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39 Diseases |  |
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18506 News |  |
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- | fentanyl citrate / Generic mfg.
Journal: Noradrenergic Mechanisms in Fentanyl-Mediated Rapid Death Explain Failure of Naloxone in the Opioid Crisis. (Pubmed Central) - Apr 26, 2020
This article reviews literature demonstrating that naloxone and other mu opioid receptor antagonists are ineffective against the underlying central noradrenergic effects of F/FA, which clinically manifest as the rapid onset of severe muscle rigidity and airway compromise (e.g. wooden chest syndrome) and are distinct from the respiratory depression seen with F/FA and morphine derived alkaloids. A physiologic model is proposed and implications for new drug development and treatment are discussed.
- ||| fentanyl citrate / Generic mfg.
Clinical, Journal, Adverse events: Opioid-related respiratory and gastrointestinal adverse events in patients with acute postoperative pain: prevalence, predictors, and burden. (Pubmed Central) - Apr 26, 2020
Utilizing the Premier Healthcare Database, we identified patients > 18 years old, who underwent at least one surgical procedure of interest (i.e., cardiothoracic/vascular, general/colorectal, obstetric/gynecologic, orthopedic, or urologic), and received at least one dose of intravenous morphine, hydromorphone, or fentanyl for acute postoperative pain...When respiratory depression or nausea/vomiting was present versus absent, LOS was significantly longer, and hospital costs were higher. In this analysis, OIRD and PONV were more prevalent than previously reported, were associated with identifiable risk factors, and had substantial effects on resource utilization and costs.
- || fentanyl citrate / Generic mfg.
Clinical, Journal: Clinical Manifestations and Diagnostic Evaluation of Opioid Allergy Labels - A Review. (Pubmed Central) - Apr 26, 2020
Thus, allergy labels to relatively lower potency opioids such as codeine may be feasibly result in the prescription of stronger medications like fentanyl that would otherwise not be indicated.This narrative review provides an overview of the epidemiology and clinical manifestations of opioid allergy labels commonly encountered by pain management practitioners along with recommendations for evaluation and management.A literature search of PubMed was performed using the comprehensive MeSH term, "Opioid Allergy".In recent years, it has become apparent that a substantial proportion of patients labeled as opioid allergic are found to be tolerant of these agents...Future directions should include larger prospective studies with systematic evaluation and classification of opioid allergy labels to determine future viability of opioid use. Abbreviations EHR electronic health record NMBA neuromuscular blocking agent IgE immunoglobulin E MC mast cell GPCR G-protein coupled receptor MRGPRX2 mas-related G-protein receptor QAI quaternary ammonium ions SCAR severe cutaneous adverse reaction AGEP acute generalized exanthematous pustulosis SDRIFE symmetrical drug-related intertriginous and flexural exanthema BAT basophil activation testing DPT drug provocation testing.
- || fentanyl citrate / Generic mfg.
Did not realize acute shortages of fentanyl in our ICU & rising tensions among regional drug cartels were linked: they rely on supply from Wuhan😳 https://t.co/bnO2Obk3Ve (Twitter) - Apr 26, 2020
- || fentanyl citrate / Generic mfg.
Clinical, Journal: A pediatric cancer patient with suspected chemical coping following high-dose opioid therapy: a case report. (Pubmed Central) - Apr 26, 2020
Abbreviations EHR electronic health record NMBA neuromuscular blocking agent IgE immunoglobulin E MC mast cell GPCR G-protein coupled receptor MRGPRX2 mas-related G-protein receptor QAI quaternary ammonium ions SCAR severe cutaneous adverse reaction AGEP acute generalized exanthematous pustulosis SDRIFE symmetrical drug-related intertriginous and flexural exanthema BAT basophil activation testing DPT drug provocation testing. When chemical coping is suspected in pediatric patients, after differentiating from pseudo-addiction, it might be necessary to restrict the prescription for appropriate use and to provide opioid education while taking into consideration the emotional background of the patient that led to chemical coping.
- || fentanyl citrate / Generic mfg.
Seems lately to have been sedation ‘dujour’ of late depending on what’s not in short supply for the week | hydromorphone vs fentanyl | maybe some inexperience in crisis of this immensity driving practice | seeing midaz on top of propofol | dex to 1.5ug | rocuronium with proning (Twitter) - Apr 25, 2020
- || fentanyl citrate / Generic mfg.
Do we really know if alcohol and THC were used before opioids? I wonder if anyone has looked at the tox report or autopsy just to be sure. Were fentanyl analogs tested? (Twitter) - Apr 25, 2020
- || fentanyl citrate / Generic mfg.
Clinical, Journal: Incidence of Chronic Opioid Use in Previously Opioid-Naïve Patients Receiving Opioids for Analgesia in the Intensive Care Unit. (Pubmed Central) - Apr 25, 2020
All patients received fentanyl infusion, for a median time of 35 hours (interquartile range 18.8-64.7 hours)...The incidence of chronic opioid use decreased at 6 and 12 months compared with that of 3 months postdischarge. ICU type and hospital admission related to surgery were not associated with increased opioid use at 3 months.
- fentanyl citrate / Generic mfg.
A novel TLR adjuvant increases the efficacy of vaccines against fentanyl-induced toxicity and overdose (Board Number: P1245) - Apr 25, 2020 - Abstract #IMMUNOLOGY2020IMMUNOLOGY_2655;
Likewise, in a fentanyl challenge model, combination adjuvanted vaccines increased protection from respiratory depression compared to mice vaccinated with antigen alone or single adjuvant controls. These data demonstrate that TLR adjuvants improve the anti-fentanyl adaptive immune response and increase protection against fentanyl challenge in mice, and may enhance vaccine-induced protection against fentanyl overdose in humans.
- || fentanyl citrate / Generic mfg.
Clinical, Journal: Comparison of Programmed Intermittent Epidural Boluses With Continuous Epidural Infusion for the Maintenance of Labor Analgesia: A Randomized, Controlled, Double-Blind Study. (Pubmed Central) - Apr 24, 2020
Under the conditions of our study, we did not find improved outcomes with programmed intermittent epidural boluses compared to continuous epidural infusion except for less motor block with programmed intermittent epidural boluses. Future studies should assess whether smaller but clinically important differences exist and evaluate different parameters of programmed intermittent epidural boluses to optimize analgesia and outcomes with this mode of analgesia.
- || fentanyl citrate / Generic mfg.
Clinical, Journal: Evaluating the Effect of Intravenous Acetaminophen in Multimodal Analgesia After Total Hip Arthroplasty: A Randomized Controlled Trial. (Pubmed Central) - Apr 24, 2020
Postoperative administration of IA significantly reduced the postoperative pain score and opioid consumption volume after primary THA. IA was useful as one role of multimodal pain management after THA.
- | fentanyl citrate / Generic mfg., Precedex (dexmedetomidine) / Orion, Pfizer
Retrospective data, Journal: The prevalence of emergence delirium and its associated factors among children at a postoperative unit: A retrospective cohort at a Middle Eastern hospital. (Pubmed Central) - Apr 23, 2020
It is crucial to address any preoperative anxiety assessment as it is associated with ED. Anxiety remains a modifiable factor that can be managed, as well as to the administration of Precedex and adjunct analgesic treatments.
- || fentanyl citrate / Generic mfg.
Retrospective data, Review, Journal: Efficacy of Intrathecal Fentanyl for Cesarean Delivery: A Systematic Review and Meta-analysis of Randomized Controlled Trials With Trial Sequential Analysis. (Pubmed Central) - Apr 22, 2020
Current evidence suggests a benefit of using fentanyl as both an additive to intrathecal bupivacaine alone and to intrathecal bupivacaine combined with morphine for cesarean delivery under spinal anesthesia. The possibility of publication bias, small sample size, and high risk of bias in some of the included studies warrant treating the results with caution.
- || fentanyl citrate / Generic mfg., epinephrine / Generic mfg.
Clinical, Journal: Perioperative Anesthetic and Transfusion Management of Veno-Venous Extracorporeal Membrane Oxygenation Patients Undergoing Noncardiac Surgery: A Case Series of 21 Procedures. (Pubmed Central) - Apr 22, 2020
VV ECMO patients can be anesthetized using either inhalational or intravenous anesthetics. Patient hemodynamics, oxygenation, and decarboxylation require frequent interventions, but can typically be optimized to meet clinically acceptable thresholds.
- | fentanyl citrate / Generic mfg.
Journal: Fentanyl shock: The changing geography of overdose in the United States. (Pubmed Central) - Apr 22, 2020
These findings shed light on the "third-wave" of the overdose epidemic, characterized by rapid and geographically disparate changes in drug supply that heighten the risk of overdose. Above all, they underscore the urgency of adopting evidence-based policies to combat addiction in light of the rapidly changing drug environment.
- || fentanyl citrate / Generic mfg.
Clinical, Journal: "One guy goes to jail, two people are ready to take his spot": Perspectives on drug-induced homicide laws among incarcerated individuals. (Pubmed Central) - Apr 22, 2020
Above all, they underscore the urgency of adopting evidence-based policies to combat addiction in light of the rapidly changing drug environment. Findings highlight the importance of centering the experiences of people with OUD in creating policies surrounding the overdose epidemic, potential unintended health consequences of drug-induced homicides laws such as deterrence from calling 911 and increased violence, and how drug-induced homicide laws may undermine advances made in expanding access to OUD treatment for people who are criminal justice-involved.
- || fentanyl citrate / Generic mfg.
PK/PD data, Journal: Automated proper lumping for simplification of linear physiologically based pharmacokinetic systems. (Pubmed Central) - Apr 22, 2020
In simplify an existing linear fentanyl PBPK model, SA was found to be robust and the most efficient and may be suitable for general application to other larger-scale linear systems. Ultimately, simplified PBPK systems with fundamental mechanisms may be readily used for data-driven PK analyses.
- || fentanyl citrate / Generic mfg., ketamine / Generic mfg.
Clinical, Journal: Oligoanalgesia in Patients With an Initial Glasgow Coma Scale Score ≥8 in a Physician-Staffed Helicopter Emergency Medical Service: A Multicentric Secondary Data Analysis of >100,000 Out-of-Hospital Emergency Missions. (Pubmed Central) - Apr 22, 2020
However, 17.1% of patients received no type of pain therapy, which suggests a scope for further improvement in prehospital pain therapy. Pharmacological and nonpharmaceutical pain relief should be initiated whenever indicated.
- || fentanyl citrate / Generic mfg.
Clinical, Journal: The Emerging Role of Toxic Adulterants in Street Drugs in the US Illicit Opioid Crisis. (Pubmed Central) - Apr 22, 2020
Pharmacological and nonpharmaceutical pain relief should be initiated whenever indicated. No abstract available
- | fentanyl citrate / Generic mfg., methadone / Generic mfg.
Retrospective data, Journal: The Persistence of Opioid Use Following Surgical Admission: An Australian Single-Site Retrospective Cohort Study. (Pubmed Central) - Apr 21, 2020
Thirteen (1.3%) patients continued Schedule 8 opioids for at least 6 months following their surgery, with the indication for treatment either related to the surgery or the condition which surgery was sought for. This study found that there was a low rate of Schedule 8 opioid persistence following surgery, indicating post-surgical pain is not a significant driver for persistent opioid use.
- | fentanyl citrate / Generic mfg., methamphetamine / Generic mfg.
Journal: Unintentional drug overdose: Is more frequent use of non-prescribed buprenorphine associated with lower risk of overdose? (Pubmed Central) - Apr 21, 2020
The findings support our hypothesis that higher frequency of non-prescribed buprenorphine use is associated with lower risk of drug overdose, a potential harm reduction consequence of diversion. Improving the availability of buprenorphine though standard substance use disorder treatment, primary care, and other innovative methods is urgently needed.
- || fentanyl citrate / Generic mfg.
Wrong, Opioid prescriptions are at the lowest in history & have been the last 2 decades statistically. Prescription opioids were never the problem, just a scapegoat. The data, facts & statistics prove it. There was never a prescription opioid crisis, just an illicit fentanyl one. (Twitter) - Apr 20, 2020
- || fentanyl citrate / Generic mfg., alprazolam / Generic mfg.
The reality is people who are overdosing are doing mostly because they buy black market drugs with no quality control and have no idea how much they are really taking. Pure fentanyl is being sold as xanax. Heroin is more powerful than ever. We need a war on stupidity. Not meds. (Twitter) - Apr 18, 2020
- | Duragesic (fentanyl) / J&J
Journal: Evaluation of Analgesic Patches in Cynomolgus Macaques (Macaca fascicularis). (Pubmed Central) - Apr 17, 2020
These findings suggest that 25-μg/h fentanyl patches should be replaced every 4 d, and the low and high-dose buprenorphine patches should be replaced every 5 and 6 d, respectively. The results of this study show that fentanyl and buprenorphine patches achieve minimal therapeutic levels for clinically relevant periods of time and should be considered viable options for pain management in cynomolgus macaques.
- fentanyl citrate / Generic mfg., Belviq (lorcaserin) / Eisai
[VIRTUAL] Studies of Continuous Lorcaserin Plus Buprenorphine in Rat Fentanyl Self-Administration () - Apr 17, 2020 - Abstract #CPDD2020CPDD_419;
Further, chronic buprenorphine, with or without lorcaserin, resulted in sustained inhibition of fentanyl intake. Taken together, these studies provide support for further interrogation of the efficacy or lorcaserin as a viable adjunct pharmacotherapy to combat OUD.
- fentanyl citrate / Generic mfg., ketamine / Generic mfg.
[VIRTUAL] Pharmacodynamic Effects, Pharmacokinetics, and Metabolism of the Novel Synthetic Opioid, U-47700, in Male Rats () - Apr 17, 2020 - Abstract #CPDD2020CPDD_402;
The drug displays linear kinetics, and its N-desmethyl metabolites achieve mean Cmax values in the same range as the parent compound, with sustained half-lives. Pharmacodynamic effects of U-47700 are closely related to plasma concentrations of the parent compound, but a role of the metabolites cannot be ruled out.
- fentanyl citrate / Generic mfg., methamphetamine / Generic mfg.
[VIRTUAL] Impact of Opioid Dependence and Withdrawal on the Relative Reinforcing Effects of Fentanyl, Methamphetamine, and Cocaine in Rats () - Apr 17, 2020 - Abstract #CPDD2020CPDD_373;
Opioid dependence and withdrawal did not affect the reinforcing effectiveness of methamphetamine or cocaine. These findings suggest that motivations to use opioids are dependent on the state of the individual whereas stimulants retain their reinforcing effects regardless of whether the individual is in a state of opioid dependence or withdrawal.
- fentanyl citrate / Generic mfg.
[VIRTUAL] Immunological Approaches to the Fentanyl Epidemic - Long-Acting Opioid Vaccine () - Apr 17, 2020 - Abstract #CPDD2020CPDD_372;
- fentanyl citrate / Generic mfg.
Immunological Approaches to the Fentanyl Epidemic - Lessons Learned From Cocaine Vaccine Clinical Trials Applied to Fentanyl Vaccines () - Apr 17, 2020 - Abstract #CPDD2020CPDD_371;
- fentanyl citrate / Generic mfg.
[VIRTUAL] Immunological Approaches to the Fentanyl Epidemic - Fentanyl Immunotherapy and Monoclonal Antibodies () - Apr 17, 2020 - Abstract #CPDD2020CPDD_370;
- fentanyl citrate / Generic mfg.
[VIRTUAL] Immunological Approaches to the Fentanyl Epidemic () - Apr 17, 2020 - Abstract #CPDD2020CPDD_369;
Session III will focus on development of both vaccines and mAb to counteract fentanyl as well as biomarkers predictive of individual variability in vaccine efficacy against fentanyl and other opioids. For instance, mAb may be deployed to counteract acute fentanyl-induced toxicity and overdose in emergency setting and potentially be combined to naloxone to improve survival after accidental or deliberate exposure to fentanyl and its analogs.
- fentanyl citrate / Generic mfg., methamphetamine / Generic mfg.
[VIRTUAL] Characteristics of Emergency Department Patients With Untreated Opioid Use Disorder in Four Geographically Diverse Cities () - Apr 17, 2020 - Abstract #CPDD2020CPDD_354;
Overall more than half the patients with OUD report unstable housing. Strategies to improve access to care and overcome barriers to treatment are needed.
- fentanyl citrate / Generic mfg.
[VIRTUAL] Vaccines to Counteract Illicit Use and Prevent Fatal Overdose of Fentanyl and Its Analogs () - Apr 17, 2020 - Abstract #CPDD2020CPDD_341;
Strategies to improve access to care and overcome barriers to treatment are needed. These pre-clinical data support translation of vaccines as a strategy to counteract toxicity and prevent fatal overdoses from fentanyl and its analogs.
- fentanyl citrate / Generic mfg., methamphetamine / Generic mfg.
[VIRTUAL] Take Home Drug Checking as a Novel Harm Reduction Strategy in British Columbia, Canada () - Apr 17, 2020 - Abstract #CPDD2020CPDD_330;
Fentanyl positivity in stimulants may not be equivalent, suggesting a need for further education and evaluation. This harm reduction strategy is feasible and acceptable to PWUD.
- fentanyl citrate / Generic mfg.
[VIRTUAL] Self-Reported Medical and Non-Medical Prescription Fentanyl Use in a Household Sample of Us Adults in 2015-2017: Associations With Other Substance Use () - Apr 17, 2020 - Abstract #CPDD2020CPDD_320;
Polysubstance use was high among people reporting non-medical prescription fentanyl use, particularly heroin and sedative/tranquilizer use, which are associated with overdose risk. Additional services may be needed for people prescribed fentanyl in order to prevent potential fentanyl-related harms, particularly among those reporting non-medical use.
- fentanyl citrate / Generic mfg.
Oral Communications: Fentanyl () - Apr 17, 2020 - Abstract #CPDD2020CPDD_301;
- fentanyl citrate / Generic mfg.
[VIRTUAL] Fentanyl-Targeted Vaccine Attenuates Fentanyl-Versus-Food Choice in Rhesus Monkeys () - Apr 17, 2020 - Abstract #CPDD2020CPDD_283;
These results translate fentanyl vaccine effectiveness from rats to rhesus monkeys to decrease fentanyl vs. food choice, albeit with more individual differences observed in monkeys. Moreover, these results support the potential of opioid-targeted vaccines as candidate Opioid Use Disorder medications.
- fentanyl citrate / Generic mfg.
[VIRTUAL] Escalation and Reinstatement of Fentanyl Self-Administration in Male and Female Rats () - Apr 17, 2020 - Abstract #CPDD2020CPDD_276;
Although initial acquisition of 1-hr fentanyl SA was more rapid in females, sex differences were not observed in escalation. However, for reinstatement, comparison between 1and 6-hr groups showed that dysregulation of intake following escalation induced greater fentanyl seeking in males only.
- methamphetamine / Generic mfg.
[VIRTUAL] Re-Emergence of Methamphetamine: Observations From a High-Risk Prenatal Population () - Apr 17, 2020 - Abstract #CPDD2020CPDD_230;
In the wake of the opioid epidemic, maternal MA use has quietly resurfaced as a national public health concern. These data demonstrate that improved efforts for primary prevention of maternal MA use is a continuing need.
- fentanyl citrate / Generic mfg.
[VIRTUAL] Predicting Counties At-Risk of a Synthetic Opioid Overdose Outbreak: A Statistical Modeling Approach () - Apr 17, 2020 - Abstract #CPDD2020CPDD_226;
We show that, by leveraging observed data from 2012-2016, our model was able to accurately predict which counties would experience a synthetic opioid overdose outbreak in 2017. Having demonstrated model performance, next steps will entail predicting future overdose outbreaks, as such modeling forecasts can inform much needed preemptive responses.
- fentanyl citrate / Generic mfg.
[VIRTUAL] Opportunities and Challenges to Piloting a Community-Based Drug-Checking Intervention for Young Sexual and Gender Minority Men in Vancouver, Canada: A Qualitative Study () - Apr 17, 2020 - Abstract #CPDD2020CPDD_75;
Our findings support the feasibility of implementing DCIs for YSGM as a means to improve access to information about substance use and to reduce potential harms, including overdose. The involvement of community-based organizations in developing DCIs is needed to provide tailored services that address the specific needs of YSGM who use substances.
- || fentanyl citrate / Generic mfg., remifentanil / Generic mfg.
Review, Journal: Opioids and cerebral physiology in the acute management of traumatic brain injury: a systematic review. (Pubmed Central) - Apr 16, 2020
Opioids are beneficial in terms of analgesia and sedation, but bolus administration should be avoided to prevent additional or prolonged unfavourable alterations in cerebral physiology. Future studies should better elucidate the effects of different opioids as well as varying dosages in order to develop improved understanding as well as allow for tighter control of cerebral physiology.
- || fentanyl citrate / Generic mfg., remifentanil / Generic mfg.
Review, Journal: Targeting the Orexin System for Prescription Opioid Use Disorder. (Pubmed Central) - Apr 16, 2020
The orexin system has been implicated in the regulation of motivation, arousal, and stress, making this system a promising target for the treatment of substance use disorder. This review discusses recent preclinical studies that suggest that orexin receptor blockade could be beneficial for the treatment of prescription opioid use disorder.
- || fentanyl citrate / Generic mfg.
Clinical, Journal: Does the Serratus Plane Block Added to the Interscalene Block Improve the Quality of Anesthesia in Arthroscopic Shoulder Surgery? A Prospective Randomized Study. (Pubmed Central) - Apr 16, 2020
This review discusses recent preclinical studies that suggest that orexin receptor blockade could be beneficial for the treatment of prescription opioid use disorder. SPB added to the ISBPB increases the quality of surgical anesthesia and reduces the need for intraoperative sedoanalgesia for arthroscopic shoulder surgery.
- | fentanyl citrate / Generic mfg.
Journal: Association between posttraumatic stress disorder and nonfatal drug overdose. (Pubmed Central) - Apr 15, 2020
The findings from this study support the need to incorporate a trauma-informed approach within the current overdose prevention framework. Education and training relating to trauma and PTSD should be prioritized for health care professionals who work with and treat PWUD.
- | fentanyl citrate / Generic mfg.
Retrospective data, Journal: Intraoperative Dexmedetomidine Versus Midazolam in Patients Undergoing Peripheral Surgery With Mild Traumatic Brain Injuries: A Retrospective Cohort Analysis. (Pubmed Central) - Apr 15, 2020
The intra- and postoperative effects of dexmedetomidine are not completely consistent and midazolam/fentanyl is most widely used in peripheral surgeries...Intraoperative DEX offers better sedation, postoperative analgesia, and clinical recovery for peripheral surgeries and suppresses inflammatory response. III.
- | fentanyl citrate / Generic mfg.
Journal: Treating Non-fentanyl-derived Synthetic Opioid Overdose with a Traditional Opioid Reversal Agent. (Pubmed Central) - Apr 15, 2020
With a high rate of success in treating opioid overdose and a low chance of negatively affecting healthy non-dependent persons, naloxone is an ideal medication in these situations. We recommend the use of naloxone in cases of NSO opioid overdose and advocate for the increased availability of naloxone products to improve overdose outcomes nationwide.
- || fentanyl citrate / Generic mfg., naloxone nasal spray / Generic mfg.
How does medicine help in the fight against #opioid abuse and deaths? @RogerCrystalMD, our President and CEO, shares his own motivation for developing NARCAN® Nasal Spray and his perspective on the opioid situation today and the danger of #fentanyl. #RXSummit2020 (Twitter) - Apr 15, 2020
- || fentanyl citrate / Generic mfg.
Clinical, Journal: Ultrasound-guided erector spinae plane block versus oblique subcostal transversus abdominis plane block for postoperative analgesia of adult patients undergoing laparoscopic cholecystectomy: Randomized, controlled trial. (Pubmed Central) - Apr 14, 2020
We recommend the use of naloxone in cases of NSO opioid overdose and advocate for the increased availability of naloxone products to improve overdose outcomes nationwide. Ultrasound-guided ESP block reduced postoperative tramadol consumption and pain scores more effectively than OSTAP block after laparoscopic cholecystectomy surgery.
- | fentanyl citrate / Generic mfg., remifentanil / Generic mfg.
Retrospective data, Journal: High-dose versus low-dose opioid anesthesia in adult cardiac surgery: A meta-analysis. (Pubmed Central) - Apr 14, 2020
Our data suggest that low-dose opioids, both short acting and long acting, are safe and effective to use in adult cardiac surgery patients, independent of the clinical characteristics of the patients and the type of opioid used. In view of the current opioid epidemic, low-dose opioid anesthesia should be considered for cardiac surgery patients.