in qualitative interviews...
August 30, 2016: Health Communication
Toni M Rudisill, Motao Zhu, George A Kelley, Courtney Pilkerton, Brandon R Rudisill
OBJECTIVES: Driving under the influence of prescription and over-the-counter medication is a growing public health concern. A systematic review of the literature was performed to investigate which specific medications were associated with increased risk of motor vehicle collision (MVC). METHODS: The a priori inclusion criteria were: (1) studies published from English-language sources on or after January 1, 1960, (2) licensed drivers 15 years of age and older, (3) peer-reviewed publications, master's theses, doctoral dissertations, and conference papers, (4) studies limited to randomized control trials, cohort studies, case-control studies, or case-control type studies (5) outcome measure reported for at least one specific medication, (6) outcome measure reported as the odds or risk of a motor vehicle collision...
November 2016: Accident; Analysis and Prevention
Alexandra Maas, Michael Krämer, Konrad Sydow, Pai-Shan Chen, Torsten Dame, Frank Musshoff, Bernd W K Diehl, Burkhard Madea, Cornelius Hess
Discrimination between street heroin consumption and poppy seed ingestion represents a major toxicological challenge in daily routine work. Several difficulties associated with conventional street heroin markers originate from their versatile occurrence in various poppy seed products and medications, respectively, as well as to small windows of detection. A novel opportunity to overcome these hindrances is represented by the new potential street heroin marker acetylated-thebaine-4-metabolite glucuronide (ATM4G), originating from thebaine during street heroin synthesis followed by metabolic reactions after administration...
August 26, 2016: Drug Testing and Analysis
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