- |||||||||| tramadol hydrochloride / Generic mfg.
Clinical, Review, Journal: Full Opioid Agonists and Tramadol: Pharmacological and Clinical Considerations. (Pubmed Central) - Oct 27, 2021
The most recognized full agonist opioids are heroin, morphine, codeine, oxycodone, meperidine, and fentanyl...Methadone acts as a synthetic opioid analgesic similar to morphine in both quality and quantity; however, methadone lasts longer and in oral form, has higher efficacy, and is considered a diphenylheptane...Chronic opioid usage has also established a relationship to opioid-induced hypogonadism and adrenal suppression. Physicians must be stewards of opioid use and use opioids only when necessary.
- |||||||||| fentanyl citrate / Generic mfg.
Journal: Covalently Loaded Naloxone Nanoparticles as a Long-Acting Medical Countermeasure to Opioid Poisoning. (Pubmed Central) - Oct 22, 2021
This enhancement was further demonstrated by cNLX-NP in subsequent in vivo studies affording protection against fentanyl-induced respiratory depression and antinociception for up to 48 h following a single intramuscular injection. These discoveries support further investigation of cNLX-NP as a potential therapeutic to reverse overdose and prevent renarcotization from fentanyl and its potent analogs.
- |||||||||| nebulized fentanyl citrate / Boehringer Ingelheim
Journal: Inspiratory neural drive and dyspnea in interstitial lung disease: Effect of inhaled fentanyl. (Pubmed Central) - Oct 22, 2021
These discoveries support further investigation of cNLX-NP as a potential therapeutic to reverse overdose and prevent renarcotization from fentanyl and its potent analogs. IND rose sharply during constant work rate exercise in association with dyspnea intensity in mild to moderate ILD but was not different after nebulized fentanyl compared with placebo.
- |||||||||| fentanyl citrate / Generic mfg.
Journal: Factors Associated with Sterile Syringe Acquisition among People Who Inject Drugs in West Virginia. (Pubmed Central) - Oct 22, 2021
Factors associated with recent sterile syringes acquisition at an SSP included: being older (aPR [adjusted prevalence ratio]: 1.011, 95% CI: 1.003-1.019), single (aPR: 0.862, 95% CI: 0.755-0.984), experiencing food insecurity (aPR: 1.233, 95% CI: 1.062-1.431), recently injecting fentanyl (aPR: 1.178, 95% CI: 1.010-1.375) and prescription opioid pain relievers (aPR: 0.681, 95% CI: 0.551-0.842), and recent naloxone acquisition (aPR: 1.360; 95% CI: 1.178-1.569)...PWID accessing sterile syringes at an SSP was associated with several sociodemographic, structural, and substance use factors. Ensuring rural SSP operations are tailored to local PWID population-level needs is paramount to the prevention of infectious disease outbreaks and overdose fatalities.
- |||||||||| Olinvyk (oliceridine) / Trevena, Jiangsu NHWA Pharma
Journal: CHARMM Force-Field Parameters for Morphine, Heroin, and Oliceridine, and Conformational Dynamics of Opioid Drugs. (Pubmed Central) - Oct 22, 2021
From potential energy profiles for bond twists and from interactions between opioids and water, we derived a set of force-field parameters that allow a good description of structural properties and intermolecular interactions of the opioids. Potential of mean force profiles computed from molecular dynamics simulations indicate that fentanyl and oliceridine have complex energy landscapes with relatively small energy penalties, suggesting that interactions with the receptor could select different binding poses of the drugs.
- |||||||||| ketamine / Generic mfg.
Journal: The occurrence of opioid compounds in wastewater treatment plants and their receiving water bodies in Gauteng province, South Africa. (Pubmed Central) - Oct 22, 2021
Upstream surface water contained less opioids (most < LOQ) than downstream (p < 0.05), with Hydrocodone, Oxycodone, Hydromorphone, Fentanyl, Ketamine and Dihydrocodeine not detected. The occurrence of high concentrations of opioid analogues in downstream surface water (298 ng/L -10.8 μg/L for Klip River, 4.49 ng/L -13.1 μg/L for Vaal River, 70.5 ng/L -10.0 μg/L for Soutspruit River and 8.0 ng/L - 2.43 μg/L for Sun Spruit River) was directly linked to their mass loads in the respective wastewater effluent samples.
- |||||||||| fentanyl citrate / Generic mfg., methamphetamine / Generic mfg.
Journal: Towards cross-Canada monitoring of the unregulated street drug supply. (Pubmed Central) - Oct 22, 2021
Results are well-suited to meet the needs of PWUD and inform the local harm reduction services they rely on. Further standardization of the survey tool and knowledge mobilization is needed to expand the system to new jurisdictions.
- |||||||||| fentanyl citrate / Generic mfg.
Clinical, Journal: Comparison of Intrathecal Fentanyl and Buprenorphine as an Adjuvant to 0.5% Hyperbaric Bupivacaine for Spinal Anesthesia. (Pubmed Central) - Oct 22, 2021
Maximum duration of analgesia after spinal drug administration was the highest in the BB group (412.17 min), P < 0.05. The addition of both buprenorphine 150 μg and fentanyl 25 μg to 0.5% hyperbaric bupivacaine 15 mg enhances the quality and duration of sensory block for spinal anesthesia providing better postoperative analgesia, while decreasing the incidence of complications associated with each drug alone.
- |||||||||| fentanyl citrate / Generic mfg., methadone / Generic mfg.
Review, Journal: What Your Death Certificate Says About You May Be Wrong: A Narrative Review on CDC's Efforts to Quantify Prescription Opioid Overdose Deaths. (Pubmed Central) - Oct 22, 2021
Opioids identified in death certificates are categorized according to six ICD T-codes: opium (T40.0), heroin (T40.1), methadone (T40.3), other synthetic narcotics (T40.4), and other and unspecified narcotics (T40.6)...We conclude that the CDC was at fault for failing to correct the miscoding of IMF. Finally, we briefly discuss some of the public policy consequences of this error, the misguided focus by public health and safety officials on pharmaceutical opioids, their prescribers and users, and the pressing necessity for the CDC to reassess how it measures and reports drug-involved mortality.
- |||||||||| Mavyret (glecaprevir/pibrentasvir) / AbbVie, Enanta Pharma
[VIRTUAL] HCV TREATMENT AMONG ACTIVE INNER CITY DRUG USERS WITH GLECAPREVIR/PIBRENTASVIR: THE GRAND PLAN STUDY () - Oct 21, 2021 - Abstract #AASLD2021AASLD_1196;
A total of 98 patients were enrolled (82% male, 47% active fentanyl users, 87% unstably housed, 9% received treatment while incarcerated, 55% GT1, 35% GT3, 2% cirrhotic, 99% treatment naive). The GRAND PLAN study demonstrates the preserved efficacy of this simple short-course HCV treatment regimen within more challenging inner city populations compared to those previously evaluated in clinical trials .
- |||||||||| sofosbuvir/velpatasvir / Generic mfg.
[VIRTUAL] COMMUNITY-BASED HCV THERAPY WITH SOFOSBUVIR AND VELPATASVIR IN THE INNER CITY () - Oct 21, 2021 - Abstract #AASLD2021AASLD_1185;
This observation study demonstrates the preserved efficacy of this simple one pill/day HCV treatment regimen within diverse inner city populations . From a policy perspective, there is a need to monitor HCV treatment success rates in this population and the means required to achieve and maintain it, such as the development of multidisciplinary programs of care such as ours .
- |||||||||| fentanyl citrate / Generic mfg.
Clinical, Journal: Comparison of Two Commercially Available Fentanyl Screening Immunoassays for Clinical Use. (Pubmed Central) - Oct 20, 2021
We demonstrated that absent reactivity, absent state changes, and absent/poor variability in cEEG of patients receiving ECMO support are associated with death at the time of hospital discharge. The ARK assay recognized the metabolite norfentanyl, demonstrated superior precision, and had better concordance with LC-MS/MS compared to the IAL assay.
- |||||||||| fentanyl citrate / Generic mfg.
Journal: Prescription History Before Opioid Overdose Death: PDMP Data and Responsible Prescribing. (Pubmed Central) - Oct 20, 2021
In response to the prescriptions filled for deceased individuals, legislators could enact a policy such as Void All Prescriptions or VAP alerts to cancel all prescriptions for individuals who have died, reducing drug diversion. It is vital that providers routinely use PDMP data along with counseling and other treatment strategies to optimize patient care.
- |||||||||| fentanyl citrate / Generic mfg.
Journal: Evaluation of Infectious Disease Test Ordering and Positivity Rates in Illicit Fentanyl Users. (Pubmed Central) - Oct 20, 2021
Patients with a positive UDS for fentanyl and suspected illicit use were more likely to test positive for HCV, were rarely screened for HCV in the ED, and had an increased risk of invasive S. aureus wound or abscess infection. These findings may represent considerable barriers to care for patients who use fentanyl illicitly.
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg.
Retrospective data, Journal: Oxycodone versus other opioid analgesics after laparoscopic surgery: a meta-analysis. (Pubmed Central) - Oct 20, 2021
The safety of acetaminophen was evaluated in Japanese patients who underwent different types of LR with different degrees of liver fibrosis. Oxycodone is superior to other analgesics within 24 h after laparoscopic surgery, but its adverse effects should be carefully considered.
- |||||||||| fentanyl citrate / Generic mfg.
Clinical, Journal: Incidence and Clinical Manifestation of Iatrogenic Opioid Withdrawal Syndrome in Mechanically Ventilated Patients. (Pubmed Central) - Oct 20, 2021
P=N/A
Patients who received rapid once-daily weaning, especially rate reduction more than 50 µg as fentanyl equivalent per hour, were associated with IOWS...Future studies to develop IOWS assessment tools with the change of hemodynamic parameters should be performed. This trial was registered in ClinicalTrials.gov; identifier NCT03374722), date of registration; December 15, 2018.
- |||||||||| fentanyl citrate / Generic mfg.
Clinical, Journal: Wooden Chest Syndrome: A Case Report of Fentanyl-Induced Chest Wall Rigidity. (Pubmed Central) - Oct 20, 2021
Given the rise of synthetic opioid deaths across the United States in the past decade, an understanding of all of fentanyl's effects on the body is necessary. In this article, we present a case of WCS in a patient with acute respiratory distress syndrome in a 61-year-old female.
- |||||||||| ketamine / Generic mfg.
Journal: Pressure-Sensitive Adhesive Combined with Paper Spray Mass Spectrometry for Low-Cost Collection and Analysis of Drug Residues. (Pubmed Central) - Oct 20, 2021
A total of 10 drugs (acetyl fentanyl, fentanyl, clonazolam, cocaine, heroin, ketamine, methamphetamine, methylone, U-47700, and XLR-11) were evaluated and found to be detectable in the picogram range using a benchtop mass spectrometer and in the low nanogram range using a portable ion trap MS. The novel approach demonstrates a simple yet effective sampling strategy, allowing for rapid identification from difficult surfaces via paper spray mass spectrometry.
- |||||||||| fentanyl citrate / Generic mfg.
Journal: Understanding the Chameleonic Breakthrough Cancer Pain. (Pubmed Central) - Oct 14, 2021
Although oral opioids may still have specific indications, fentanyl products have been found to be more rapid and effective, providing analgesia in 5-15 min...In contrast, regulatory studies have suggested using the minimal available dose to be titrated until the effective dose. Further large studies should definitely settle this never-ending question.
- |||||||||| midazolam hydrochloride / Generic mfg.
[VIRTUAL] SPINAL MYOCLONUS LEADING TO ENDOTRACHEAL TUBE BITING AND CARDIAC ARREST () - Oct 13, 2021 - Abstract #CHEST2021CHEST_710;
Attempts to redirect patient were not successful, and he was given boluses of fentanyl and midazolam without resolution of biting...Post arrest, his mental status was poor and there was concern for status epilepticus, so propofol infusion was started and levetiracetam was given...Neurology diagnosed the patient with spinal segmental myoclonus, and he was initiated on clonazepam for treatment... In patients with a history of myoclonus, it may be prudent to prophylactically apply bite guard devices to prevent this rare complication of mechanical ventilation.
- |||||||||| gabapentin / Generic mfg.
[VIRTUAL] COCAINE-INDUCED COMPLETE HEART BLOCK THAT WAS REVERSED BY NALOXONE () - Oct 13, 2021 - Abstract #CHEST2021CHEST_683;
CASE PRESENTATION: 49-year-old woman with history of coronary artery disease, mechanical mitral valve, heart failure, anxiety, and depression on aspirin, warfarin, furosemide, gabapentin, citalopram, quetiapine, and clonazepampresented with 3 days history of abdominal pain, diarrhea, and vomiting...Patient was started on IV fluids, IV antibiotics for acute colitis and morphine for pain...Patient underwent permanent pacemaker placement due to persistent CHB and during the procedure, patient received fentanyl... In conclusion, naloxone might be a possible treatment for cocaine induced CHB, but further studies are required to further elicit this observed effect.
- |||||||||| [VIRTUAL] A CASE OF STATUS EPILEPTICUS SECONDARY TO BUPROPION OVERDOSE TREATED WITH IV LIPID EMULSION THERAPY () - Oct 13, 2021 - Abstract #CHEST2021CHEST_638;
Her roommate reported finding empty pill bottles of bupropion, gabapentin, and propranolol at her apartment...Salicylates, acetaminophen, and alcohol levels were undetectable...Despite being on lorazepam drip, her seizures continued and were also resistant to phenobarbital, levetiracetam, valproate, fentanyl, and propofol...Positive amphetamines on urine toxicology are expected with bupropion use as their metabolites have chemical structures similar to amphetamine... ILE therapy can be used as an antidote for severe bupropion toxicity.
- |||||||||| fentanyl citrate / Generic mfg.
[VIRTUAL] FENTANYL-INDUCED PERSISTENT ENCEPHALOPATHY () - Oct 13, 2021 - Abstract #CHEST2021CHEST_636;
Sedation should be used with caution especially in elderly patients. Intermittent pushes or shorter duration of use may prevent this rare complication.
- |||||||||| fentanyl citrate / Generic mfg.
Clinical, Journal: Hepatic Hilar Nerve Block for Hepatic Interventions: Anatomy, Technique, and Initial Clinical Experience in Thermal Ablation of Liver Tumors. (Pubmed Central) - Oct 13, 2021
However, the 20 ml volume resulted in a lower analgesic dose requirement during the early postoperative period, and it also delayed the requirement for analgesia. Participants who received the nerve block had a lower mean visual analog scale score for pain than the control group (3.9 ± 2.4 vs 7.0 ± 2.8, respectively; P = .01) and decreased need for intraprocedural fentanyl (mean dose, 152 μg ± 78.0 vs 235.4 μg ± 58.2, respectively; P = .01)...Conclusion A dedicated hepatic hilar nerve block with 0.25% bupivacaine can be safely performed to provide anesthesia during liver tumoral ablation.
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