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Oxycodone therapeutic range

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https://www.readbyqxmd.com/read/28662625/oxycodone-in-palliative-care-art-and-empathy-still-have-a-place
#1
William P Tormey
A 47-year-old woman who was receiving palliative care for metastatic breast cancer, which included oxycodone, was found dead in bed. The femoral blood level of oxycodone at autopsy was 1200 µg/L, which is a value within the lethal range. Could the cause of death be attributed to misadventure or suicide? Would the coroner consider a recommendation of therapeutic drug monitoring in palliative care which could have a serious negative impact on pain relief practice? A narrative verdict was the outcome linking the primary cause of death with the drug cocktail found at autopsy...
January 2017: Journal of Palliative Care
https://www.readbyqxmd.com/read/28340451/the-role-of-drug-drug-interactions-in-prostate-cancer-treatment-focus-on-abiraterone-acetate-prednisone-and-enzalutamide
#2
REVIEW
Marzia Del Re, Stefano Fogli, Lisa Derosa, Francesco Massari, Paul De Souza, Stefania Crucitta, Sergio Bracarda, Daniele Santini, Romano Danesi
Elderly patients with cancer may have comorbidities, each requiring additional pharmacologic treatment. Therefore, the occurrence of pharmacokinetic (PK) and pharmacodynamic (PD) interactions is very likely, and the risk of adverse reactions (ADRs), due to the narrow therapeutic window of anticancer drugs, is increased. Drug-drug interactions (DDIs) may occur in prostate cancer patients due to inhibition by abiraterone of liver cytochrome P450 (CYP)-dependent enzymes CYP2C8 and 2D6, which are involved in the metabolism of approximately 25% of all drugs, and induction by enzalutamide of CYP3A4, 2C9 and 2C19, which metabolize up to 50% of medications...
March 9, 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/28339737/a-novel-chronic-opioid-monitoring-tool-to-assess-prescription-drug-steady-state-levels-in-oral-fluid
#3
Naum Shaparin, Neel Mehta, Frank Kunkel, Richard Stripp, Damon Borg, Elizabeth Kolb
Objective. : Interpretation limitations of urine drug testing and the invasiveness of blood toxicology have motivated the desire for the development of simpler methods to assess biologically active drug levels on an individualized patient basis. Oral fluid is a matrix well-suited for the challenge because collections are based on simple noninvasive procedures and drug concentrations better correlate to blood drug levels as oral fluid is a filtrate of the blood. Well-established pharmacokinetic models were utilized to generate oral fluid steady state concentration ranges to assess the interpretive value of the alternative matrix to monitor steady state plasma oxycodone levels...
February 23, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28107783/lorcaserin-suppresses-oxycodone-self-administration-and-relapse-vulnerability-in-rats
#4
Harshini Neelakantan, Erica D Holliday, Robert G Fox, Sonja J Stutz, Sandra D Comer, Margaret Haney, Noelle C Anastasio, F 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 approved by the United States Food and Drug Administration (FDA) for the treatment of obesity, will suppress oxycodone self-administration and oxycodone-associated cue reactivity in rats...
May 17, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/26607771/quantitative-determination-of-opioids-in-whole-blood-using-fully-automated-dried-blood-spot-desorption-coupled-to-on-line-spe-lc-ms-ms
#5
Ruth Verplaetse, Jack Henion
Opioids are well known, widely used painkillers. Increased stability of opioids in the dried blood spot (DBS) matrix compared to blood/plasma has been described. Other benefits provided by DBS techniques include point-of-care collection, less invasive micro sampling, more economical shipment, and convenient storage. Current methodology for analysis of micro whole blood samples for opioids is limited to the classical DBS workflow, including tedious manual punching of the DBS cards followed by extraction and liquid chromatography-tandem mass spectrometry (LC-MS/MS) bioanalysis...
January 2016: Drug Testing and Analysis
https://www.readbyqxmd.com/read/25985806/does-tapentadol-affect-sex-hormone-concentrations-differently-from-morphine-and-oxycodone-an-initial-assessment-and-possible-implications-for-opioid-induced-androgen-deficiency
#6
RANDOMIZED CONTROLLED TRIAL
Gary Eichenbaum, Karin Göhler, Mila Etropolski, Ilona Steigerwald, Joseph Pergolizzi, Myoung Kim, Gary Vorsanger
OBJECTIVES: Opioid-induced androgen deficiency (OPIAD) affects patients treated with opioid analgesics. The norepinephrine reuptake inhibitor (NRI) and µ-opioid receptor (MOR) agonist activities of tapentadol may result in tapentadol having less effect on serum androgen concentrations than analgesics acting through the MOR alone, such as morphine and oxycodone. The objectives of this publication are to 1) evaluate the effects of tapentadol (NUCYNTA and NUCYNTA extended release [ER]) on sex hormone concentrations in healthy male volunteers (vs placebo and morphine) and patients with osteoarthritis (vs placebo and oxycodone), and 2) present a mechanistic hypothesis explaining how the combined MOR agonist and NRI activities of tapentadol may result in less impact on androgen concentrations...
May 2015: Journal of Opioid Management
https://www.readbyqxmd.com/read/25278772/clinical-potential-of-naloxegol-in-the-management-of-opioid-induced-bowel-dysfunction
#7
REVIEW
Jakob Lykke Poulsen, Christina Brock, Anne Estrup Olesen, Matias Nilsson, Asbjørn Mohr Drewes
Opioid-induced bowel dysfunction (OIBD) is a burdensome condition which limits the therapeutic benefit of analgesia. It affects the entire gastrointestinal tract, predominantly by activating opioid receptors in the enteric nervous system, resulting in a wide range of symptoms, such as reflux, bloating, abdominal cramping, hard, dry stools, and incomplete evacuation. The majority of studies evaluating OIBD focus on constipation experienced in approximately 60% of patients. Nevertheless, other presentations of OIBD seem to be equally frequent...
2014: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/25059282/exploring-pharmacological-activities-and-signaling-of-morphinans-substituted-in-position-6-as-potent-agonists-interacting-with-the-%C3%AE-opioid-receptor
#8
Tanila Ben Haddou, Davide Malfacini, Girolamo Calo, Mario D Aceto, Louis S Harris, John R Traynor, Andrew Coop, Helmut Schmidhammer, Mariana Spetea
BACKGROUND: Opioid analgesics are the most effective drugs for the treatment of moderate to severe pain. However, they also produce several adverse effects that can complicate pain management. The μ opioid (MOP) receptor, a G protein-coupled receptor, is recognized as the opioid receptor type which primarily mediates the pharmacological actions of clinically used opioid agonists. The morphinan class of analgesics including morphine and oxycodone are of main importance as therapeutically valuable drugs...
2014: Molecular Pain
https://www.readbyqxmd.com/read/24452412/efficacy-and-tolerability-of-controlled-release-oxycodone-for-oxaliplatin-induced-peripheral-neuropathy-and-the-extension-of-folfox-therapy-in-advanced-colorectal-cancer-patients
#9
Makoto Nagashima, Mitsuru Ooshiro, Ayako Moriyama, Yui Sugishita, Kengo Kadoya, Ayami Sato, Tomoaki Kitahara, Ryuichi Takagi, Tasuku Urita, Yutaka Yoshida, Hiroshi Tanaka, Takashi Oshiro, Shinichi Okazumi, Ryoji Katoh
BACKGROUND: The oxaliplatin-based regimen FOLFOX is widely used to treat patients with advanced colorectal cancer (CRC). However, dose-limiting toxicity after continuous oxaliplatin administration can lead to peripheral neuropathy. Several agents, including opioids, that have been employed to treat oxaliplatin-induced peripheral neuropathy (OIPN) have been examined in clinical settings regarding their protective and therapeutic effects. However, the pharmacotherapy of these agents has not yet been established...
June 2014: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/24123621/opioid-overdose-mortality-in-kansas-2001-2011-toxicologic-evaluation-of-intent
#10
Merisa Okic, Leslie Cnossen, Joseph A Crifasi, Christopher Long, Erik K Mitchell
Drug concentration is a factor in the determination of the manner of death, but considerable overlap exists between therapeutic and toxic concentrations. This study aims to quantify opioid mortality in Kansas from use of fentanyl, methadone and oxycodone and to evaluate utility of drug concentrations for the determination of the manner of death. Cases referred to a forensic pathology practice in Kansas for autopsy from 1 January 2001 to 31 December 2011 were considered. The criterion for inclusion was detection of fentanyl, methadone and/or oxycodone in postmortem toxicology...
November 2013: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/23783166/quantitative-analysis-of-26-opioids-cocaine-and-their-metabolites-in-human-blood-by-ultra-performance-liquid-chromatography-tandem-mass-spectrometry
#11
María del Mar Ramírez Fernández, Sarah M R Wille, Nathalie Kummer, Vincent Di Fazio, Evi Ruyssinckx, Nele Samyn
A sensitive and selective ultra performance liquid chromatographic-tandem mass spectrometric method was developed and fully validated for the simultaneous determination of (in order of chromatographic elution) methylecgonine, pholcodine, morphine, hydromorphone, oxymorphone, norcodeine, codeine, dihydrocodeine, oxycodone, 6-Monoacetylmorphine (6-MAM), hydrocodone, ethylmorphine, norfentanyl, benzoylecgonine, tramadol, normeperidine, meperidine, cocaine, pentazocine, cocaethylene, fentanyl, norbuprenorphine, 2-ethylidine-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP), buprenorphine, propoxyphene, and methadone in blood...
August 2013: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/23648497/-emergent-drugs-ii-the-pharming-phenomenon
#12
REVIEW
G Burillo-Putze, A Aldea-Perona, C Rodríguez-Jiménez, M M García-Sáiz, B Climent, A Dueñas, P Munné, S Nogué, R S Hoffman
The use of medicines, with or without medical prescription, for recreational ends by the young population has received little attention from doctors. In the USA, one in five adolescents has used medicines for recreational purposes, and consultations in Emergency Departments for medicine abuse have exceeded those for illegal drugs. Although few data are available in Spain, such consumption is situated between 3.1 and 8.6% according to surveys. The medicines most used are dextromethorphan and methylphenidate...
January 2013: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/23534696/systematic-review-and-meta-analysis-of-pharmacological-therapies-for-painful-diabetic-peripheral-neuropathy
#13
REVIEW
Sonya J Snedecor, Lavanya Sudharshan, Joseph C Cappelleri, Alesia Sadosky, Sonam Mehta, Marc Botteman
BACKGROUND: Painful diabetic peripheral neuropathy (pDPN) is prevalent among persons with diabetes and increases over time. Published guidelines recommend a number of medications to treat this condition providing clinicians with a variety of treatment options. This study provides a comprehensive systematic review and meta-analysis of published pharmacologic therapies for pDPN. METHODS: The published literature was systematically searched to identify randomized, controlled trials of all available pharmacologic treatments for pDPN (recommended or nonrecommended) reporting predefined efficacy and safety outcomes...
February 2014: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/22884575/comparison-of-fatal-poisonings-by-prescription-opioids
#14
COMPARATIVE STUDY
Margareeta Häkkinen, Terhi Launiainen, Erkki Vuori, Ilkka Ojanperä
There is a rising trend of fatal poisonings due to medicinal opioids in several countries. The present study evaluates the drug and alcohol findings as well as the cause and manner of death in opioid-related post-mortem cases in Finland from 2000 to 2008. During this period, fatal poisonings by prescription opioids (buprenorphine, codeine, dextropropoxyphene, fentanyl, methadone, oxycodone, tramadol) increased as a share of all drug poisonings from 9.5% to 32.4%, being 22.3% over the whole period. A detailed study including the most prevalent opioids was carried out for the age group of 14-44 years, which is the most susceptible age for drug abuse in Finland...
October 10, 2012: Forensic Science International
https://www.readbyqxmd.com/read/22798176/interpretation-of-oxycodone-concentrations-in-oral-fluid
#15
COMPARATIVE STUDY
Christine Moore, Tara Kelley-Baker, John Lacey
OBJECTIVE: The purpose of this retrospective study was to compare oxycodone concentrations in saliva and whole blood with a view to propose therapeutic concentrations in oral fluid. Oral fluid is an easy specimen to collect with several advantages over urine, including ease of collection and difficulty of adulteration. As oral fluid is a reflection of free drug circulating in the blood, drug concentrations in saliva are more closely related to blood levels than urine concentrations. The number of testing laboratories offering the analysis of prescription pain medications in urine has increased significantly over the last few years, along with the overuse and abuse of pain killing drugs, specifically oxycodone...
May 2012: Journal of Opioid Management
https://www.readbyqxmd.com/read/22717418/dose-proportionality-and-the-effects-of-food-on-bioavailability-of-an-immediate-release-oxycodone-hydrochloride-tablet-designed-to-discourage-tampering-and-its-relative-bioavailability-compared-with-a-marketed-oxycodone-tablet-under-fed-conditions-a-single
#16
RANDOMIZED CONTROLLED TRIAL
Almasa Bass, Jeffrey G Stark, Glenn C Pixton, Kenneth W Sommerville, Cynthia A Zamora, Mark Leibowitz, Robert Rolleri
BACKGROUND: An immediate-release oxycodone hydrochloride formulation (IRO-A) indicated for moderate to severe pain was designed (by adding functional excipients) to discourage tampering associated with intranasal and intravenous abuse of prescription opioids. OBJECTIVES: The primary objective of this study was to determine the dose proportionality of oxycodone in IRO-A tablets under fasted conditions. Secondary objectives were to assess food effects on the pharmacokinetics of IRO-A tablets, to compare the relative bioavailability of oxycodone in IRO-A tablets versus marketed oxycodone hydrochloride (IRO) tablets under fed conditions and to evaluate the single-dose safety profile of the IRO-A tablets in healthy volunteers pretreated with naltrexone...
July 2012: Clinical Therapeutics
https://www.readbyqxmd.com/read/22357166/a-single-dose-3-way-crossover-pharmacokinetic-comparison-between-immediate-release-oxycodone-hydrochloride-with-aversion-technology-iro-a-oxecta-iro-a-with-niacin-and-oxycodone-hydrochloride-roxicodone-in-healthy-adults-under-fasting-conditions
#17
RANDOMIZED CONTROLLED TRIAL
Mark T Leibowitz, Cynthia A Zamora, Albert W Brzeczko, Jeffrey G Stark
Snorting and intravenous use are common routes of administration for advanced opioid abusers. A tablet form of immediate-release oxycodone (IRO) developed using Aversion Technology combines immediate release (IR) oxycodone HCl with inactive functional excipients that are intended to discourage tampering associated with intranasal and intravenous abuse (IRO-A; Oxecta, Pfizer). The purpose of this single-dose, open-label, randomized, 3-period, 3-treatment crossover study was to evaluate the bioequivalence of IRO-A to the marketed immediate-release oxycodone HCl (IRO; Roxicodone, Xanodyne Pharmaceuticals Inc...
March 2014: American Journal of Therapeutics
https://www.readbyqxmd.com/read/22262924/an-oxycodone-conjugate-vaccine-elicits-drug-specific-antibodies-that-reduce-oxycodone-distribution-to-brain-and-hot-plate-analgesia
#18
COMPARATIVE STUDY
M Pravetoni, M Le Naour, T M Harmon, A M Tucker, P S Portoghese, P R Pentel
Opioid conjugate vaccines have shown promise in attenuating the behavioral effects of heroin or morphine in animals. The goal of this study was to extend this approach to oxycodone (OXY), a commonly abused prescription opioid. Haptens were generated by adding tetraglycine (Gly)(4) or hemisuccinate (HS) linkers at the 6-position of OXY. Immunization of rats with OXY(Gly)(4) conjugated to the carrier proteins bovine serum albumin (BSA) or keyhole limpet hemocyanin (KLH) produced high-titer antibodies to OXY and its metabolite oxymorphone with substantially lower affinities for other structurally related opioid agonists and antagonists...
April 2012: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/21491207/is-saliva-a-valid-substitute-for-plasma-in-pharmacokinetic-studies-of-oxycodone-and-its-metabolites-in-patients-with-cancer
#19
COMPARATIVE STUDY
Janet Hardy, Ross Norris, Helen Anderson, Angela O'Shea, Bruce Charles
PURPOSE: Little is known about the pharmacokinetics (PKs) of oxycodone in patients with advanced cancer. There is considerable reluctance to subject these patients to non-essential tests including repeated venipuncture that has been necessary in PK studies to date. We investigated the possibility of using saliva sampling as a simple non-invasive test to investigate opioid PKs. METHODS: Patients with malignant disease receiving oral sustained release (SR) oxycodone at any dose were asked to provide saliva samples at the same time as blood samples...
April 2012: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/20859312/therapeutic-use-abuse-and-nonmedical-use-of-opioids-a-ten-year-perspective
#20
Laxmaiah Manchikanti, Bert Fellows, Hary Ailinani, Vidyasagar Pampati
The treatment of chronic pain, therapeutic opioid use and abuse, and the nonmedical use of prescription drugs have been topics of intense focus and debate. After the liberalization of laws governing opioid prescribing for the treatment of chronic non-cancer pain by state medical boards in the late 1990s, and with the introduction of new pain management standards implemented by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) in 2000, opioids, in general, and the most potent forms of opioids including Schedule II drugs, in particular, have dramatically increased...
September 2010: Pain Physician
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