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Journal: Qualitative and quantitative characteristics of xylazine-associated deaths detected using a post-mortem toxicology testing program. (Pubmed Central) - Dec 13, 2023 A total of 279 deaths were xylazine-positive between October 2019 and June 2023, with 100 percent positive for fentanyl...Overdose-related deaths with xylazine detection are increasing in Michigan and across the United States. Further clinical and toxicological research can help contextualize the clinical significance of xylazine in opioid overdose, clarify epidemiologic and clinical research, and inform appropriate public health messaging.
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Journal: Forty years of National Poison Data System Annual Reports. (Pubmed Central) - Dec 12, 2023 Fentanyl exposures reported to the National Poison Data System have increased rapidly since 2019, driven by non-prescription fentanyl...Poison center data gives a robust, reproducible image of the populations that utilize poison center resources and seems to mirror trends noted from other data sources. This supports the continued need for poison centers in the information age to support the management of patients potentially exposed to poisons and those who are more severely poisoned.
- |||||||||| betahistine intranasal (AM-201) / Altamira Therap
Preclinical, Journal: Effects of cannabinoid agonists and antagonists in male rats discriminating the synthetic cannabinoid AM2201. (Pubmed Central) - Dec 11, 2023 Next, the generalization profiles of AM411 and AM4089 with CB full agonists (JWH-018, CP-55,940, AM8936), partial agonist (?-THC), and non-cannabinoids (fentanyl, atropine) were compared...All CB drugs were more potent than ?-THC and correlation analysis confirmed that the relative behavioral potencies of CBs corresponded strongly with their relative affinities at the CB but not CB receptors. Together, our results further demonstrate that AM411 and AM4089 exhibit better pharmacological profiles compared to ?-THC, in that they are more potent and display in vivo partial agonist-like actions that are centrally mediated via CB receptors.
- |||||||||| fentanyl citrate / Generic mfg., sevoflurane / Generic mfg.
Journal: Perioperative considerations for adult patients with Dravet syndrome in regional centres. (Pubmed Central) - Dec 11, 2023 Her perioperative care was optimised for seizure prevention with continuation of antiepileptic medications, strict temperature monitoring and control, optimised anaesthetic agents encompassing induction with propofol and fentanyl with maintenance sevoflurane, followed by attentive postoperative care and monitoring. This case demonstrates that general anaesthesia can safely be delivered to adult patients with DS in rural and regional areas with thorough perioperative planning.
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Journal: Proportion of Non-Medical Opioid Use of Prescription Opioids among Cancer Patients in Korea. (Pubmed Central) - Dec 11, 2023 The most commonly misused opioids were oxycodone and fentanyl...This study found that 0.23% of cancer patients who had been prescribed opioids in Korea demonstrated NMOU. Despite this relatively low rate, careful monitoring is necessary to minimize the risk of NMOU in this population, especially among long-term PO users.
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Journal: Quantifying a potential protective effect of buprenorphine on fatality risk during acute fentanyl exposures. (Pubmed Central) - Dec 10, 2023 These findings suggest that sustained or longer-term buprenorphine intake might exert some protective effect on fatalities resulting from fentanyl exposure as documented by the association of higher fentanyl blood concentrations with buprenorphine presence among fatal drug overdoses. As fentanyl availability and overdose rates increase nationally, buprenorphine is a vital tool for effective opioid use disorder treatment that might also reduce the risk of fatality in an acute fentanyl exposure.
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Journal: Perioperative Ultrasound-Guided Continuous Caudal Epidural Analgesia in Newborns: A Case Series in a Tertiary Medical Center. (Pubmed Central) - Dec 6, 2023 An epidural bolus of ropivacaine was administered to every patient before the surgical incision, and an epidural infusion of ropivacaine 0.05% was administered for 24 hours...Epidural pain control was not successful in one neonate, and thus an intravenous fentanyl infusion was added...Conclusion Continuous caudal epidural analgesia may be a valuable technique with a low risk of complications, decreasing the incidence of respiratory adverse events in this patient population. Although more cases are needed for a stronger conclusion, it has become a useful analgesic strategy for major abdominal surgery in neonates in our institution.
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Journal: Exploring trends in benzodiazepine-positive fatal drug overdoses in Tennessee, 2019-2021. (Pubmed Central) - Dec 5, 2023 Most benzodiazepine-positive overdoses involved fentanyl (71.3%)...Given the high proportion of opioids in this population, further education also is needed on the dangers of polysubstance drug use. The differences between prescription and illicit benzodiazepine-positive fatal overdoses indicate the need to develop substance-specific prevention and treatment strategies.
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Journal: Comprehensive evaluation of drug cases in Seoul and its metropolitan areas - 2022. (Pubmed Central) - Dec 5, 2023 In addition to the controlled substances regulated by the Narcotics Control Act, new psychoactive substances are being found to be circulating, and various measures are required to address this issue. This study is expected to improve future drug analyses methods and assist in establishing drug policies, and responding to future investigations.
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Journal: Quantitative Assay of Fentanyl and Analogs Using LC-MS/MS. (Pubmed Central) - Dec 5, 2023 To address this, a rapid, robust, and accurate LC-MS/MS method for the quantitation of fentanyl and fentanyl analogs was developed. Identification and quantitation of each analyte was made using multiple reaction monitoring (MRM) with two transitions, along with the corresponding deuterated internal standard for each analyte for accurate measurement.
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Most off- label medications were used for conventional (albeit not licensed) reasons, but nine out of 81 (11.1%) were not; for example, acetazolamide for hypertension, aminophylline for oliguria, and dexmedetomidine for seizures. Recognising the challenges of formally registering an indication with the Therapeutic Goods Administration, but also the value of reducing the incidence of medications used for potentially incorrect purposes, we suggest guideline endorsement of what constitutes standard critical care practice as an alternative to regulatory control.
- |||||||||| fentanyl citrate / Generic mfg., naltrexone / Generic mfg.
Preclinical, Journal: Fentanyl-induced respiratory depression in rodents is inhibited by bioabsorbable, subcutaneous naltrexone implants at 3.5?months. (Pubmed Central) - Dec 3, 2023 Recognising the challenges of formally registering an indication with the Therapeutic Goods Administration, but also the value of reducing the incidence of medications used for potentially incorrect purposes, we suggest guideline endorsement of what constitutes standard critical care practice as an alternative to regulatory control. The mean plasma concentrations of NTX, 3.5?months after implantation, ranged from 7.4 (
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Preclinical, Journal: Rapid appearance of negative emotion during oral fentanyl self-administration in male and female rats. (Pubmed Central) - Dec 3, 2023 Using fibre photometry, we found that the lateral habenula differentially processed drug cues and drug consumption depending on affective state, with potentiated modulation by drug cues and consumption during the negative affective maintenance phase. Together, these results indicate a rapid progression from positive to negative reinforcement occurs even within an active drug taking session, revealing a within-session opponent process.
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Journal: American College of Medical Toxicology and the American Academy of Clinical Toxicology position statement: nalmefene should not replace naloxone as the primary opioid antidote at this time. (Pubmed Central) - Dec 1, 2023 We have decades of experience using naloxone safely and effectively as the primary opioid antidote, even in cases of fentanyl and fentanyl analog overdoses...As nalmefene is untested in the current clinical environment of synthetic opioid overdoses and has the potential to cause harm via prolonged withdrawal, it is the opinion of the American College of Medical Toxicology and the American Academy of Clinical Toxicology that nalmefene should not replace naloxone as the primary opioid antidote at this time. We recommend additional clinical studies of nalmefene, administered via all approved routes, be conducted in a comparative fashion with naloxone, and that safety and effectiveness outcomes be evaluated before nalmefene is recommended as a primary opioid antidote.
- |||||||||| fentanyl citrate / Generic mfg., ropivacaine / Generic mfg.
Journal: Pre-peritoneal Plus Portal Infiltration Versus Bilateral Transversus Abdominis Plane Block in Laparoscopic Hernia Repair. (Pubmed Central) - Nov 30, 2023 Group A patients were given pre-peritoneal plus portal infiltration of 15 mL of 0.5% ropivacaine for each technique by the operating surgeon, while Group B patients were administered bilateral TAP block with 0.5% ropivacaine, 15 mL on each side under ultrasound guidance by the anesthesiologist...Also, the postoperative requirement of fentanyl between the two groups was insignificant...Conclusion Both ultrasound-guided TAP block and the PILA plus portal infiltration are effective techniques for pain relief after laparoscopic hernia repair. Either of these two techniques can be chosen depending on the availability of resources, expertise, etc.
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Journal: Trends in Fentanyl Content on Reddit Substance Use Forums, 2013-2021. (Pubmed Central) - Nov 28, 2023 Fentanyl-related posts on Reddit trended upward, with the fastest rate of change for multi-substance and stimulant subreddits. Beyond opioids, harm reduction and public health messaging should ensure inclusion of individuals who use other drugs.
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Journal: A survey of North American drug checking services operating in 2022. (Pubmed Central) - Nov 27, 2023 DCS are scaling up in North America. Given the evolving and localized nature of illicit drug supplies, supporting the establishment and operations of DCS could enhance the public's understanding of local drug supplies to reduce drug-related harms over time.
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Journal: Mortality, incarceration and cost implications of fentanyl felonization laws: A modeling study. (Pubmed Central) - Nov 27, 2023 Given the evolving and localized nature of illicit drug supplies, supporting the establishment and operations of DCS could enhance the public's understanding of local drug supplies to reduce drug-related harms over time. Our model shows that lowering thresholds for felony possession of fentanyl containing drugs can lead to more opioid overdose deaths and incarceration.
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