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- fentanyl citrate / Generic mfg., Duragesic (fentanyl) / J&J
Evaluating Clinical Outcomes Following Fentanyl Patch Prior Authorization Drug Review Across Seven Health Care Systems in the Department of Veterans Affairs (VA) Heart of Texas Health Care Network () - May 6, 2020 - Abstract #AMCP2020AMCP_328;
Conclusions of this QA project are not yet available; will be presented at AMCP Nexus in April. Sponsorship: None
- ||| fentanyl citrate / Generic mfg.
We found a similar effect with Fentanyl vials in @BJAJournals @BWHAnesthesia https://t.co/uNVVfTMihR (Twitter) - May 4, 2020
- || fentanyl citrate / Generic mfg.
Pharmaceutically manufactured Fentanyl is essential in surgery and for intubation to quiet the cough reflex.The street version will kill you or worse. (Twitter) - May 4, 2020
- || fentanyl citrate / Generic mfg.
Clinical, Journal: Comparison of programmed intermittent epidural bolus and continuous epidural infusion for post-operative analgesia after major abdominal surgery: A randomized controlled trial. (Pubmed Central) - May 4, 2020
Sponsorship: None Our study suggests that within the context of an established ERAS program, PIEB and CEI modes of epidural analgesia can be equally efficacious and safe in providing postoperative analgesia after major abdominal surgery.
- fentanyl citrate / Generic mfg.
IDENTIFYING WHO BEST TOLERATES MODERATE SEDATION: RESULTS FROM A NATIONAL DATABASE OF GASTROINTESTINAL (GI) ENDOSCOPIC PROCEDURAL OUTCOMES () - May 4, 2020 - Abstract #DDW2020DDW_6670;
In a nationwide survey of patients undergoing GI endoscopies with moderate sedation, specific factors associated with low sedation requirements include female sex, older age, non-white race, and having a lower BMI. Clinicians should consider these patient profiles in determining which patients will better tolerate moderate sedation versus those better suited for monitored anesthesia care.
- fentanyl citrate / Generic mfg.
A TIME PERFORMANCE COMPARISON BETWEEN MODERATE AND DEEP SEDATION FOR SCREENING COLONOSCOPIES IN OBESE PATIENTS WITH OBSTRUCTIVE SLEEP APNEA () - May 4, 2020 - Abstract #DDW2020DDW_6660;
This can be interpreted as moderate sedation being a less time-consuming modality than deep sedation for screening colonoscopies in obese patients with OSA. This could potentially decrease health care costs and increase productivity by the number of patients that can be seen in a day while maintaining equivalent patient safety.
- fentanyl citrate / Generic mfg.
COLONOSCOPY QUALITY METRICS DURING GASTROENTEROLOGY FELLOWSHIP: LOOKING BEYOND ADENOMA DETECTION RATE () - May 4, 2020 - Abstract #DDW2020DDW_5957;
Interestingly, there was improved adherence based on year of training. Adherence to guideline-based surveillance interval recommendations is an important quality metric that should be emphasized and tracked during fellowship training.
- fentanyl citrate / Generic mfg.
SHORT TERM CARDIOVASCULAR COMPLICATIONS RELATED TO MODERATE AND DEEP SEDATION FOR PATIENTS WITH OBESITY AND OBSTRUCTIVE SLEEP APNEA UNDERGOING SCREENING COLONOSCOPY () - May 4, 2020 - Abstract #DDW2020DDW_5758;
This study highlights the need for caution with use of deep sedation for patient preference alone. Patient safety should be paramount and informed shared decision of these risks should be undertaken.
- fentanyl citrate / Generic mfg.
A NEW DISCHARGE SCALE DIRECTED TO PATIENTS SUBMITTED TO ENDOSCOPIC PROCEDURES WITH SEDATION. () - May 4, 2020 - Abstract #DDW2020DDW_5232;
All patients in this study were sedated using Fentanyl, Midazolam and Propofol, being evaluated 15-20'' after the procedure and re-evaluated every 15'', using both scales... Regarding the discharge decision, the new proposed scale has shown to be more sensitive than the modified Aldrete-Kroulik score, since it was able to identify patients that would have otherwise been inappropriately discharged by the MAK score.
- fentanyl citrate / Generic mfg.
POST-OPERATIVE CROHN'S DISEASE PATIENTS UNDERGOING COLONOSCOPY REQUIRE SIGNIFICANTLY MORE ANALGESIA & SEDATION COMPARED TO A NON-IBD POST-OPERATIVE POPULATION () - May 4, 2020 - Abstract #DDW2020DDW_5178;
The median dose of midazolam administered was 3mg (IQR 2.12-4mg); median fentanyl dose was 50mcg...Comfort scores are significantly worse when compared to non-IBD patients who have had similar intestinal resections. Endoscopists should use techniques e.g. CO2 insufflation, in addition to medication to ensure comfort amongst patients with Crohn’s disease.
- fentanyl citrate / Generic mfg.
ASSESSING RESPIRATORY COMPLICATIONS IN PATIENTS WITH OBESITY AND OBSTRUCTIVE SLEEP APNEA UNDERGOING A SCREENING COLONOSCOPY WITH MODERATE AND DEEP SEDATION () - May 4, 2020 - Abstract #DDW2020DDW_5153;
There were no major background differences in sex, age or BMI (table 1). A significant race difference was noted between the two groups with majority African American (59.6%) for deep and Caucasian (59.1%) for moderate sedation (p<.001, table 1).
- fentanyl citrate / Generic mfg.
HIGH SEDATION REQUIREMENTS FOR PATIENTS AGES 45-49 YEARS UNDERGOING COLONOSCOPY COMPARED TO PATIENTS AGES 50-54 YEARS () - May 4, 2020 - Abstract #DDW2020DDW_4281;
Patients ages 45-49 years old are significantly more likely to have a high sedation requirement when undergoing colonoscopy with CS compared to patients ages 50-54 years old. When considering the cost effectiveness of population screening all average-risk adults starting at age 45 years, it is salient that younger patients added to the screening pool may require colonoscopy with anesthesia assistance more often than the currently screened population, potentially adding more cost than predicted.
- ketamine / Generic mfg.
RANDOMIZED CONTROLLED TRIAL COMPARING ENDOSCOPIST-ADMINISTERED KETAMINE TO OPIOID/BENZODIAZEPINE MODERATE SEDATION FOR ADULT OUTPATIENT ENDOSCOPY () - May 4, 2020 - Abstract #DDW2020DDW_3845;
Ketamine has the potential to greatly enhance sedation in many settings, including those with baseline abnormal hemodynamics, as well as for difficult to sedate patients. Use of ketamine will likely require education about its benefits.
- fentanyl citrate / Generic mfg.
PERSONALIZED MEDICINE IN ENDOSCOPY: PHARMACOGENOMICS PREDICT RESPONCE TO CONSCIOUS SEDATION () - May 4, 2020 - Abstract #DDW2020DDW_3844;
Rapid metabolizers for the enzyme CYP1A2 and intermediate metabolizers for enzyme CYP2C19 were more likely to require normal sedation requirements during endoscopy. These preliminary findings describe a potential benefit of applying individualized medicine in patients pursing outpatient endoscopic procedures.
- ||||| fentanyl citrate / Generic mfg.
Clinical: Another study showing larger vial size of #opioid assoc with ⬆️ intraop dosing without changes in PACU opioid administration (e.g. patients not coming to recovery with increased sings of #pain). No difference in intraop fentanyl. Need to evaluate supply chains for #anesthesiology (Twitter) - May 3, 2020
- ||| fentanyl citrate / Generic mfg.
Clinical: #TruthMatters #chronicpain Pts are NOT the casualties of ILLICIT FENTANYL AND HEROIN. We ARE CASUALTIES of MISAPPLIED MISINTERPRETED @CDCDirector CDC guidelines. #FactCheck your data‼️ STOP lying to #Americans (Twitter) - May 3, 2020
- fentanyl citrate / Generic mfg.
[VIRTUAL] Efficacy of four different analgesia techniques for patients undergoing extracorporeal shock wave lithotripsy () - May 2, 2020 - Abstract #EAUI2020EAU-I_634;
Outpatient ESWL based on an analgesic treatment protocol consisting of midazolam, fentanyl, and dexketoprofen is safe and is associated with slight pain as reported by patients. Addition of nitrous oxide, music, or a combination of both does not improve perceived pain or treatment outcomes.
- | fentanyl citrate / Generic mfg., Duragesic (fentanyl) / J&J
Journal: Utilization of transdermal fentanyl in German nursing home residents from 2010 to 2014. (Pubmed Central) - May 1, 2020
Addition of nitrous oxide, music, or a combination of both does not improve perceived pain or treatment outcomes. No abstract available
- || fentanyl citrate / Generic mfg.
Clinical, Journal: Thoracolumbar interfascial plane block provides effective perioperative pain relief for patients undergoing lumbar spinal surgery; a prospective, randomized and double blinded trial. (Pubmed Central) - May 1, 2020
No abstract available Bilateral TLIP block combined with general anesthesia provides more effective perioperative pain relief than that provided by general anesthesia alone in patients who undergo lumbar spinal surgery.
- || fentanyl citrate / Generic mfg., Instanyl (fentanyl) / Takeda
Clinical, Journal: Nitrous Oxide 70% for Procedural Analgosedation in a Pediatric Emergency Department With or Without Intranasal Fentanyl?: Analgesic Efficacy and Adverse Events if Combined With Intranasal Fentanyl. (Pubmed Central) - May 1, 2020
Because of the study design and limitations, no conclusions about adding INF to N20 70% can be made. Additional research is needed to investigate the effect of combining N20 70% with INF.
- || fentanyl citrate / Generic mfg., Instanyl (fentanyl) / Takeda
Clinical, Retrospective data, Journal: Effects of the Introduction of Intranasal Fentanyl on Reduction of Pain Severity Score in Children: An Interrupted Time-Series Analysis. (Pubmed Central) - May 1, 2020
This large study of a system-wide clinical practice guideline change has demonstrated a significant improvement in the outcome of interest. However, a proportion of children with moderate to severe pain did not receive analgesia.
- | fentanyl citrate / Generic mfg., methadone / Generic mfg.
Journal: Density of low-barrier opioid agonist clinics and risk of non-fatal overdose during a community-wide overdose crisis: A spatial analysis. (Pubmed Central) - Apr 30, 2020
However, a proportion of children with moderate to severe pain did not receive analgesia. This study found that higher availability of methadone clinics was associated with decreased odds of living within OD clusters.
- | fentanyl citrate / Generic mfg.
Journal: Metabolite Profiling of Ortho-, Meta- and Para-Fluorofentanyl by Hepatocytes and High-Resolution Mass Spectrometry. (Pubmed Central) - Apr 30, 2020
This in vitro study showed that the metabolic pattern for ortho-, meta-, and para-fluorofentanyl was close to those previously reported for other fentanyl analogues. We suggest that the hydroxymethoxy metabolite and the metabolite hydroxylated on the ethylphenyl ring should be the metabolites primarily investigated in further studies to determine the most appropriate marker for intake of fluorofentanyl derivatives in urine drug screening for human subjects.
- || fentanyl citrate / Generic mfg.
Love this paper and think it is an important consideration for the #anesthesiology community. Smaller vials of fentanyl lead to lower dosing. Fent often overused during #surgery and the need to account for waste likely pushes people to just give the rest when bigger ampules (Twitter) - Apr 30, 2020
- fentanyl citrate / Generic mfg., Duragesic (fentanyl) / J&J
[VIRTUAL] A single-arm, prospective, multicenter study on the efficacy and safety of low-dose transdermal fentanyl patch in opioid-naive patients with moderate to severe cancer pain. () - Apr 29, 2020 - Abstract #ASCO2020ASCO_6067;
Adverse reactions are mild and the quality of life of patients is improvedwith little losson cognitive function. Further randomized controlled studies are warranted to investigate the value of low-dose TDF in the treatment of opioid intolerant cancer pain.
- fentanyl citrate / Generic mfg., furosemide / Generic mfg., nebulized fentanyl citrate / Boehringer Ingelheim
[VIRTUAL] Aggregated n-of-1 randomized controlled trial of nebulized fentanyl or nebulized furosemide in palliative care patients with refractory breathlessness. () - Apr 29, 2020 - Abstract #ASCO2020ASCO_6056;
No significant different in efficacy, adverse events in nebulized fentanyl, furosemide and sterile water. N-of-1 trials may provide a rational and effective method to best choose drugs for individuals with breathlessness.
- Movantik (naloxegol) / AstraZeneca, RedHill
[VIRTUAL] Naloxegol for patients with cancer pain diagnosed with opioid induced constipation (OIC): NACASY observational study. () - Apr 29, 2020 - Abstract #ASCO2020ASCO_5059;
P=N/A
Toxicity profile was as expected. RW evidence seems to be a useful methodology to assess the real-life use of naloxegol and its efficacy in cancer patients.
- Duragesic (fentanyl) / J&J, pregabalin / Generic mfg.
[VIRTUAL] Prior authorization process improvement for pain medications in an oncology unit: Timely initiation of test claim request form. (Poster Board 322) - Apr 29, 2020 - Abstract #ASCO2020ASCO_1996;
As a result of the project, the new process has become policy and is now being used on other units in the institution for additional medications that requires CR and PA. Research Funding: None
- fentanyl citrate / Generic mfg.
[VIRTUAL] Association of intraoperative opioids with improved recurrence-free survival in triple-negative breast cancer. (Poster Board 34) - Apr 29, 2020 - Abstract #ASCO2020ASCO_1664;
Future work will focus on elucidating the underlying mechanism for this effect, including possible modulation of endogenous opioid signaling pathways and immunologic correlates. Research Funding: None
- MK-6482 / Merck (MSD)
[VIRTUAL] Phase II study of the oral HIF-2α inhibitor MK-6482 for Von Hippel-Lindau disease–associated renal cell carcinoma. () - Apr 29, 2020 - Abstract #ASCO2020ASCO_963;
P2
These data support further investigation of MK-6482 in VHL disease. Research Funding: Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA
- | fentanyl citrate / Generic mfg.
Journal: Amount of naloxone used to reverse opioid overdoses outside of medical practice in a city with increasing illicitly manufactured fentanyl in illicit drug supply. (Pubmed Central) - Apr 29, 2020
Our findings differ from studies in different areas also experiencing increasing IMF prevalence. Additional investigations are needed to clarify the amount of naloxone needed to reverse opioid overdoses in the community caused by new synthetic opioids.
- | fentanyl citrate / Generic mfg., clonazepam / Generic mfg.
Journal: Seizures as a complication of recreational drug use: Analysis of the Euro-DEN Plus data-set. (Pubmed Central) - Apr 29, 2020
This substantiates observations that the synthetic cannabinoids as a group of novel psychoactive substances are clinically different in consequence of intoxication than cannabis, and that individuals who suffer a seizure in the context of recreational drug intoxication are likely to have worse outcomes overall. Utilising this information of what substances have a greater risk of seizures, could provide tailored harm reduction and education strategies to users to reduce the risk of seizures and their associated complications.
- || fentanyl citrate / Generic mfg.
Clinical, Journal: Likelihood of Depressive Symptoms in U.S. Older Adults by Prescribed Opioid Potency: National Health and Nutrition Examination Survey 2005-2013. (Pubmed Central) - Apr 29, 2020
Compared to older adults without depressive symptoms, older adults with severe depressive symptoms are more likely to be taking high-potency opioid medications. Future prescription opioid medication research should prioritize investigations among older adults with pain-related diagnoses, other than arthritis, reporting preexisting or new symptoms of severe depression.
- | fentanyl citrate / Generic mfg., arecoline / Cogent, nalbuphine / Endo
Journal: Enhancement of opioid antinociception by nicotine. (Pubmed Central) - Apr 28, 2020
Dose-response functions for tail-withdrawal latency and operant performance were determined for fentanyl, oxycodone, buprenorphine, and nalbuphine alone and after treatment with nicotine...Failure of arecoline to augment the antinociceptive effects of oxycodone and antagonism by mecamylamine suggests this nicotine-induced augmentation of prescription opioid antinociception was nicotinic acetylcholine receptor (nAChR) mediated...The present results indicate that nicotine enhances antinociceptive effects of various opioid agonists in nonhuman primates without increasing their disruptive effects on operant performance. These results suggest that nicotine might function as an opioid adjuvant for pain management by decreasing clinically effective analgesic doses of prescription opioids without exacerbating their adverse behavioral effects.
- | fentanyl citrate / Generic mfg.
Journal: Keeping the Fentanyl Narrative Accurate. (Pubmed Central) - Apr 28, 2020
These results suggest that nicotine might function as an opioid adjuvant for pain management by decreasing clinically effective analgesic doses of prescription opioids without exacerbating their adverse behavioral effects. No abstract available
- | fentanyl citrate / Generic mfg.
Journal: The Geographic Distribution of Fentanyl-Involved Overdose Deaths in Cook County, Illinois. (Pubmed Central) - Apr 28, 2020
Published online ahead of print November 21, 2019: e1-e8. doi:10.2105/AJPH.2019.305368).
- || PK/PD data, Journal: Effect of the Most Relevant CYP3A4 and CYP3A5 Polymorphisms on the Pharmacokinetic Parameters of 10 CYP3A Substrates. (Pubmed Central) - Apr 28, 2020
Although there are few subjects carrying CYP3A4 double mutations, the effect in those might be relevant, especially due to the majority of subjects lacking the CYP3A5 enzyme. In heterozygous subjects, the consequence might be less noticeable due to the high inducible potential of the CYP3A4 enzyme.
- |||| fentanyl citrate / Generic mfg.
Clinical: You absolutely know most ODs R caused by illicit fentanyl & polypharmaceutical abuse. Most ODs have no valid Rx of any kind, any pharma produced drugs on board are stolen/scammed. Stop lying & propaganda. Don’t punish pain patients because of drug addicts.... fully treat both. (Twitter) - Apr 28, 2020
- |||| fentanyl citrate / Generic mfg.
Clinical: You never expect that chronic & intractable pain pts., cancer pts., palliative care pts. would b tortured bcause of addicts abusing heroin, illicit fentanyl & rarely diverted prescription opioids either but, it’s happening! (Twitter) - Apr 28, 2020
- |||| fentanyl citrate / Generic mfg.
Clinical: That is a noble goal It would be best facilitated by going after the production and import of illicit fentanyl and heroin Making mental health accessible & affordable to those with chemical addiction disease Leave the access to pain medication available to patients & their MDs (Twitter) - Apr 28, 2020
- || fentanyl citrate / Generic mfg.
Pandemic disrupts #fentanyl supply chain via Wuhan https://t.co/06YANzCFac @DrPtw @kellyrayknight @Kasimpson10 (Twitter) - Apr 27, 2020
- || fentanyl citrate / Generic mfg., Suboxone (buprenorphine/naloxone sublingual film) / Indivior
Statistics have proven time & again that there's no prescription opioid crisis just illicit fentanyl &heroin showing up as opioids in tests! You’re correct that it stems from greed tho, PROP & Andrew Kolodny wanted to sell Suboxone! Research it! #DontPunishPainNational (Twitter) - Apr 27, 2020
- |||| fentanyl citrate / Generic mfg.
Clinical: Sadly the corrupt jackasses will do nothing about the illicit fentanyl epidemic and instead keep destroying the lives of pain patients (Twitter) - Apr 27, 2020
- | pregabalin / Generic mfg.
Journal, Benefit-risk assessment: A pragmatic utility function to describe the risk-benefit composite of opioid and non-opioid analgesic medication. (Pubmed Central) - Apr 27, 2020
Study 2 was an experimental study on the effect of intravenous fentanyl on antinociception and respiratory depression in healthy volunteers...A pragmatic utility function based on the probability of two binary outcomes, analgesia and adverse effect, was successfully constructed using data from two previous studies. Results yielded valuable insights into the utility of treatment and may be highly educative for physicians and may be used in development of potent analgesics with serious side effects.
- || fentanyl citrate / Generic mfg.
Even fentanyl! (Twitter) - Apr 27, 2020
- fentanyl citrate / Generic mfg.
Minimizing Cardiac Oedema during Ex Vivo Perfusion in a Juvenile Porcine Model - How Much Does Coronary Flow Matter? () - Apr 26, 2020 - Abstract #ISHLT2020ISHLT_873;
After intubation and propofol/fentanyl anesthesia was induced, median sternotomy was performed and the heart prepared for harvest...Conclusion We found a lower degree of oedema formation in the 600ml/min perfusion group, but similar metabolic response as the group with higher flows. . We suggest using this slightly reduced flow when investigating juvenile porcine hearts in an ex-vivo perfusion model.
- | Selincro (nalmefene oral) / Lundbeck, Acorda, nalmefene intranasal (OPNT003) / Opiant
Journal: Fighting fire with fire: development of intranasal nalmefene to treat synthetic opioid overdose. (Pubmed Central) - Apr 26, 2020
following a 1 mg IV dose. The high affinity, very rapid onset, and long half-life (>7 h) of IN nalmefene present distinct advantages as a rescue medication, particularly against longer-lived synthetic opioids.
- | fentanyl citrate / Generic mfg.
Journal: Navigating social norms of injection initiation assistance during an overdose crisis: A qualitative study of the perspectives of people who inject drugs (PWID) in Vancouver, Canada. (Pubmed Central) - Apr 26, 2020
Despite the proliferation of fentanyl and fentanyl-adulterated opioids in North America, the impacts of this drug market change on injection initiation processes have not been examined...Our analysis of how PWID practice interpersonal responsibility helps conceptualise how 'moral codes' prohibiting initiation assistance are managed and negotiated amidst structural vulnerability. Structural interventions reducing the vulnerability of novice injectors should be prioritized, including the implementation of supervised injection sites allowing for assisted injection, Good Samaritan laws, and policy changes conducive to a safer drug supply.
- || fentanyl citrate / Generic mfg.
Apparently Fentanyl and 2.5" computer hard drives (the kinds used in many laptops) were primary industries in Wuhan. An IT guy was telling me that there was a period of a few weeks where none of the major IT retailers could get hard drives. (Twitter) - Apr 26, 2020
- | fentanyl citrate / Generic mfg.
Preclinical, Journal: Methocinnamox (MCAM) produces long-lasting antagonism of the behavioral effects of µ opioid receptor agonists but not prolonged precipitated withdrawal in rats. (Pubmed Central) - Apr 26, 2020
Before MCAM, morphine, fentanyl, and the κ-opioid receptor agonist spiradoline dose dependently increased tail-withdrawal latency from 50°C water; MCAM attenuated the antinociceptive effects of morphine and fentanyl, but not spiradoline...This study demonstrates that MCAM selectively antagonizes multiple effects mediated by μ opioid receptor agonists for 2 weeks or longer, and like naloxone, MCAM precipitates withdrawal in morphine-dependent rats. Despite this persistent antagonism, withdrawal signs precipitated by MCAM are not significantly different from signs precipitated by naloxone or occurring after discontinuation of morphine, suggesting that using MCAM for opioid abuse or overdose would not produce sustained withdrawal.