- |||||||||| fentanyl citrate / Generic mfg.
Journal: Analysis of over 250 novel synthetic opioids and xylazine by LC-MS-MS in blood and urine. (Pubmed Central) - Mar 9, 2024
Assessed in blood and urine qualitatively were 261 unique analytes including fentanyl analogs (fentalogs), nitazenes and other miscellaneous synthetic opioids...Additionally, 617 fatal accidental overdoses within San Francisco in 2022 were retroactively analyzed by this method with almost 10% of cases containing a new NSO substance(s). Such trends and NSO substances were previously unknown in this community.
- |||||||||| fentanyl citrate / Generic mfg.
Journal: Efficacy and safety of general anesthesia with caudal block for inguinal hernioplasty in children: a randomized controlled trial. (Pubmed Central) - Mar 8, 2024
Analyzing historic drug administration data using the novel 4-step VERB analysis identified optimized drug preparations and fluid bag sizes for the most-prescribed epidural drug combinations at the hospital study site. In children, the combination of general anesthesia with caudal block, compared to general anesthesia only, is more efficient in suppressing visceral pain, leading to better hemodynamic stability, and reducing the consumption of medicines in the perioperative period.
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg., amphetamine / Generic mfg.
Journal: Evaluating cross-reactivity of new psychoactive substances (NPS) in human whole blood by enzyme-linked immunosorbent assay (ELISA). (Pubmed Central) - Mar 8, 2024
A variety of novel synthetic opioids were tested at concentrations of 1-80?ng/mL and 50-2000?ng/mL and demonstrated no cross-reactivity to a morphine ELISA plate at either concentration range...4-Fluoroamphetamine was the only novel stimulant with cross-reactivity (3,354%) to the amphetamine ELISA plate...Both hydroxy-PCP (151%) and chloro-PCP (137%) showed cross-reactivities above that of PCP. This research has demonstrated the utility of using ELISA-based screening for novel benzodiazepines, hallucinogens and for fentanyl analogs; however, there is limited application and risk of false-negative results for the other drug classes due to low or non-existent cross-reactivities.
- |||||||||| Fatal Outcomes from Drug Interactions: Insights from the FDA Adverse Event Reporting System () - Mar 8, 2024 - Abstract #ISPOR2024ISPOR_378;
Despite the high frequency of reports involving specific drug families, it's important to recognize that not all fatal adverse reactions due to drug interactions may be identified. This study underscores the complexity of assessing drug interaction harms and the necessity for further research in this critical area.
- |||||||||| fentanyl citrate / Generic mfg.
Factors Associated With Drug Overdose Mortality Rate in California () - Mar 8, 2024 - Abstract #ISPOR2024ISPOR_277;
This study found the sociodemographic factors of age and rate of poverty as significant predictors of the drug overdose death rate in California. Recognizing these determinants may support the development of evidence-based measures to mitigate the drug overdose crisis in the state and help appropriate scarce economic resources.
- |||||||||| fentanyl citrate / Generic mfg.
Synthetic Fentanyl and Xylazine (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_3518;
Illicit fentanyl-xylazine overdoses can cause toxic leukoencephalopathy and severe hypoxic-ischemic injury to cortical and subcortical brain regions due to rapid CNS penetration and interference with neurotransmitter release. By decreasing the protective cerebral autoregulatory mechanisms, there is increased vulnerability to systemic hypoxia and hypotension.
- |||||||||| fentanyl citrate / Generic mfg., methadone / Generic mfg.
Case Series of MRI Findings Resembling CHANTER Syndrome (Colorado Convention Center | Exhibit Hall B-E) - Mar 8, 2024 - Abstract #AAN2024AAN_2223;
The etiologies and pathophysiology of these findings are unknown, but past reports suggest association with synthetic opioid contaminants or other, unidentified toxic metabolites. Without clear opioid use in these patients, it may prove difficult to determine fentanyl or other synthetic opiates as the causing factor.
- |||||||||| fentanyl citrate / Generic mfg.
Journal, Surgery: Airway Management During Diagnostic Laparoscopic Surgery: A Comparison of I-Gel and Proseal Laryngeal Mask Airway. (Pubmed Central) - Mar 7, 2024
Anaesthesia was induced with standard dose of propofol, patient received atracurium, fentanyl and the SAD inserted...In the I-gel group, 12.5% of the patients had oropharyngeal morbidities compared with 37.5% in the PLMA group (P = 0.009). Both I-gel and PLMA provide optimal ventilation during abdominal insufflation, with PLMA providing a better oropharyngeal seal, whereas I-gel has a better haemodynamic profile.
- |||||||||| fentanyl citrate / Generic mfg.
Journal, Surgery: Bupivacaine-fentanyl isobaric spinal anesthesia reduces the risk of ICU admission in elderly patients undergoing lower limb orthopedic surgery. (Pubmed Central) - Mar 6, 2024
The meta-analysis conducted in this study revealed that TAP block could reduce the incidence of PONV, and the efficacy of TAP block may be influenced by factors such as administration time, local anesthetic dosage and concentration, types of opioid drugs in PCA. Bupivacaine-fentanyl isobaric spinal anesthesia significantly reduced the risk of ICU admission and unplanned intubation, and provided better intraoperative hemodynamics in elderly patients undergoing lower limb orthopedic surgery.
- |||||||||| fentanyl citrate / Generic mfg.
Journal: Are carfentanil and acrylfentanyl naloxone resistant? (Pubmed Central) - Mar 6, 2024
The efficacy of frontline antidotes such as naloxone in reversing such poisoning events has been questioned, and the possibility of naloxone-resistant synthetic opioids has been raised. In this manuscript, we applied in vitro techniques to establish the median effective inhibitory concentrations for fentanyl, acrylfentanyl, and carfentanil and subsequently evaluate naloxone's ability to reverse agonist-receptor interactions.
- |||||||||| fentanyl citrate / Generic mfg., methamphetamine / Generic mfg., methadone / Generic mfg.
The Opioid Use Disorder Care Cascade for PWH Experiencing Homelessness in Low-Barrier HIV Care (Poster hall) - Mar 5, 2024 - Abstract #CROI2024CROI_336;
As all patients retained on MOUD were on methadone, it is crucial to investigate barriers to buprenorphine retention and to enhance methadone clinic referrals from primary care. Finally, addressing the widespread stimulant use observed in this sample of PWH experiencing homelessness is a top priority.
- |||||||||| fentanyl citrate / Generic mfg.
HIV Prevention Service Use Among PWID in Washington, DC, Pre- and Post-COVID Pandemic Eras (Poster hall) - Mar 5, 2024 - Abstract #CROI2024CROI_327;
In 2022, more PWID owned naloxone (35.0% vs. 81.8%, p<0.0001) and sought out fentanyl (10.6% vs. 26.2%, p<0.001) in the past year...Significant decreases in injection-related risk behaviors and increases in utilization of drug-related services were observed among PWID in Washington, DC. Changes in drug use behaviors over time and where PWID received services were also observed, suggesting the need to better understand how changes in service utilization and drug use patterns impact PWID health.
- |||||||||| fentanyl citrate / Generic mfg.
Journal: Influent wastewater analysis to investigate emerging trends of new psychoactive substances use in Europe. (Pubmed Central) - Mar 3, 2024
In this study, a WBE approach was applied to monitor the use of more than 300 NPS, together with fentanyl and its main metabolite norfentanyl, in influent wastewater collected from 12 European cities during March-June 2021...Spatial trends of NPS use were observed between cities and countries, and a changing weekly profile of use was observed for 3-MMC. WBE is a useful tool to rapidly evaluate emerging trends of NPS use, complementing common indicators (i.e. population surveys, seizures) and helping to establish measures for public health protection.
- |||||||||| fentanyl citrate / Generic mfg.
Journal: Opioid Use Disorder in Missouri: An Evidence-Based, Public Health-Oriented Approach. (Pubmed Central) - Mar 1, 2024
The increasing presence of fentanyl and xylazine in the drug supply represent new challenges to the OUD crisis in Missouri. Optimal implementation of evidence-based interventions will require action at the individual physician, community, and state policy level.
- |||||||||| fentanyl citrate / Generic mfg.
Adolescent drug overdoses: A need to confront a toxic drug supply with policy and overdose prevention (Metro Toronto Convention Centre: 104 CD) - Mar 1, 2024 - Abstract #PAS2024PAS_784;
Session Description: Despite declining rates of substance use among US adolescents, there has been a dramatic rise in teen overdose deaths, fueled by the presence of lethal adulterants such as fentanyl and psychostimulants in the illicit drug supply...Learning Objectives: Describe the impact of drug supply trends, contaminants, and adulterants on adolescent opioid-related deaths across the four waves of the opioid epidemic,. Compile lessons learned from the slow adoption of overdose prevention strategies like increased naloxone access, that can be incorporated into current policy targeting adolescents Describe new clinical practice guidelines on the treatment of stimulant use disorder in the setting of the fourth wave of the opioid crisis
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg.
Journal: Effect of different anesthetic modalities with multimodal analgesia on postoperative pain level in colorectal tumor patients. (Pubmed Central) - Mar 1, 2024
Compile lessons learned from the slow adoption of overdose prevention strategies like increased naloxone access, that can be incorporated into current policy targeting adolescents Describe new clinical practice guidelines on the treatment of stimulant use disorder in the setting of the fourth wave of the opioid crisis For patients with colorectal cancer, general anesthesia coupled with epidural anesthesia and multi-mode analgesia can achieve better postoperative analgesia and sedation effects, promote postoperative rehabilitation of patients, improve inflammatory stress and immune status, and have higher safety.
- |||||||||| fentanyl citrate / Generic mfg.
Retrospective data, Journal: Evaluation of the relationship of xylazine and fentanyl blood concentrations among fentanyl-associated fatalities. (Pubmed Central) - Mar 1, 2024
Postmortem fentanyl concentrations were greater in cases with xylazine detected than those without xylazine detected. Though it is unclear why patients who were exposed to xylazine tolerated higher opioid doses prior to succumbing to death, we postulate that xylazine may act to competitively antagonize some degree of mu-opioid receptor binding by opioids.
- |||||||||| fentanyl citrate / Generic mfg.
Review: Systematic review on intentional non-medical fentanyl use among people who use drugs. (Pubmed Central) - Feb 28, 2024
In response to the increasing number of individuals who use fentanyl, alternative treatment approaches need to be developed for more effective management of withdrawal and opioid use disorder. https://www.crd.york.ac.uk/prospero/, identifier CRD42021272111.
- |||||||||| Penthrox (methoxyflurane) / Medical Developments International
Journal: Deployed Combat Use of Methoxyflurane for Analgesia. (Pubmed Central) - Feb 27, 2024
The inclusion of a basal fentanyl infusion in the IVA protocol did not provide any advantages over an IVA devoid of a basal rate infusion in managing acute pain following CS. Methoxyflurane use in deployed combat shows both feasibility and usability for analgesia.
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg.
PK/PD data, Journal: Developing mathematical models to compare and analyse the pharmacokinetics of morphine and fentanyl. (Pubmed Central) - Feb 26, 2024
These comparative mathematical models on morphine and fentanyl enable the determination of drug dosages and understanding of drug efficacy that facilitates optimising dosing regimens. The right choice between them can be made based on the time to reach the target therapeutic concentration in the blood, elimination time, severity of pain, and patient characteristics.
- |||||||||| fentanyl citrate / Generic mfg.
Journal: Feasibility of paying people who use drugs cash to distribute naloxone within their networks. (Pubmed Central) - Feb 21, 2024
These programs demonstrate that providing cash stipends to peers is feasible and expanded naloxone distribution at two existing syringe service programs. Providing cash stipends for peers who engage in secondary naloxone distribution offers promise in delivering naloxone to people not accessing syringe services.
- |||||||||| fentanyl citrate / Generic mfg.
Journal: Guidelines for Rational Clinical Use of Fentanyl Transdermal Patch. (Pubmed Central) - Feb 20, 2024
Finally, all experts of the preparation team certify and finalize the draft. This "Guide" prepared by experts of the Cancer Rehabilitation and Palliative Treatment Professional Committee of the Hubei Anti-cancer Association and the expert advisory group with joint efforts, aims to play a positive role in promoting the rational clinical use of fentanyl transdermal patch, reducing the mental and economic burden of patients, and ensuring medical quality and medical safety.
- |||||||||| fentanyl citrate / Generic mfg.
Journal: Xylazine and Adulterants in the Evolving Drug Supply: Urgent Call for Responsive Education Models. (Pubmed Central) - Feb 20, 2024
Since 2020, xylazine, a veterinary tranquilizer, has become increasingly common in the illicit opioid supply, especially alongside fentanyl...We conducted 14 training sessions between October 2022 and July 2023, which were attended by over 2000 individuals across 49 states. We review our experience developing innovative training content and managing flexible training logistics and highlight our lessons learned, including targeting multidisciplinary professionals, leveraging online synchronous delivery methods, and a need for sustainable funding for TTA programs.
- |||||||||| fentanyl citrate / Generic mfg.
From Painkiller to Brain Thriller: The Curious Case of Fentanyl-induced Serotonin Syndrome (San Diego Convention Center, Room 1A-B (Upper Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_7703;
This is an off-label use for dexmedetomidine, which works by stimulating the alpha-2 receptors and may also inhibit serotonin release (Rushton, 2014). In this case, the insidious onset of serotonin syndrome symptoms after the fentanyl patch dose increase underscores the need for heightened awareness of this uncommon yet plausible association.
- |||||||||| Bridion (sugammadex) / Merck (MSD)
Post-operative Diffuse Alveolar Hemorrhage Associated With Vaping, Desflurane, and Negative Pressure Pulmonary Edema (San Diego Convention Center, Area I (Hall H, Ground Level)) - Feb 20, 2024 - Abstract #ATS2024ATS_6412;
General anesthesia was induced with fentanyl, propofol, rocuronium, and an endotracheal tube was placed...After procedure, patient received sugammadex...Patient received clindamycin, furosemide, and nebulizer treatment...Inhaled anesthetic agents, were documented in several case reports to be the potential cause of DAH, especially in the patients with smoking and vaping history. Early diagnosis with radiology imaging study and supportive treatment usually can avoid fatal outcomes.
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