- |||||||||| avotaciclib (BEY1107) / BeyondBio
[VIRTUAL] CLINICAL PRACTICE OF SPIRAL ENTEROSCOPY (SPE) IN THE LEARNING PHASE OF A REAL-WORLD SETTING (Poster Exhibition) - Jul 20, 2021 - Abstract #UEGW2021UEGW_1127;
This can partly be explained by the high degree of difficulty (average 2.4 out of 3) and various comorbidities of the pts.; however, at the beginning SpE requires a similar timing as for a DBE/SBE in the endoscopy unit and this is in contrary to actual published SpE trials. Due to the high need for sedation, we currently consider performing SpE under intubation anesthesia which is no prerequisite for DBE or SBE.
- |||||||||| midazolam hydrochloride / Generic mfg.
[VIRTUAL] A NOVEL ONE-DAY VIRTUAL-LIVE HYBRID TRAINING COURSE IS FEASIBLE AND HAS A POSITIVE IMPACT ON COLONOSCOPY KEY PERFORMANCE INDICATORS OF EXPERIENCED ENDOSCOPY TRAINEES (Poster Exhibition) - Jul 20, 2021 - Abstract #UEGW2021UEGW_1010;
Colonoscopy KPIs were assessed on trainee-performed colonoscopies [unsedated or midazolam/fentanyl sedation] for 3 weeks prior and 4 weeks after the training. Standardization of colonoscopy training is critical to the consistent attainment of KPIs by practicing colonoscopists and improving patient experience [3].This is the first demonstration of delivering live colonoscopy training remotely: an approach acceptable to trainees and trainers that has a positive impact on KPIs.Pending larger studies focused on efficacy, this approach has the potential to create a standardized curriculum for colonoscopy training removing the barriers of travel and allowing expanded exposure to consciously-competent expert trainers.
- |||||||||| midazolam hydrochloride / Generic mfg.
[VIRTUAL] A SURVEY BASED ASSESSMENT OF MANAGEMENT OF ESOPHAGEAL FOOD IMPACTIONS IN THE US AND EUROPE (Poster Exhibition) - Jul 20, 2021 - Abstract #UEGW2021UEGW_133;
The majority recommended monitored anesthesia care (46%, vs. conscious sedation with disoprivan (32%), midazolam (6%), fentanyl with midazolam (4%), or other medications given without an anesthesiologist (3%). The considerable practice variation in the management of EFI in patients with EoE provides a rationale for the creation of consensus practice guidelines.
- |||||||||| fentanyl citrate / Generic mfg.
Prevalence of Fentanyl Use in Routine Cataract Surgery () - Jul 19, 2021 - Abstract #ASCRSASOA2021ASCRS_ASOA_204;
ConclusionCataract surgery is thought of as a minimally painful operation, but opioids are often used in cataract surgery as part of MAC protocols for sedation. Ophthalmologists can work with anesthesia colleagues to help identify which patients require opioids and utilize non-opioid alternatives for a successful and comfortable surgical experience.
- |||||||||| midazolam hydrochloride / Generic mfg.
Clinical, Journal: Lack of recall after sedation for cataract surgery and its effect on validity of measuring patient satisfaction. (Pubmed Central) - Jul 18, 2021
Because we studied sedation with low doses of midazolam and fentanyl, the same conclusion reliably would apply to larger doses of anxiolytics administered intraoperatively. The results match previous findings that when patients receive preoperative midazolam prior to meeting the anesthesiologist, even if the patient fully answers questions, they may have negligible recall of having met the anesthesiologist.
- |||||||||| sevoflurane / Generic mfg., dexmedetomidine / Generic mfg.
Clinical, Journal: Effect of dexmedetomidine on dynamic cerebral autoregulation and carbon dioxide reactivity during sevoflurane anesthesia in healthy patients. (Pubmed Central) - Jul 18, 2021
Demographic parameters, durations of surgery and anesthesia, THR ratio [Group D: 1.26(0.11) vs. Group C: 1.23(0.04); p=0.357], relative CO2 reactivity [Group D: 1.19(0.34) %/mmHg vs. Group C: 1.23(0.25) %/mmHg; p=0.547], blood pressure, SpO2, BIS, MCAFV, time to recovery, time to extubation and modified Aldrete scores were comparable. Dexmedetomidine administration does not impair dCA and CO2 reactivity in patients undergoing spine surgery under sevoflurane anesthesia.
- |||||||||| dexamethasone / Generic mfg.
Review, Journal: PROSPECT guideline for hallux valgus repair surgery: a systematic review and procedure-specific postoperative pain management recommendations. (Pubmed Central) - Jul 18, 2021
No studies of sciatic nerve block met the inclusion criteria for PROSPECT methodology due to a wider scope of included surgical procedures or the lack of a control (no block) group. The analgesic regimen for hallux valgus repair should include, in the absence of contraindication, paracetamol and a non-steroidal anti-inflammatory drug or cyclo-oxygenase-2 selective inhibitor administered preoperatively or intraoperatively and continued postoperatively, along with systemic steroids, and postoperative opioids for rescue analgesia.
- |||||||||| fentanyl citrate / Generic mfg.
Keynote Speaker 7 - Investigating the War on Drugs: Learnings and Recommendations for the Future () - Jul 17, 2021 - Abstract #ANZAC2021ANZAC_57;
Despite the welcome changes around marijuana in many jurisdictions, drug use and abuse of harder substances such as heroin, fentanyl or synthetics reveal the dark side of drug prohibition and the need for a new approach...How would legalisation and regulation help the communities most negatively impacted by the "war on drugs". 3x learnings:- Legal/regulated drugs are both possible and necessary to address the negative consequences of the "war on drugs";- Legal/regulated drugs aren't the solution to all drug/addiction problems but one important tool;- Explain realities on the ground, from Honduras to the Philippines, with the current "war on drugs" and how it negatively impacts civilians.
- |||||||||| fentanyl citrate / Generic mfg.
Clinical, Journal: Tolerance to opioid-induced respiratory depression in chronic high-dose opioid users: a model-based comparison with opioid-naïve individuals. (Pubmed Central) - Jul 17, 2021
C , the effect-site concentration causing 50% ventilatory depression, was 0.42 ± 0.07 ng/mL in opioid-naïve subjects and 1.82 ± 0.39 ng/mL in chronic opioid users, indicative of a 4.3-fold sensitivity difference. Despite higher tolerance to fentanyl-induced respiratory depression, apnea still occurred in the opioid-tolerant population indicative of the potential danger of high-dose opioids in causing life-threatening respiratory depression in all individuals, opioid-naïve and opioid-tolerant.
- |||||||||| nalmefene intranasal (OPNT003) / Opiant
Review, Journal: Countermeasures for preventing and treating opioid overdose. (Pubmed Central) - Jul 17, 2021
This paper provides an overview of several presentations at that meeting that discussed emerging new approaches for treating opioid overdose, including the following: 1) intranasal nalmefene, a competitive, reversible opioid receptor antagonist with a longer duration of action than naloxone; 2) methocinnamox, a novel opioid receptor antagonist; 3) covalent naloxone nanoparticles; 4) serotonin (5-HT) receptor agonists; 5) fentanyl-binding cyclodextrin scaffolds; 6) detoxifying biomimetic "nanosponge" decoy receptors; and 7) antibody-based strategies. These strategies could also be applied to treat opioid use disorder (OUD).
- |||||||||| fentanyl citrate / Generic mfg.
Journal: Performance Evaluation of an Automated Fentanyl Immunoassay. (Pubmed Central) - Jul 16, 2021
Clinical implementation of the ARK II assay led to a reduction in samples that were falsely positive from 11.7% using the ARK assay to 2.0%. Improvements to the original ARK fentanyl assay are likely to reduce false-positive fentanyl screens and reduce unnecessary confirmatory assays.
- |||||||||| ketorolac / Generic mfg., dexamethasone / Generic mfg., ketamine / Generic mfg.
Review, Journal: Adjuncts to local anesthetic wound infiltration for postoperative analgesia: a systematic review. (Pubmed Central) - Jul 16, 2021
We performed a systematic review on adjuncts (excluding epinephrine) to local infiltrative anesthesia to determine their analgesic efficacy and opioid-sparing properties...Adjuncts included opioids, non-steroidal anti-inflammatory drugs, steroids, alpha-2 agonists, ketamine, magnesium, neosaxitoxin, and methylene blue...Fentanyl, ketorolac, dexamethasone, magnesium and several other agents show potential as adjuncts but require more evidence...Further well-powered RCTs are needed to compare various infiltration regimens and agents. PROTOCOL REGISTRATION: PROSPERO (CRD42018103851) (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=103851).
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg., methadone / Generic mfg.
Clinical, Journal: Use of a novel prescribing approach for the treatment of opioid use disorder: Buprenorphine/naloxone micro-dosing - a case series. (Pubmed Central) - Jul 16, 2021
PROTOCOL REGISTRATION: PROSPERO (CRD42018103851) (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=103851). Buprenorphine/naloxone micro-dosing may offer a promising alternative approach for successful induction for individuals with opioid use disorder who desire treatment with buprenorphine/naloxone, and further research to determine effectiveness is warranted.
- |||||||||| hydroxyurea / Generic mfg.
Reimbursement, Journal, Medicaid: The association between hydroxyurea adherence and opioid utilization among Texas Medicaid enrollees with sickle cell disease. (Pubmed Central) - Jul 16, 2021
Barner and Kang report grants from Novartis Pharmaceuticals, unrelated to this work. A part of this study was presented as a poster at the American Pharmacists Association (APhA) 2019 Annual Meeting and Exposition (March 22-25, 2019, Seattle, WA) and received the 2019 APhA-APRS Presentation Award in the APhA-APRS Contributed Research Paper, Graduate Student/Fellow/Postdoctoral Scholar category.
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg.
Journal: Development, Validation, and Feasibility Testing of a Yoga Module for Opioid Use Disorder. (Pubmed Central) - Jul 16, 2021
Practices were added or excluded based on the phase. The yoga module that was developed for reducing withdrawal symptoms and cravings in OUD patients was found to be safe, feasible, and potentially useful as an adjunct therapy to conventional treatment.
- |||||||||| fentanyl citrate / Generic mfg.
Journal: A 2017-2019 Update on Acute Intoxications and Fatalities from Illicit Fentanyl and Analogues. (Pubmed Central) - Jul 15, 2021
Recently marketed FAs such as crotonylfentanyl and valerylfentanyl were not involved in intoxications to date, but should be carefully monitored. Many intoxications and fatalities might have gone unnoticed, and research efforts should focus on metabolite identification studies and the implementation of updated and comprehensive analytical methods.
- |||||||||| fentanyl citrate / Generic mfg., loperamide / Generic mfg.
Review, Journal: New Designer Drugs. (Pubmed Central) - Jul 15, 2021
Kratom, a plant occasionally used for opiate detoxification, along with the sedatives etizolam and phenibut, will be discussed. Lastly, this article discusses the phenethylamines and marijuana.
- |||||||||| fentanyl citrate / Generic mfg.
Retrospective data, Journal: Local anesthetic volume in ultrasound-guided interscalene block and opioid consumption during shoulder arthroscopic surgery: A retrospective comparative study. (Pubmed Central) - Jul 15, 2021
The use of intraoperative analgesics and sedatives, and the reduction in intraoperative maximum blood pressure and heart rate were compared through retrospective analysis.Fentanyl was used in 55.6% of patients in group 1, which was significantly higher than in those groups 2 and 3 (22.3% and 30.7%, respectively); furthermore, it was also higher than those in groups 2 and 3 in dose-specific comparisons (P 30 mL or increased opioid consumption with <20 mL of local anesthetics could increase the risk of cardiovascular instability intraoperatively. Our findings indicate that 24 mL of local anesthetic could be used to lower the incidence of hypotensive bradycardic events.
- |||||||||| fentanyl citrate / Generic mfg.
Clinical, Journal: The fentanyls: pharmacological and clinical aspects relevant to Australia. (Pubmed Central) - Jul 11, 2021
The extreme potency of the fentanyls underlie their lethality. Vigilance and investment from both policy makers and health care providers are required to mitigate harm from a possible future Australian fentanyl epidemic.
- |||||||||| fentanyl citrate / Generic mfg.
Journal: The fentanyls: a 'future threat' for Australia? (Pubmed Central) - Jul 11, 2021
Differences in drug use 'culture' and a supply of cheap high-quality methamphetamine in Australia may be reasons for the observed difference in fentanyl-related harm. More worryingly, it is possible that Australia is following North American trends and that the fentanyl epidemic is still to come.
- |||||||||| fentanyl citrate / Generic mfg., morphine sulphate / Generic mfg.
Clinical, Journal: Structural Assessment of Agonist Efficacy in the μ-Opioid Receptor: Morphine and Fentanyl Elicit Different Activation Patterns. (Pubmed Central) - Jul 11, 2021
As conformational changes in TM6 and TM7 are widely described as being the most crucial aspect in GPCR activation, this may contribute to the greater efficacy of fentanyl over morphine. These computationally observed functional differences between fentanyl and morphine may provide new avenues for the design of safer but not weaker opioid drugs because it is desirable to increase the safety of medicines without sacrificing their efficacy.
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