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https://www.readbyqxmd.com/read/29622698/value-of-supportive-care-pharmacogenomics-in-oncology-practice
#1
REVIEW
Jai N Patel, Lauren A Wiebe, Henry M Dunnenberger, Howard L McLeod
Genomic medicine provides opportunities to personalize cancer therapy for an individual patient. Although novel targeted therapies prolong survival, most patients with cancer continue to suffer from burdensome symptoms including pain, depression, neuropathy, nausea and vomiting, and infections, which significantly impair quality of life. Suboptimal management of these symptoms can negatively affect response to cancer treatment and overall prognosis. The effect of genetic variation on drug response-otherwise known as pharmacogenomics-is well documented and directly influences an individual patient's response to antiemetics, opioids, neuromodulators, antidepressants, antifungals, and more...
April 5, 2018: Oncologist
https://www.readbyqxmd.com/read/29531570/the-effect-of-nitrous-oxide-in-comparison-to-oxygen-combined-with-fentanyl-on-the-hospitalization-time-and-pain-reduction-in-renal-colic-patients-at-emergency-department
#2
Omid Ahmadi, Amir Shirvani Dehkordi, Farhad Heydari, Mohammad Nasr Esfahani, Behzad Mahaki
Background: Renal colic is a painful medical emergency, needs urgent intervention to reduce pain. Nonsteroidal anti-inflammatory drugs, opioids, and entonox are pain-relieving agents. This study was aimed to compare fentanyl + entonox (nitrous oxide + O2 ) versus fentanyl + oxygen. Materials and Methods: One hundred and twenty patients with acute renal colic presenting to the emergency department were enrolled. First, 50 μg fentanyl was infused for all patients...
2018: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/29511854/correction-to-treatment-strategies-for-the-opioid-dependent-patient
#3
Shweta Teckchandani, Meredith Barad
The original version of this article contains an error in the gender listing of the first author in the Conflict of Interest statement.
March 6, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29508897/hydromorphone-use-for-acute-pain-misconceptions-controversies-and-risks
#4
Maryann Mazer-Amirshahi, Sergey Motov, Lewis S Nelson
Hydromorphone (HM) is a potent opioid analgesic that is commonly administered in the emergency department (ED) and other acute care settings, such as medical surgical wards. In recent years, there has been a significant increase in the ED administration of HM relative to other opioids. Although HM is an effective analgesic, its use has been commonly implicated in adverse drug events and medication errors. In addition, intravenous HM has potent euphoric effects that may contribute to its abuse liability. There are limited data regarding how acute parenteral administration of opioid analgesics in the setting of high rates of preexisting chronic opioid use (medical or nonmedical) may contribute to or reinforce addictive behavior, making the potential contribution of rising HM administration to subsequent prescription opioid abuse and overdose uncertain...
January 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29485952/the-effect-of-opioid-use-and-mental-illness-on-chronic-disease-medication-adherence-in-superutilizers
#5
Satya Surbhi, Ilana Graetz, Jim Y Wan, Justin Gatwood, James E Bailey
BACKGROUND: Nonadherence to essential chronic medications has been identified as a potential driver of high health care costs in superutilizers of inpatient services. Few studies, however, have documented the levels of nonadherence and factors associated with nonadherence in this high-cost, vulnerable population. OBJECTIVE: To examine the factors associated with nonadherence to essential chronic medications, with special emphasis on mental illness and use of opioid medications...
March 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29473770/exploring-factors-contributing-to-medication-errors-with-opioids-in-australian-specialist-palliative-care-inpatient-services-a-multi-incident-analysis
#6
Nicole Heneka, Tim Shaw, Debra Rowett, Samuel Lapkin, Jane L Phillips
BACKGROUND: Opioid errors have the potential to cause significant patient harm. These high-risk medications are used in high volumes in palliative care services to manage pain and other symptoms. Palliative patients are at greater risk of harm from opioid errors, as they are generally older and taking numerous medications to manage multiple comorbidities. Understanding factors contributing to opioid errors in inpatient palliative care services is a largely underexplored, yet, essential aspect of patient safety...
February 23, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29452813/incidence-characteristics-and-predictive-factors-for-medication-errors-in-paediatric-anaesthesia-a-prospective-incident-monitoring-study
#7
C Gariel, B Cogniat, F-P Desgranges, D Chassard, L Bouvet
BACKGROUND: Medication errors are not uncommon in hospitalized patients. Paediatric patients may have increased risk for medication errors related to complexity of weight-based dosing calculations or problems with drug preparation and dilution. This study aimed to determine the incidence of medication errors in paediatric anaesthesia in a university paediatric hospital, and to identify their characteristics and potential predictive factors. METHODS: This prospective incident monitoring study was conducted between November 2015 and January 2016 in an exclusively paediatric surgical centre...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29435555/opioid-analgesic-use-and-risk-for-invasive-pneumococcal-diseases-a-nested-case-control-study
#8
Andrew D Wiese, Marie R Griffin, William Schaffner, C Michael Stein, Robert A Greevy, Edward F Mitchel, Carlos G Grijalva
Background: Although certain opioid analgesics have immunosuppressive properties and increase the risk for infections in animals, the clinical effects of prescription opioid use on infection risk among humans are unknown. Objective: To test the hypothesis that prescription opioid use is an independent risk factor for invasive pneumococcal disease (IPD). Design: Nested case-control study. Setting: Tennessee Medicaid database linked to Medicare and Active Bacterial Core surveillance system databases (1995 to 2014)...
February 13, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29432292/acute-pain-management-in-children-challenges-and-recent-improvements
#9
Catherine E Ferland, Eduardo Vega, Pablo M Ingelmo
PURPOSE OF REVIEW: The evidence regarding the efficacy of analgesics available to guide postoperative pain treatment in pediatric patients is limited. Opioid medications are very often an important component of pediatric postoperative pain treatment but have been associated with perioperative complications. We will focus on initiatives aiming to provide effective treatment minimizing the use of opioids and preventing the long-term consequences of pain. RECENT FINDINGS: Interpatient variability in postoperative pain is currently managed by applying protocols or by trial and error, thus often leading to patients being either undertreated or overtreated...
February 9, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29338273/adverse-drug-reactions-of-non-opioid-and-opioid-analgesics-reported-to-croatian-national-authority-from-2007-to-2014
#10
Petra Sunara, Darko Krnic, Livia Puljak
OBJECTIVE: Adverse drug reactions (ADRs) are commonly observed in the health services because of system weaknesses and individual errors. Analgesics are widely used and it can be expected that with the increased use one can expect increased number of ADRs of analgesics. The aim of this study was to analyze ADRs of non-opioid and opioid analgesics reported to the Croatian Agency for Medicinal Products and Medical Devices (HALMED) from 2007 to 2014. METHODS: HALMED provided data on generic drug name, year of the ADR report, type of report, institution, reporting person, patient's age, sex and ADR type...
November 2017: Acta Medica Academica
https://www.readbyqxmd.com/read/29334809/accidental-pharmacological-poisonings-in-young-children-population-based-study-in-three-settings
#11
Jane C Bell, Jason P Bentley, Catriona Downie, Rose Cairns, Nicholas A Buckley, Annette Katelaris, Sallie-Anne Pearson, Natasha Nassar
INTRODUCTION: Pharmacological poisonings in young children are avoidable. Previous studies report calls to poisons centres, presentations to emergency departments (ED) or hospital admissions. There are limited data assessing concurrent management of poisonings across all three settings. We aimed to describe accidental pharmacological poisonings in young children across our Poisons Information Centre (PIC), EDs and hospitals. METHODS: A population-based study in New South Wales, Australia, of PIC calls, ED presentations and hospital admissions for accidental pharmacological poisoning in children aged <5 years, 2007-2013...
January 15, 2018: Clinical Toxicology
https://www.readbyqxmd.com/read/29307863/opioid-errors-in-inpatient-palliative-care-services-a-retrospective-review
#12
Nicole Heneka, Tim Shaw, Debra Rowett, Samuel Lapkin, Jane L Phillips
Opioids are a high-risk medicine frequently used to manage palliative patients' cancer-related pain and other symptoms. Despite the high volume of opioid use in inpatient palliative care services, and the potential for patient harm, few studies have focused on opioid errors in this population. OBJECTIVES: To (i) identify the number of opioid errors reported by inpatient palliative care services, (ii) identify reported opioid error characteristics and (iii) determine the impact of opioid errors on palliative patient outcomes...
January 4, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29234968/a-cross-national-analysis-of-the-association-between-years-of-implementation-of-opioid-substitution-treatments-and-drug-related-deaths-in-europe-from-1995-to-2013
#13
Phillip L Marotta, Charlotte A McCullagh
Data at the individual-level provide evidence that opioid substitution treatment (OST) programs protect against mortality for opioid dependent populations. Prior research has not examined the merits of national implementation of opioid substitution programs for reducing mortality at the country-level. This study elucidates longitudinal associations between country-level implementation of opioid substitution treatment programs on mortality rates of drug related deaths (DRD) from 1995 to 2013 in 30 European nations...
December 12, 2017: European Journal of Epidemiology
https://www.readbyqxmd.com/read/29186557/analgesic-related-medication-errors-reported-to-us-poison-control-centers
#14
Madhulika Eluri, Henry A Spiller, Marcel J Casavant, Thitphalak Chounthirath, Kristen A Conner, Gary A Smith
Objective: This study investigates the characteristics and trends of medication errors involving analgesic medications. Design and Methods: A retrospective analysis was conducted of analgesic-related medication errors reported to the National Poison Data System (NPDS) from 2000 through 2012. Results: From 2000 through 2012, the NPDS received 533,763 reports of analgesic-related medication errors, averaging 41,059 medication errors annually...
November 23, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29181095/quantitation-of-fentanyl-analogs-in-dried-blood-spots-by-flow-through-desorption-coupled-to-online-solid-phase-extraction-tandem-mass-spectrometry
#15
Rebecca L Shaner, Nicholas D Schulze, Craig Seymour, Elizabeth I Hamelin, Jerry D Thomas, Rudolph C Johnson
An automated dried blood spot (DBS) elution coupled with solid phase extraction and tandem mass spectrometric analysis for multiple fentanyl analogs was developed and assessed. This method confirms human exposures to fentanyl, sufentanil, carfentanil, alfentanil, lofentanil, α-methyl fentanyl, and 3-methyl fentanyl in blood with minimal sample volume and reduced shipping and storage costs. Seven fentanyl analogs were detected and quantitated from DBS made from venous blood. The calibration curve in matrix was linear in the concentration range of 1...
2017: Analytical Methods: Advancing Methods and Applications
https://www.readbyqxmd.com/read/29180552/neighborhood-socioeconomic-status-and-receipt-of-opioid-medication-for-new-back-pain-diagnosis
#16
Sarah Gebauer, Joanne Salas, Jeffrey F Scherrer
BACKGROUND: Although treatment for new back pain is heavily guideline driven, deviations occur frequently. Neighborhood socioeconomic status (nSES) may contribute to these deviations. OBJECTIVE: Determine whether nSES is associated with type of treatment provided for patients seeking treatment for new back pain in primary care clinics. METHODS: This retrospective cohort was conducted in academic internal and family medicine practices. Data were examined from the Primary Care Patient Data Registry...
November 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29167147/medication-errors-resulting-in-harm-using-chargemaster-data-to-determine-association-with-cost-of-hospitalization-and-length-of-stay
#17
Bryan C McCarthy, Kristin A Tuiskula, Tara P Driscoll, Andrew M Davis
PURPOSE: Results of an analysis of the economic impact of adverse drug events (ADEs) resulting in patient harm on hospitalization costs and length of stay (LOS) are reported. METHODS: In a retrospective single-site study, medication errors among patients admitted to an academic medical center during the period April 2014-May 2015 were identified using voluntary event reporting system data and diagnosis codes. Hospitalization cases involving documented ADEs resulting in harm, as defined on a widely used medication error classification index, were matched with control cases by admission period, diagnosis-related group, and patient age and sex...
December 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29156896/proutine-a-feasibility-study-assessing-surveillance-of-electronic-patient-reported-outcomes-and-adherence-via-smartphone-app-in-advanced-cancer
#18
Gesine Benze, Friedemann Nauck, Bernd Alt-Epping, Giuseppe Gianni, Thomas Bauknecht, Johannes Ettl, Anna Munte, Luisa Kretzschmar, Jan Gaertner
BACKGROUND: In advanced cancer, quality of life (QoL) is a major treatment goal. In order to achieve this, the identification of suffering by screening for patient-reported-outcomes (PROs, i.e., symptoms) is of utmost importance. The use of paper-pencil questionnaires is associated with significant shortcomings due to missing data, recall bias and transcription errors. Other than that, the electronic recording of PROs by mobile Health (mHealth) offers a number of advantages. The aim of this study was to test whether the routine assessment of PROs via a newly developed smartphone application (MeQoL®) is feasible...
October 26, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29121712/epidemiologic-incidence-of-rhabdomyolysis-in-opioid-overdose-in-icu-of-poisoning-center-in-iran-2014
#19
Babak Khoshideh, Mohammad Arefi, Mazaher Ghorbani, Samaneh Akbarpour, Fatemeh Taghizadeh
Objectives: The aim of this study is to investigate the clinical, demographical characteristics and some laboratory findings of hospitalized patients with acute opioid toxicity and rhabdomyolysis. Methods: In this cross-sectional study, 354 hospitalized patients were investigated at Baharloo Educational Hospital in Tehran, with acute illicit drug toxicity in 2014. Data was collected by an investigator-made check lists. The collected data and variations (such as mortality rate, demographic data, and renal function tests as well as serum biochemical elements) were analyzed by descriptive statistics and x-square test...
November 8, 2017: Epidemiology and Health
https://www.readbyqxmd.com/read/29045256/a-quality-improvement-initiative-to-increase-scoring-consistency-and-accuracy-of-the-finnegan-tool-challenges-in-obtaining-reliable-assessments-of-drug-withdrawal-in-neonatal-abstinence-syndrome
#20
Wendy Timpson, Cheryl Killoran, Louise Maranda, Alan Picarillo, Elisabeth Bloch-Salisbury
BACKGROUND: Current practice for diagnosing neonatal abstinence syndrome and guiding pharmacological management of neonatal drug withdrawal is dependent on nursing assessments and repeated evaluation of clinical signs. PURPOSE: This single-center quality improvement initiative was designed to improve accuracy and consistency of Finnegan scores among neonatal nurses. METHODS: One-hundred seventy neonatal nurses participated in a single-session withdrawal-assessment program that incorporated education, scoring guidelines, and a restructured Finnegan scale...
February 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
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