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https://www.readbyqxmd.com/read/29054049/individual-variability-in-clinical-effect-and-tolerability-of-opioid-analgesics-importance-of-drug-interactions-and-pharmacogenetics
#1
REVIEW
Vigdis Solhaug, Espen Molden
BACKGROUND: As pain is often a comorbid condition, many patients use opioid analgesics in combination with several other drugs. This implies a generally increased risk of drug interactions, which along with inherent pharmacogenetic variability and other factors may cause differences in therapeutic response of opioids. AIM: To provide an overview of interactions and pharmacogenetic variability of relevance for individual differences in effect and tolerability of opioid analgesics, which physicians and other healthcare professionals should be aware of in clinical practice...
October 17, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29054032/constipation-and-other-common-symptoms-reported-by-women-and-men-in-methadone-and-buprenorphine-maintenance-treatment
#2
Paul S Haber, Mahmoud Elsayed, David Espinoza, Nicholas Lintzeris, Anne-Sophie Veillard, Richard Hallinan
BACKGROUND: Opioid substitution treatment (OST) is often continued long-term and, therefore, opioid-associated symptoms are of interest. Symptoms associated with methadone maintenance treatment (MMT) in men are well described, but there are fewer reports concerning symptoms associated with buprenorphine maintenance treatment (BMT) and very few reports among women. METHOD: Recipients of BMT (n=113) and MMT (n=184), non-opioid users (n=105) and opioid users not receiving OST (n=87) completed the Patient Assessment of Constipation (PAC-SYM) and a general symptom checklist...
October 13, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29051703/buprenorphine-naloxone-maintenance-therapy-an-observational-retrospective-report-on-the-effect-of-dose-on-18%C3%A2-months-retention-in-an-office-based-treatment-program
#3
Theodore V Parran, A G Mace, Yael J Dahan, Christopher A Adelman, Mykola Kolganov
CONTEXT AND OBJECTIVE: Buprenorphine has been available with few reports of the dose range necessary to adequately maintain patients. We report on the effect of 8 mg/d versus 16 mg/d of buprenorphine on long-term patient retention in office-based opioid maintenance (OBOMT). DESIGN SETTING AND PARTICIPANTS: Case series, at an urban hospital-based primary care clinic providing OBOMT to 157 opiate-dependent, low socioeconomic status, uninsured, nonhomeless patients...
2017: Substance Abuse: Research and Treatment
https://www.readbyqxmd.com/read/29050999/chemical-capture-of-impala-aepyceros-melampus-a-review-of-factors-contributing-to-morbidity-and-mortality
#4
REVIEW
Gareth E Zeiler, Leith C R Meyer
OBJECTIVE: To review the factors that contribute to morbidity and mortality of impala undergoing chemical capture, and discuss how they are potentially mitigated. DATABASES USED: PubMed, Science Direct, Google Scholar and Onderstepoort Veterinary Academic Hospital records. CONCLUSIONS AND CLINICAL RELEVANCE: Impala are an important species of antelope in Africa and are often captured during management procedures, veterinary interventions and research projects...
May 18, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29050538/evaluation-of-the-head-and-neck-cancer-patient-population-and-the-incidence-of-hospitalization-at-an-academic-medical-center
#5
Lindsay A Hazelden, Matthew J Newman, Stephanie Shuey, Julie M Waldfogel, Victoria T Brown
Purpose Patients with head and neck cancer are at risk for disease- and treatment-related toxicities that may be severe enough to require hospitalization. The risk factors associated with hospitalization in these patients are not well defined. Methods We conducted a single-center, retrospective observational study of patients with head and neck cancer receiving chemotherapy at an academic medical center infusion clinic in a one-year period. The primary objective was to characterize the head and neck cancer population at an academic medical center...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29049469/the-effectiveness-of-injectable-extended-release-naltrexone-vs-daily-buprenorphine-naloxone-for-opioid-dependence-a-randomized-clinical-noninferiority-trial
#6
Lars Tanum, Kristin Klemmetsby Solli, Zill-E-Huma Latif, Jurate Šaltyte Benth, Arild Opheim, Kamni Sharma-Haase, Peter Krajci, Nikolaj Kunøe
Importance: To date, extended-release naltrexone hydrochloride has not previously been compared directly with opioid medication treatment (OMT), currently the most commonly prescribed treatment for opioid dependence. Objective: To determine whether treatment with extended-release naltrexone will be as effective as daily buprenorphine hydrochloride with naloxone hydrochloride in maintaining abstinence from heroin and other illicit substances in newly detoxified individuals...
October 18, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/29049282/behavioral-intervention-to-reduce-opioid-overdose-among-high-risk-persons-with-opioid-use-disorder-a-pilot-randomized-controlled-trial
#7
Phillip Oliver Coffin, Glenn-Milo Santos, Tim Matheson, Emily Behar, Chris Rowe, Talia Rubin, Janelle Silvis, Eric Vittinghoff
OBJECTIVE: The United States is amidst an opioid epidemic, including synthetic opioids that may result in rapid death, leaving minimal opportunity for bystander rescue. We pilot tested a behavioral intervention to reduce the occurrence of opioid overdose among opioid dependent persons at high-risk for subsequent overdose. MATERIALS AND METHODS: We conducted a single-blinded randomized-controlled trial of a repeated dose motivational interviewing intervention (REBOOT) to reduce overdose versus treatment as usual, defined as information and referrals, over 16 months at the San Francisco Department of Public Health from 2014-2016...
2017: PloS One
https://www.readbyqxmd.com/read/29049278/illicit-drug-use-illicit-drug-use-disorders-and-drug-overdose-deaths-in-metropolitan-and-nonmetropolitan-areas-united-states
#8
Karin A Mack, Christopher M Jones, Michael F Ballesteros
PROBLEM/CONDITION: Drug overdoses are a leading cause of injury death in the United States, resulting in approximately 52,000 deaths in 2015. Understanding differences in illicit drug use, illicit drug use disorders, and overall drug overdose deaths in metropolitan and nonmetropolitan areas is important for informing public health programs, interventions, and policies. REPORTING PERIOD: Illicit drug use and drug use disorders during 2003-2014, and drug overdose deaths during 1999-2015...
October 20, 2017: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
https://www.readbyqxmd.com/read/29049121/opioids-for-the-treatment-of-chronic-pain-mistakes-made-lessons-learned-and-future-directions
#9
Jane C Ballantyne
An overreliance on opioids has impacted all types of pain management, making it undoubtedly a root cause of the "epidemic" of prescription opioid abuse in the United States. Yet, an examination of the statistics that led the US Centers for Disease Control and Prevention to declare that prescription opioid abuse had reached epidemic levels shows that the abuse occurrences and deaths are arising outside the hospital or hospice setting, which strongly implicates the outpatient use of opioids to treat chronic pain...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049120/a-contemporary-medicolegal-analysis-of-outpatient-medication-management-in-chronic-pain
#10
Christopher R Abrecht, Ethan Y Brovman, Penny Greenberg, Ellen Song, James P Rathmell, Richard D Urman
BACKGROUND: Opioids are frequently used in chronic pain management but are associated with significant morbidity and mortality in some patient populations. An important avenue for identifying complications-including serious or rare complications-is the study of closed malpractice claims. The present study is intended to complement the existing closed claims literature by drawing on claims from a more recent timeframe through a partnership with a large malpractice carrier, the Controlled Risk Insurance Company (CRICO)...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049118/risk-factors-for-opioid-use-disorder-and-overdose
#11
Lynn R Webster
Opioid analgesics are recognized as a legitimate medical therapy for selected patients with severe chronic pain that does not respond to other therapies. However, opioids are associated with risks for patients and society that include misuse, abuse, diversion, addiction, and overdose deaths. Therapeutic success depends on proper candidate selection, assessment before administering opioid therapy, and close monitoring throughout the course of treatment. Risk assessment and prevention include knowledge of patient factors that may contribute to misuse, abuse, addiction, suicide, and respiratory depression...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049114/alternatives-to-opioids-in-the-pharmacologic-management-of-chronic-pain-syndromes-a-narrative-review-of-randomized-controlled-and-blinded-clinical-trials
#12
Andrea L Nicol, Robert W Hurley, Honorio T Benzon
Chronic pain exerts a tremendous burden on individuals and societies. If one views chronic pain as a single disease entity, then it is the most common and costly medical condition. At present, medical professionals who treat patients in chronic pain are recommended to provide comprehensive and multidisciplinary treatments, which may include pharmacotherapy. Many providers use nonopioid medications to treat chronic pain; however, for some patients, opioid analgesics are the exclusive treatment of chronic pain...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049113/the-us-opioid-crisis-current-federal-and-state-legal-issues
#13
Cobin D Soelberg, Raeford E Brown, Derick Du Vivier, John E Meyer, Banu K Ramachandran
The United States is in the midst of a devastating opioid misuse epidemic leading to over 33,000 deaths per year from both prescription and illegal opioids. Roughly half of these deaths are attributable to prescription opioids. Federal and state governments have only recently begun to grasp the magnitude of this public health crisis. In 2016, the Centers for Disease Control and Prevention released their Guidelines for Prescribing Opioids for Chronic Pain. While not comprehensive in scope, these guidelines attempt to control and regulate opioid prescribing...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049111/risk-management-for-opioid-prescribing-in-the-treatment-of-patients-with-pain-from-cancer-or-terminal-illness-inadvertent-oversight-or-taboo
#14
David J Copenhaver, Nicolas B Karvelas, Scott M Fishman
As the United States experiences an epidemic of prescription drug abuse, and guidelines on safe practices in prescribing opioids in chronic pain have subsequently emerged from professional organizations and governmental agencies, limited guidance exists for prescribers of opioids to treat pain in patients with cancer or terminal illness. Patients with active cancer or terminal illness often have pain and are frequently prescribed opioids and other controlled substances. Current studies suggest that patients with cancer have similar rates of risk for misuse, abuse, and addiction as the general public...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049110/evidence-for-the-efficacy-of-systemic-opioid-sparing-analgesics-in-pediatric-surgical-populations-a-systematic-review
#15
Alyssa Zhu, Hubert A Benzon, T Anthony Anderson
While a large number of studies has examined the efficacy of opioid-sparing analgesics in adult surgical populations, fewer studies are available to guide postoperative pain treatment in pediatric patients. We systematically reviewed available publications on the use of systemic nonopioid agents for postoperative analgesia in pediatric surgical populations. A comprehensive literature search identified meta-analyses and randomized controlled trials (RCTs) assessing the effects of systemic, nonopioid agents on postoperative narcotic requirements or pain scores in pediatric surgical populations...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29046888/imaging-sex-differences-in-regional-brain-metabolism-during-acute-opioid-withdrawal
#16
Giovanni C Santoro, Joseph Carrion, Stephen L Dewey
The rate of opioid overdose continues to rise, necessitating improved treatment options. Current therapeutic approaches rely on administration of either a blocking agent, such as naloxone, or chronic treatment with replacement drugs, including methadone and/or buprenorphine. Recent findings suggest that males and females respond to these treatments uniquely. In an effort to better understand this sex-specific variation in treatment efficacy, we investigated the effects of acute opioid withdrawal in male and female rats using 18FDG and microPET...
April 2017: Journal of Alcoholism and Drug Dependence
https://www.readbyqxmd.com/read/29046364/randomized-study-of-iv-prochlorperazine-plus-diphenhydramine-vs-iv-hydromorphone-for-migraine
#17
Benjamin W Friedman, Eddie Irizarry, Clemencia Solorzano, Alexander Latev, Karolyn Rosa, Eleftheria Zias, David R Vinson, Polly E Bijur, E John Gallagher
OBJECTIVE: To determine outcomes among patients with migraine in the emergency department (ED) who receive IV hydromorphone vs IV prochlorperazine + diphenhydramine. METHODS: This study was conducted in 2 EDs in New York City. Patients who met international criteria for migraine were eligible for participation if they had not used an opioid within the previous month. Clinicians, participants, investigators, and research personnel were blinded to treatment. Patients were randomized in blocks of 4...
October 18, 2017: Neurology
https://www.readbyqxmd.com/read/29045243/use-of-ketamine-in-a-multimodal-analgesia-setting-for-rapid-opioid-tapering-in-a-profoundly-opioid-tolerant-patient-a-case-report
#18
Elise M Strickler, Eric S Schwenk, Mitchell J Cohen, Eugene R Viscusi
Opioids are frequently used for the treatment of chronic pain, and patients taking high doses are at increased risk of complications and adverse opioid-related events. Ketamine is appealing as an opioid adjunct because of its lack of respiratory depression and potential prevention of hyperalgesia and central sensitization. We present a case in which a ketamine infusion was utilized over a 7-day period to provide rapid taper of a daily dose of 400 mg of morphine equivalents to less than one-third of that dose on discharge with unchanged pain levels and no symptoms of opioid withdrawal...
October 17, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29042810/changes-in-pain-and-concurrent-pain-medication-use-following-compounded-topical-analgesic-treatment-for-chronic-pain-3-and-6-month-follow-up-results-from-the-prospective-observational-optimizing-patient-experience-and-response-to-topical-analgesics-study
#19
Jeffrey A Gudin, Michael J Brennan, E Dennis Harris, Peter L Hurwitz, Derek T Dietze, James D Strader
BACKGROUND: Opioids and other controlled substances prescribed for chronic pain are associated with abuse, addiction, and death, prompting national initiatives to identify safe and effective pain management strategies including topical analgesics. METHODS: This prospective, observational study evaluated changes from baseline in overall mean severity and interference scores on the Brief Pain Inventory scale and the use of concurrent pain medications at 3- and 6-month follow-up assessments in chronic pain patients treated with topical analgesics...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29041950/convenience-without-disclosure-a-formative-research-study-of-a-proposed-integrated-methadone-and-antiretroviral-therapy-service-delivery-model-in-dar-es-salaam-tanzania
#20
Alexis Cooke, Haneefa Saleem, Dorothy Mushi, Jessie Mbwambo, Saria Hassan, Barrot H Lambdin
BACKGROUND: Though timely initiation of antiretroviral therapy (ART) is a vital component of effective HIV prevention, care and treatment, people who inject drugs are less likely to receive ART than their non-drug using counterparts. In an effort to increase access to ART for people who inject drugs, we examined perceived benefits, challenges, and recommendations for implementing an integrated methadone and ART service delivery model at an opioid treatment program (OTP) clinic in Dar es Salaam, Tanzania...
October 18, 2017: Addiction Science & Clinical Practice
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