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Opioid Overuse

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https://www.readbyqxmd.com/read/28330429/effects-of-inhaled-aerosolized-carfentanil-on-real-time-physiological-responses-in-mice-a-preliminary-evaluation-of-naloxone
#1
Benjamin Wong, Michael W Perkins, Justin Tressler, Ashley Rodriguez, Jennifer Devorak, Alfred M Sciuto
This study examined the real-time exposure-response effects of aerosolized carfentanil (CRF) on opioid-induced toxicity, respiratory dynamics and cardiac function in mice. Unrestrained, conscious male CD-1 mice (25-30 g) were exposed to 0.4 or 4.0 mg/m(3) of aerosolized CRF for 15 min (Ct = 6 or 60 mg min/m(3)) in a whole-body plethysmograph chamber. Minute volume (MV), core body temperature (Tc), mean arterial blood pressure (MAP) and heart rate (HR) were evaluated in animals exposed to CRF or sterile H2O...
February 2017: Inhalation Toxicology
https://www.readbyqxmd.com/read/28266337/analgesic-consumption-in-nursing-homes-observational-study-about-99-nursing-homes
#2
Priscilla Clot-Faybesse, François Bertin-Hugault, Caroline Blochet, Philippe Denormandie, Patrice Rat, Paul-Emile Hay, Sylvie Bonin-Guillaume
Few analgesics' studies in nursing homes are available. Quantitative and qualitative analgesic consumption evaluation in nursing homes in 2012. Multicenter, descriptive, retrospective and observational study about French Korian Nursing homes' residents, using Medissimo solution, and under at least one analgesic treatment during 2012. We considered as chronic prescription a duration greater than or equal to 28 days and as short prescription a duration less than 28 days. Population studied is 10.818 residents...
March 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/28258674/ibudilast-a-non%C3%A2-selective-phosphodiesterase-inhibitor-in-brain-disorders
#3
Joanna Schwenkgrub, Małgorzata Zaremba, Dagmara Mirowska-Guzel, Iwona Kurkowska-Jastrzębska
Ibudilast (IBD) is a non‑selective (3, 4, 10, 11) phosphodiesterase (PDE) inhibitor, used mainly as a bronchodilator for the treatment of bronchial asthma. PDE play a central role in cellular function (e.g. differentiation, synaptic plasticity and inflammatory response) by metabolizing cyclic nucleotides. The results from preclinical and clinical studies indicate that IBD has a broader range of action through suppression of pro‑inflammatory cytokines (IL‑6, IL‑1β, TNF‑α), toll‑like receptor 4 blockade (TLR‑4), inhibition of a macrophage migration inhibitory factor (MIF), up‑regulation the anti‑inflammatory cytokine (IL‑10), and promotion of neurotrophic factors (GDNF, NGF, NT‑4)...
March 2, 2017: Postȩpy Higieny i Medycyny Doświadczalnej
https://www.readbyqxmd.com/read/28226336/educational-outreach-to-opioid-prescribers-the-case-for-academic-detailing
#4
Margot Trotter Davis, Brian Bateman, Jerry Avorn
Nonmedical use of opioid medications constitutes a serious health threat as the rates of addiction, overdoses, and deaths have risen in recent years. Increasingly, inappropriate and excessively liberal prescribing of opioids by physicians is understood to be a central part of the crisis. Public health officials, hospital systems, and legislators are developing programs and regulations to address the problem in sustained and systematic ways that both insures effective treatment of pain and appropriate limits on the availability of opioids...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28217968/payer-type-and-low-value-care-comparing-choosing-wisely-services-across-commercial-and-medicare-populations
#5
Carrie H Colla, Nancy E Morden, Thomas D Sequist, Alexander J Mainor, Zhonghe Li, Meredith B Rosenthal
OBJECTIVE: To compare low-value health service use among commercially insured and Medicare populations and explore the influence of payer type on the provision of low-value care. DATA SOURCES: 2009-2011 national Medicare and commercial insurance administrative data. DESIGN: We created claims-based algorithms to measure seven Choosing Wisely-identified low-value services and examined the correlation between commercial and Medicare overuse overall and at the regional level...
February 19, 2017: Health Services Research
https://www.readbyqxmd.com/read/28199807/opioid-prescribing-patterns-of-emergency-physicians-and-risk-of-long-term-use
#6
Michael L Barnett, Andrew R Olenski, Anupam B Jena
Background Increasing overuse of opioids in the United States may be driven in part by physician prescribing. However, the extent to which individual physicians vary in opioid prescribing and the implications of that variation for long-term opioid use and adverse outcomes in patients are unknown. Methods We performed a retrospective analysis involving Medicare beneficiaries who had an index emergency department visit in the period from 2008 through 2011 and had not received prescriptions for opioids within 6 months before that visit...
February 16, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28141758/eradicating-the-overuse-of-opioids-on-the-front-line
#7
Jennifer Gillon, Lynn S Muller
No abstract text is available yet for this article.
March 2017: Professional Case Management
https://www.readbyqxmd.com/read/28097532/medication-overuse-in-chronic-pain
#8
REVIEW
Eric S Hsu
PURPOSE OF REVIEW: Chronic pain is usually managed by various pharmacotherapies after exhausting the conservative modalities such as over-the-counter choices. The goal of this review is to investigate current state of opioids and non-opioid medication overuse that includes NSAIDs, skeletal muscle relaxants, antidepressants, membrane stabilization agents, and benzodiazepine. How to minimize medication overuse and achieve better outcome in chronic pain management? RECENT FINDINGS: Although antidepressants and membrane stabilization agents contribute to the crucial components for neuromodulation, opioids were frequently designated as a rescue remedy in chronic pain since adjunct analgesics usually do not provide instantaneous relief...
January 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28062816/primary-care-clinic-re-design-for-prescription-opioid-management
#9
Michael L Parchman, Michael Von Korff, Laura-Mae Baldwin, Mark Stephens, Brooke Ike, DeAnn Cromp, Clarissa Hsu, Ed H Wagner
BACKGROUND: The challenge of responding to prescription opioid overuse within the United States has fallen disproportionately on the primary care clinic setting. Here we describe a framework comprised of 6 Building Blocks to guide efforts within this setting to address the use of opioids for chronic pain. METHODS: Investigators conducted site visits to thirty primary care clinics across the United States selected for their use of team-based workforce innovations...
January 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/27882516/risk-of-medication-overuse-headache-across-classes-of-treatments-for-acute-migraine
#10
REVIEW
Kristian Thorlund, Christina Sun-Edelstein, Eric Druyts, Steve Kanters, Shanil Ebrahim, Rahul Bhambri, Elodie Ramos, Edward J Mills, Michel Lanteri-Minet, Stewart Tepper
BACKGROUND: The most commonly prescribed medications used to treat migraine acutely are single analgesics, ergots, opioids, and triptans. Due to varying mechanisms of action across drug classes, there is reason to believe that some classes may be less likely than others to elicit Medication Overuse Headache (MOH) than others. We therefore aimed to determine whether certain classes of acute migraine drugs are more likely to elicit MOH than others. METHODS: A comprehensive systematic literature was conducted to identify studies of varying designs that reported on MOH within the considered treatment classes...
December 2016: Journal of Headache and Pain
https://www.readbyqxmd.com/read/27844475/rhode-island-board-of-medical-licensure-and-discipline-illustration-of-the-disciplinary-process-as-it-pertains-to-cases-involving-opioid-prescribing
#11
James V McDonald
Prescription-drug overuse/overdose and misuse is an important and pivotal issue to state medical boards. This is an illustration of how some cases involving overprescribing of opioids have been addressed by the Rhode Island Board of Medical Licensure and Discipline.
September 2016: Journal of Opioid Management
https://www.readbyqxmd.com/read/27745712/non-specific-low-back-pain
#12
REVIEW
Chris Maher, Martin Underwood, Rachelle Buchbinder
Non-specific low back pain affects people of all ages and is a leading contributor to disease burden worldwide. Management guidelines endorse triage to identify the rare cases of low back pain that are caused by medically serious pathology, and so require diagnostic work-up or specialist referral, or both. Because non-specific low back pain does not have a known pathoanatomical cause, treatment focuses on reducing pain and its consequences. Management consists of education and reassurance, analgesic medicines, non-pharmacological therapies, and timely review...
February 18, 2017: Lancet
https://www.readbyqxmd.com/read/27615418/medication-overuse-headache-risk-factors-pathophysiology-and-management
#13
REVIEW
Hans-Christoph Diener, Dagny Holle, Kasja Solbach, Charly Gaul
Medication-overuse headache (MOH) is defined by the International Classification of Headache Disorders as a headache in patients with a pre-existing primary headache disorder that occurs on ≥15 days per month for >3 months, and is caused by overuse of medication intended for acute or symptomatic headache treatment. The prevalence of MOH in the general population is around 1%, but the condition is much more common in people with headache, in particular chronic migraine. The phenotype of the headache in MOH depends on the initial primary headache and the type of overused acute medication...
October 2016: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/27457368/drug-interaction-and-serotonin-toxicity-with-opioid-use-another-reason-to-avoid-opioids-in-headache-and-migraine-treatment
#14
REVIEW
Hossein Ansari, Leila Kouti
Treatment of headache, specifically migraine attacks, has always been a challenging subject, especially for neurologist and pain specialists. Triptans are generally underutilized, despite being the gold standard abortive medication for migraine attacks. On the other hand, opioid analgesics are overused as a treatment for headache. One reason for this could be physician unfamiliarity with drug interactions between opioids and other medications, especially the possibility of serotonin toxicity. The general awareness of potential serotonin toxicity with using opioid analgesics is low...
August 2016: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/27441875/a-description-and-comparison-of-treatments-for-low-back-pain-in-the-united-states
#15
Elizabeth Salt, Yevgeniya Gokun, Anna Rankin Kerr, Jeffery Talbert
BACKGROUND/OBJECTIVES: Low back pain (LBP), a prevalent costly condition, has evidence-based pharmacological and nonpharmacological treatments. Because the prevalence of LBP and the use of opioids differ between the U.S. Census Regions, we compared the treatments used for LBP and their related costs between regions. METHODS: Deidentified patient health claims data from persons with LBP along with treatments received were extracted from a large commercially insured data set (2007-2009; N = 1,630,438)...
July 2016: Orthopaedic Nursing
https://www.readbyqxmd.com/read/27322907/how-to-apply-the-ahs-evidence-assessment-of-the-acute-treatment-of-migraine-in-adults-to-your-patient-with-migraine
#16
Tamara Pringsheim, William Jeptha Davenport, Michael J Marmura, Todd J Schwedt, Stephen Silberstein
The "Acute Treatment of Migraine in Adults: The American Headache Society Evidence Assessment of Migraine Pharmacotherapies" provides levels of evidence for medication efficacy for acute treatment of migraine. The goal of this companion paper is to provide guidance on how to choose between evidence-based treatment options, and, based on the clinical characteristics of the patient and their migraine attacks, to provide guidance on designing an individualized strategy for managing migraine attacks. The acute pharmacological treatments described in the American Headache Society evidence assessment can be divided into those initially taken by the patient during the headache phase of the migraine attack, those taken by the patient later in the attack when initial treatments fail, and those administered intravenously or intramuscularly in urgent care settings...
July 2016: Headache
https://www.readbyqxmd.com/read/27194343/dopamine-d1-like-receptors-regulate-constitutive-%C3%AE-opioid-receptor-mediated-repression-of-use-dependent-synaptic-plasticity-in-dorsal-horn-neurons-more-harm-than-good
#17
Zigor Aira, Teresa Barrenetxea, Itsaso Buesa, Gontzal García Del Caño, Jon Jatsu Azkue
UNLABELLED: The current study reports on a synaptic mechanism through which D1-like receptors (D1LRs) modulate spinal nociception and plasticity by regulating activation of the μ-opioid receptor (MOR).D1LR stimulation with agonist SKF 38393 concentration-dependently depressed C-fiber-evoked potentials in rats receiving spinal nerve ligation (SNL), but not in uninjured rats. Depression was prevented by MOR- but not GABA-receptor blockade. Neurons expressing the D1 subtype were immunopositive for met-enkephalin and vesicular glutamate transporter VGLUT2, but not for GABAergic marker vGAT...
May 18, 2016: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/27140988/payments-for-opioids-shifted-substantially-to-public-and-private-insurers-while-consumer-spending-declined-1999-2012
#18
Chao Zhou, Curtis S Florence, Deborah Dowell
Deaths from opioid pain reliever overdose in the United States quadrupled between 1999 and 2013, concurrent with an increase in the use of the drugs. We used data from the Medical Expenditure Panel Survey to examine trends in opioid pain reliever expenditures, financing by various payers, and use from 1999 to 2012. We found major shifts in expenditures by payer type for these drugs, with private and public insurers paying a much larger share than patients in recent years. Consumer out-of-pocket spending on opioids per 100 morphine milligram equivalents (a standard reference measure of strength for various opioids) declined from $4...
May 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27136283/hair-testing-in-clinical-setting-simultaneous-determination-of-50-psychoactive-drugs-and-metabolites-in-headache-patients-by-lc-tandem-ms
#19
Manuela Licata, Cecilia Rustichelli, Federica Palazzoli, Anna Ferrari, Carlo Baraldi, Daniele Vandelli, Patrizia Verri, Filippo Marchesi, Enrico Silingardi
Headache patients suffering from recurrent attacks are a population at risk of overuse and abuse of analgesic medications. Associated with triptans, the first-line drugs recommended for the acute treatment, these patients usually take other medications such as opioids analgesics for the attack treatment, antidepressants and antiepileptics for prophylaxis treatment and benzodiazepines, non-benzodiazepine hypnotics and antipsychotics for the treatment of comorbidities. Regular and frequent use of triptans, like of any other symptomatic analgesic, can cause chronic headache and medication-overuse headache (MOH)...
July 15, 2016: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/27056579/benzodiazepine-use-misuse-and-harm-at-the-population-level-in-canada-a-comprehensive-narrative-review-of-data-and-developments-since-1995
#20
REVIEW
Yoko Murphy, Emily Wilson, Elliot M Goldner, Benedikt Fischer
Benzodiazepines are commonly prescribed psycho-pharmaceuticals (e.g., for anxiety, tension, and insomnia); they are generally considered safe but have potential adverse effects. Benzodiazepine use in Canada versus internationally is comparably high, yet no recent comprehensive review of use, misuse, or related (e.g., morbidity, mortality) harm at the population level exists; the present review aimed to fill this gap. We searched four key scientific literature databases (Medline, CINAHL, EBM Reviews, and Web of Science) with relevant search terms, and collected relevant "gray literature" (e...
July 2016: Clinical Drug Investigation
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