- |||||||||| fentanyl citrate / Generic mfg.
Journal: The exercise pressor reflex and chemoreflex interaction: cardiovascular implications for the exercising human. (Pubmed Central) - Mar 16, 2020
The EPR and hypercapnia-induced CR interaction results in a simple addition of the individual responses to each reflex (i.e. additive interaction). Collectively, EPR:CR co-activation results in significant cardiovascular interactions with restriction in peripheral hemodynamics, resulting from the EPR:CR interaction in hypoxia, likely having the most crucial impact on the functional capacity of an exercising human.
- |||||||||| fentanyl citrate / Generic mfg., Ultane (sevoflurane) / Generic mfg.
Aerosol Inhalation Therapy of Ipratropium Bromide Improve Perioperative Respiratory Mechanics in Patients Undergoing Orthotopic Liver Transplantation (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area J) - Mar 15, 2020 - Abstract #ATS2020ATS_10289;
Ipratropium bromide 500 μg in 10ml of normal saline was aerosol inhaled before anesthesia induction and 1 hour of neohepatic phase in group A. The same volume of physiological saline (10ml) was aerosol inhaled in group C. Peak inspiratory pressure (PIP), Mean inspiratory pressure (Pmean), Dynamic lung compliance (Cdyn), Oxygenation index (OI), Respiratory index (RI) and the concentrations of inflammatory cytokines in Exhaled breath condensate (EBC) were recorded immediately before operation (T1), at the end of the operation(T2), and at 24 hours after the operation(T3). The occurrence of pulmonary complications was recorded with 7 days after the operation.Results Compared with group C, PIP, Pmean, RI and TNF-α and IL-8 concentrations in EBC were significantly decreased, while Cdyn and OI were increased at T1 and T3, and the incidence of acute lung injury and pulmonary infection were decreased within 7 days after the operation (P<0.05).Conclusions Aerosol inhalation therapy of Ipratropium bromide has protective effect on lung in patients undergoing orthotopic liver transplantation.
- |||||||||| fentanyl citrate / Generic mfg.
Feasibility of Using a Pharmacogenetic Assay in Mechanically Ventilated Adults (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area K) - Mar 15, 2020 - Abstract #ATS2020ATS_9746;
We targeted adult patients who had initiation of mechanical ventilation in the previous 72 hours and who had received >1 dose of fentanyl 25 mcg IV or morphine 2 mg IV or continuous infusion in the prior 24 hours...This was our only observed adverse event. ConclusionAlthough the sample size of our current study is too small to conduct inferential analyses, our demonstration of feasibility paves the way for a large study utilizing pharmacogenomics to determine the effects of genetic variability on response to analgesosedation in the ICU.
- |||||||||| fentanyl citrate / Generic mfg., vancomycin / Generic mfg., azithromycin / Generic mfg.
An Unexplained Non-Convulsive Status Epilepticus: Always Do a Medication Review (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area A) - Mar 15, 2020 - Abstract #ATS2020ATS_9601;
He was sedated with continuous infusion of propofol and intermittent doses of fentanyl with daily sedation holiday where he would wake up and respond to verbal commands...Once diagnosis is reached, treatment is easily done by discontinuation of cefepime although some patients may require hemodialysis. Benzodiazepines and other anticonvulsants could be used for active seizures until the medication is cleared out of the body.
- |||||||||| fentanyl citrate / Generic mfg., vancomycin / Generic mfg.
A Rare Cause for a Broken Heart: Right-Sided Invasive Infectious Endocarditis (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area A) - Mar 15, 2020 - Abstract #ATS2020ATS_9513;
A 34-year-old female with a history of intravenous fentanyl abuse presented to emergency department (ED) with fevers, generalized malaise, nausea, vomiting, abdominal pain, and back pain with high grade gram-positive cocci bacteremia...She was continued on Vancomycin due to persistent methicillin-resistant staphylococcus aureus bacteremia and required pressor support for developing septic shock...She was continued on antibiotics for 6 weeks after the surgery and was eventually discharged home but was unfortunately readmitted one year later with relapse of disease from recurrent intravenous drug use. The rarity of invasive right sided endocarditis has been thought to be due to the pressures exerted by the heart2, but this case shows that invasive disease can be apparent in the setting of intravenous abuse.
- |||||||||| Duragesic (fentanyl) / J&J
Aaaah-choo! It’s the Flu...and an Arterial Thrombosis Too (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area A) - Mar 15, 2020 - Abstract #ATS2020ATS_9499;
Due to difficulty with oxygenation on maximum ventilator settings, a neuromuscular blocker (NMB) was started in addition sedation with Propofol and Fentanyl...Pathogenesis of arterial thromboses is thought to be associated with increased release of pro-inflammatory mediators, inflammation induced endothelial damage and platelet activation. Due to the high morbidity of arterial thromboses, it is important to be aware of this entity to ensure prompt diagnosis and appropriate therapy when available.
- |||||||||| Flagyl (metronidazole) / SLA
An Old Foe Returns: Fulminant Generalized Tetanus in a Community Setting (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area A) - Mar 15, 2020 - Abstract #ATS2020ATS_9484;
A diagnosis of generalized tetanus was made, prompting the administration of human tetanus immunoglobulin, tetanus toxoid, and metronidazole...Given her history of polysubstance abuse and high tolerance to sedatives, she required high dose propofol, fentanyl, and midazolam infusions...Tetanus is a rare but severe illness that most practitioners in the USA are not familiar with, but is something healthcare providers should be vigilant for, given the prevalent era of vaccine skepticism. Treatment involves neutralization of the offending toxin with immunoglobulin, and antibiotics.
- |||||||||| fentanyl citrate / Generic mfg.
Impact of Group III/IV Afferent Feedback on Breathing Pattern During Incremental Cycling Exercise to Peak Capacity in Patients with COPD (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area H) - Mar 15, 2020 - Abstract #ATS2020ATS_8544;
These tests were separated at least by 7 days, and were performed after either active (intrathecal administration of 25 μg fentanyl) or sham (NaCl) spinal anesthesia, in a cross-over, randomized, and double-blind fashion... Spinal anesthesia exerted only a modest influence on breathing pattern during incremental cycling exercise tests in patients with COPD suggesting that group III/IV afferent signalization of the lower limbs is not a major regulator of exercise performance during this form of exercise in patients with COPD.
- |||||||||| fentanyl citrate / Generic mfg.
Percutaneous Tracheostomy in Pregnancy: Case Series (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area E) - Mar 15, 2020 - Abstract #ATS2020ATS_8177;
There are limited reports of tracheostomy during pregnancy. We report case series of 2 patients who required percutaneous tracheostomy.
- |||||||||| Decadron (dexamethasone) / Merck (MSD)
A Rare Case of Acquired Pseudocholinesterase Deficiency (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area E) - Mar 15, 2020 - Abstract #ATS2020ATS_8152;
The following medications were administered in the OR: fentanyl 150mcg, propofol 220mg, midazolam 2mg, decadron, toradol, rocuronium 70mg and succinylcholine 150mg...Reversal agents sugammadex 600mg, glycopyrrolate, ephedrine 100mg and neostigmine were administered...This case demonstrates the importance to identify patients at risk and recognize the signs and symptoms of this deficiency in order to prevent complications including prolonged mechanical ventilation. The infrequency of encountering this deficiency made it a unique presentation.
- |||||||||| fentanyl citrate / Generic mfg.
Fentanyl Induced Chest Wall Rigidity (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area G) - Mar 15, 2020 - Abstract #ATS2020ATS_7885;
It is, therefore, important to consider this rare side effect of opioids as a cause of inadequate ventilation. Future use of fentanyl or other opioids is not contraindicated as per current guidelines.
- |||||||||| ketamine / Generic mfg.
Ketamine Infusion for ICU Sedation and Analgesia: A Multicenter Evaluation (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area G) - Mar 15, 2020 - Abstract #ATS2020ATS_6934;
Other sedative or opioid infusions were administered with ketamine in 76% (propofol most frequently) and 92% (fentanyl most frequently) of cases, respectively. Ketamine infusion was most frequently used as an adjunct to more standard sedative and opioid infusions in this ICU population, with noticeable but unintended effects attributed to ketamine in nearly one-quarter of cases.
- |||||||||| fentanyl citrate / Generic mfg.
Pulsus Bisferiens Without Aortic Valve Disease (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area K) - Mar 15, 2020 - Abstract #ATS2020ATS_6791;
Urine toxicology was positive for fentanyl, cocaine and alcohol...Despite supportive management, the patient succumbed to multi-system organ failure. Knowledge of arterial waveforms is important in managing critically ill patients and provides rapid insight to underlying cardiovascular pathophysiology.
- |||||||||| Palliative Care Utilization Among Veterans with Advanced Interstitial Lung Disease (PENNSYLVANIA CONVENTION CENTER, Hall G (100 Level)) - Mar 15, 2020 - Abstract #ATS2020ATS_2710;
Within the cohort who died, the median age at diagnosis was 74 years (IQR 68-82 years), all were men, 69% had idiopathic pulmonary fibrosis, 65% received pirfenidone, 4% nintedanib, and 31% mycophenolate mofetil...No patients received palliative medications, including morphine, oxycodone, fentanyl and dilaudid, outside of palliative care or hospice...Over half of veterans at this center who died following initiation of advanced ILD therapies had been referred to palliative care. Given the high mortality of ILD in this population, attention should be paid ensuring that all veterans have the opportunity to avail themselves of this service.
- |||||||||| fentanyl citrate / Generic mfg.
Clinical, Journal: Spectrum of Current Management of Pediatric Pulmonary Hypertensive Crisis. (Pubmed Central) - Mar 14, 2020
Fentanyl and dexmedetomidine were the preferred sedative infusions...Findings from this survey may inform formal recommendations - particularly with regard to care team composition and pulmonary vasodilator therapies - as North American guidelines are currently lacking. Additional work is needed to determine best practice, standardization of practice, and resulting impact on outcomes.
- |||||||||| 3-day fentanyl transdermal patcht / Generic mfg., olanzapine / Generic mfg.
Clinical, Journal: Craving Behavior from Opioid Addiction Controlled with Olanzapine in an Advanced Cancer Patient: A Case Report. (Pubmed Central) - Mar 14, 2020
We present a case of a 59-year-old man with advanced colon cancer whose compulsive craving for the buccal tablet of fentanyl citrate (BTFC) was improved with the use of olanzapine...Craving behavior as a result of opioid addiction may be controlled with olanzapine. Further prospective studies on this issue are warranted.
- |||||||||| fentanyl citrate / Generic mfg.
Journal: Identification of Opioids and Related Substances using Handheld Raman Spectrometers. (Pubmed Central) - Mar 13, 2020
This study describes the performance of handheld Raman devices for detecting one hundred opioids and related substances including fentanyl and several analogs...The devices yielded true-negative, false-positive and false-negative rates of 100%, 0%, and 2.7%, respectively, where false negatives were due to weak signal and fluorescence. These data demonstrate that the parent-daughter electronic transfer method was successful and effective, which permits the ability to develop methods in the laboratory that can be seamlessly pushed out to field devices.
- |||||||||| fentanyl citrate / Generic mfg.
Journal: LC-QTOF-MS Identification of Major Urinary Cyclopropylfentanyl Metabolites Using Synthesized Standards. (Pubmed Central) - Mar 12, 2020
Cyclopropylfentanyl is a fentanyl analog implicated in 78 deaths in Europe and over 100 deaths in the United States, but toxicological information including metabolism data about this drug is scarce...Interestingly, with the exception of norcyclopropylfentanyl (M1), the metabolites appeared to be between 40% and 90% conjugated in urine. In total, 11 metabolites of cyclopropylfentanyl were identified, including most metabolites previously reported after hepatocyte incubation.
- |||||||||| fentanyl citrate / Generic mfg.
Journal: Higher naloxone dosing may be required for opioid overdose. (Pubmed Central) - Mar 12, 2020
Opioid-free anesthesia as a part of multimodal analgesia and a new anesthesiology technique is a safe procedure, where opioid-related negative effects in patients undergoing elective laparoscopic cholecystectomy are avoided. While more robust studies should be considered, emergency personnel should be comfortable using higher-than-standard doses of naloxone in appropriate cases.
- |||||||||| fentanyl citrate / Generic mfg.
Journal: Towards a Non-Invasive Cardiac Arrest Monitor: an in vivo pilot study. (Pubmed Central) - Mar 10, 2020
Also, tissue motion represents a significant obstacle for CABF measurement during CPR. Additional work will determine the feasibility and utility of non-imaging ultrasound measurements of CABF during resuscitation.
- |||||||||| fentanyl citrate / Generic mfg., methadone / Generic mfg.
Clinical, Journal: Opioid Safety and Concomitant Benzodiazepine Use in End-Stage Renal Disease Patients. (Pubmed Central) - Mar 10, 2020
Current safety classification of opioids in these patients is misleading, and even drugs considered safe based on pharmacokinetic data are associated with moderate to very high risk of hospitalization. We propose a risk-stratified classification of opioids and suggest starting to use them in all ESRD patients.
- |||||||||| fentanyl citrate / Generic mfg.
Journal: Optical fiber sensors for monitoring in critical care. (Pubmed Central) - Mar 10, 2020
Drug level monitoring is demonstrated in vitro using a long period grating coated with molecularly imprinted polymer nanoparticles that are sensitive to fentanyl. The sensor has a limit of detection of 50ng/ml.
- |||||||||| fentanyl citrate / Generic mfg.
[VIRTUAL] DESCRIPTION OF PRESCRIPTION OPIOID USE AMONG US ADULTS () - Mar 8, 2020 - Abstract #ISPOR2020ISPOR_164;
This study showed that opioids prescription use varied based on patient’s sociodemographic and clinical characteristics. The results of this study can inform prescribing behavior, research related to the opioid epidemic, and clinical decision-making processes.
- |||||||||| fentanyl citrate / Generic mfg., Vivitrol (naltrexone extended-release injectable suspension) / Alkermes, methadone / Generic mfg.
Review, Journal: Opioid use disorder and treatment: challenges and opportunities. (Pubmed Central) - Mar 4, 2020
Governments must take decisions based on efficacy, safety, and cost-effectiveness of medications. This special issue focuses on how health services research has emerged as an important contributor to efforts to control the opioid epidemic in North America and Europe.
- |||||||||| fentanyl citrate / Generic mfg., morphine/oxycodone (Q8011) / QRxPharma, methadone / Generic mfg.
[VIRTUAL] USE OF OPIATE FOR HIP AND KNEE OSTEOARTHRITIS BEFORE AND AFTER JOINT REPLACEMENT SURGERY (Poster Tour) - Mar 4, 2020 - Abstract #EULAR2020EULAR_888;
Multiple strategies need to be used to develop analgesic plans that allow adequate rehabilitation, without precipitating a chronic opiate dependence. Clinicians would also benefit from clear guidelines for prescribing strong opiates.
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