fentanyl citrate News - LARVOL Sigma

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Years of Life Lost Due to Opioid Overdose in Ohio () - Feb 20, 2020 - Abstract #ASAM2020ASAM_275;
Opioid overdose mortality rose annually. Fentanyl involved overdoses accounted for an increasing proportion of excess mortality.

|||||||||| fentanyl citrate / Generic mfg., ketamine / Generic mfg., methadone / Generic mfg.
Three Cases of Buprenorphine Microinduction in Critically Ill Patients () - Feb 20, 2020 - Abstract #ASAM2020ASAM_268;
Buprenorphine microinduction should be considered in any situation where a patient cannot tolerate the standard induction. Potential applications include transitioning from full opioid agonist analgesia, sedation weans in critically ill patients, and induction for traditional application in the treatment of opioid dependence.

|||||||||| methadone / Generic mfg.
Race-Based Differences in Self-Report Drug Use at an Urban Methadone Treatment Program () - Feb 20, 2020 - Abstract #ASAM2020ASAM_258;
They were also more likely to have ever been prescribed opioids and to have used prescription opioids prior to heroin/fentanyl. These differences, which cannot be accounted for by indicators of socioeconomic status, may reflect cultural, environmental and/or geographic differences leading to different exposures.

|||||||||| fentanyl citrate / Generic mfg., methadone / Generic mfg.
Promise of Illicit Drug Mortality Reduction After Jail Through Opioid Agonist Treatment () - Feb 20, 2020 - Abstract #ASAM2020ASAM_257;
Discordant trends in illicit drug fatalities during the study period between detainees released from Cook County Jail and the rest of Cook County suggest CCH’s system-wide harm reduction efforts inclusive of jail-based agonist treatment may be effective. Effect of continuation of opioid agonist treatment after release should be followed.

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Real-world use of extended-release buprenorphine (XR-BUP) in a low threshold Bridge clinic () - Feb 20, 2020 - Abstract #ASAM2020ASAM_210;
This real-world application of XR-BUP in a low threshold clinic setting found that treatment was feasible, well tolerated, and outcomes were good, with most individuals choosing to continue treatment and a majority with no evidence of ongoing opioid use or precipitated withdrawal. Administering SL BUP for fewer than the recommended seven days was safe and did not worsen outcomes, XR-BUP 300mg monthly dosages were safe, and a substantial portion of patients required supplemental SL BUP during the first few months of XR-BUP.

|||||||||| fentanyl citrate / Generic mfg., methamphetamine / Generic mfg.
Implementing Supervised Consumption Service Access for Emergency Department Patients () - Feb 20, 2020 - Abstract #ASAM2020ASAM_185;
Discussion / Impact Being able to reduce unintentional overdoses and unwitnessed injection drug use in the ED has the potential to improve both patient and staff safety. Next steps include a case series designed to examine the impact of SCS access on emergency care, retention in treatment and uptake into addiction treatment.

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Fentanyl Frenzy: Truth and Pearls in a New Era of Addiction Medicine. (Colorado Ballroom, Level 3) - Feb 20, 2020 - Abstract #ASAM2020ASAM_131;

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[VIRTUAL] A population-based study on the risk and causes of death among long-term opioid analgesics users in Taiwan (Station 12) - Feb 20, 2020 - Abstract #EPA2020EPA_3085;
This was a population-based cohort study including a sample of 12,990 non-cancer long-term opioid analgesics (Fentanyl, Morphin, Tramadol, and Codeine) adult users (>18 years) selected from Taiwan’s National Health Insurance claims in 2000-2012... Long-term opioid analgesics uses in Taiwan were associated with significantly elevated risk of mortality from all-cause and various natural and non-natural causes.

|||||||||| Duragesic (fentanyl) / J&J
[VIRTUAL] Prescription of opioid drugs in a patient sample with head and neck tumors (All Screens in Poster Area) - Feb 20, 2020 - Abstract #EPA2020EPA_1300;
The results about the prevalence of prescription of opioids in the sample of patients studied reflect a good practice of the use of these drugs in patients with head and neck tumours. The high prevalence of risk factors that are associated with the development of misuse, abuse and dependence of these drugs must be taken into account.

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Clinical, Journal: Pre-emptive analgesia with continuous fascia iliaca compartment block reduces postoperative delirium in elderly patients with hip fracture. A randomized controlled trial. (Pubmed Central) - Feb 20, 2020
The incidence of PD was lower in the experimental group (13.9% versus 35.7%, p=0.018). In addition, before the surgery, a drop in consumption of fentanyl was noted in the experimental group (0.08±0.21 versus 0.28±0.13, p=0.037).Conlusion: Pre-emptive analgesia with continuous FICB is an effective technique to reduce PD in geriatric patients with hip fracture.

|||||||||| fentanyl citrate / Generic mfg., Duragesic (fentanyl) / J&J
Clinical, Journal: Risk Factors for Poor Pain Control after Opioid Switching from Oxycodone Tablet to Fentanyl Patch. (Pubmed Central) - Feb 20, 2020
The initial dose increase after switching to FP was earlier in patients with CDHPBR and/or without LM than those without CDHPBR and with LM (p < 0.05, log-rank test). It was suggested that the analgesic effect of FP after switching from OXC is likely to be insufficient in patients treated with CDHPBR and patients without LM.

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Came on service in despite fentanyl and midazolam infusion constant high ICP, @changc808 started pentobarbital and ICP significant decrease #CCC49 #PharmICU (Twitter) - Feb 18, 2020

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Facing a looming fentanyl crisis, organizations in the US/Mex are promoting safe consumption practices Education, not scare tactics @PrevencasaAc @AnyPosChange @LeoBeletsky @DanCiccarone @DrPtw @alexhkral @BCCSU @Narcocast @Talkingdrugs @RyanMarino @rs_mcneil (Twitter) - Feb 17, 2020

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Clinical: I do not know why you are against opioid use for chronic pain patients when less than 1% addict this is statistics and number the real epidemic which is illicit Fentanyl has skyrocketed since prescriptions went down prests are not the cause of the epidemic (Twitter) - Feb 16, 2020

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Clinical, Observational data, Journal: Prospective Observational Evaluation of Sedation and Pain Management Guideline Adherence Across New Jersey Intensive Care Units. (Pubmed Central) - Feb 16, 2020
It was suggested that the analgesic effect of FP after switching from OXC is likely to be insufficient in patients treated with CDHPBR and patients without LM. Current sedation practices suggest that integration of evidence-based PAD guidelines across New Jersey adult ICUs is inconsistent despite pharmacist involvement.

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Journal: Sex differences in the effectiveness of buprenorphine to decrease rates of responding in rhesus monkeys. (Pubmed Central) - Feb 16, 2020
The present study compared the behavioral effects of three MOR ligands (fentanyl, buprenorphine, and naltrexone) that varied in efficacy to stimulate [S]-GTPγS binding (from highest to lowest: fentanyl, buprenorphine, and naltrexone) in male and female rhesus monkeys...Naltrexone did not significantly alter behavior in either females or males. Overall, these results suggest that the expression of sex differences in MOR pharmacology depends upon both the efficacy of the MOR ligand and the behavioral endpoint.

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Journal: Fentanyl test strips as an opioid overdose prevention strategy: Findings from a syringe services program in the Southeastern United States. (Pubmed Central) - Feb 16, 2020
We found that using FTS and receiving a positive test result was associated with changes in drug use behavior and perceptions of overdose safety. FTS may represent an effective addition to current overdose prevention efforts when included with other evidence-based strategies to prevent opioid overdose and related harm.

|||||||||| fentanyl citrate / Generic mfg., methadone / Generic mfg.
Clinical, Journal: Agreement between self-reported psychoactive substance use and urine toxicology results for adults with opioid use disorder admitted to hospital. (Pubmed Central) - Feb 15, 2020
The change in agreement over time of self-reported heroin use may reflect an increasing number of patients unknowingly using illicit fentanyl products. Among hospitalized patients with OUD, agreement between reported psychoactive substance use history and UDS results is strong with the exception of opiates, heroin, and benzodiazepines.

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Clinical, Journal, Adverse events: Health benefits of an adverse events reporting system for chronic pain patients using long-term opioids. (Pubmed Central) - Feb 14, 2020
Among hospitalized patients with OUD, agreement between reported psychoactive substance use history and UDS results is strong with the exception of opiates, heroin, and benzodiazepines. This data recording system provided important information to achieve a better control of CNCP pharmacological pain therapy, improving patient's health status and reducing costs to the Health System.

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Journal: Impact of intracranial hypertension on the short-term prognosis in dogs undergoing brain tumor surgery. (Pubmed Central) - Feb 14, 2020
All dogs were administered midazolam and droperidol-fentanyl as premedication...ICP hypertension (>13 mmHg) measured after 15 min of recovery from the moment after discontinuation of anesthesia by turning off the vaporizer dial was associated with poor prognosis (odds ratio, 20.00; 95% confidence interval, 1.39-287.60, P=0.028). This suggests that intracranial pressure influences the postoperative mortality rate in dogs undergoing brain tumor surgery.

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Observational data, Retrospective data, Journal: Factors associated with polyp detection during colonoscopy: A retrospective observational study. (Pubmed Central) - Feb 14, 2020
Moreover, when stratified by sex and age, the midazolam/fentanyl sedation was associated with polyp detection in male patients and patients over 50 years old. This study has highlighted the role of midazolam/fentanyl sedation administered by colonoscopists as a modifiable factor that may increase polyp detection during colonoscopy.

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Journal: Malignant cerebellar edema in three-year-old girl following accidental opioid ingestion and fentanyl administration. (Pubmed Central) - Feb 14, 2020
This case adds insight by suggesting that lipophilic opioid analgesics may worsen this neurotoxicity. When intervening with mechanical ventilation, clinicians should consider avoiding lipophilic opioid drugs for analgesia until the pathogenesis of cerebellar edema is better understood.

|||||||||| methamphetamine / Generic mfg.
Journal: Methamphetamine Use: A New Wave in the Opioid Crisis? (Pubmed Central) - Feb 14, 2020
Some individuals are more likely to respond to medications such as long-acting naltrexone, bupropion, and mirtazapine, who have light-to-moderate use of methamphetamine. Naloxone kits should be considered for all patients who are actively using stimulants because of a high potential of adulterated methamphetamine.

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Journal: Development of an UPLC-MS/MS method for the analysis of 16 synthetic opioids in segmented hair, and evaluation of the polydrug history in fentanyl analogue users. (Pubmed Central) - Feb 14, 2020
Two authentic samples from two Belgian post-mortem cases, were also analysed showing fentanyl use and in one case polydrug use. The results demonstrated multi-analyte quantitative methods, including fentanyl analogues, are becoming useful in forensic laboratories involved in hair analysis, and in particular when polydrug use is suspected.

|||||||||| fentanyl citrate / Generic mfg., remifentanil / Generic mfg.
Clinical, Review, Journal: Study of the rational dose of propofol in elderly patients under bispectral index monitoring during total intravenous anesthesia: A PRISMA-compliant systematic review. (Pubmed Central) - Feb 14, 2020
The results demonstrated multi-analyte quantitative methods, including fentanyl analogues, are becoming useful in forensic laboratories involved in hair analysis, and in particular when polydrug use is suspected. Propofol maintenance in the O group was significantly lower than that in the nonelderly group; this indicates that the anesthetic drug delivery rate for elderly patients should be reduced.

|||||||||| fentanyl citrate / Generic mfg., methamphetamine / Generic mfg.
Near Real-Time Determination of the Prevalence of Illicit Drugs, Cannabinoids, Cathinones, and Synthetic Opioids in four Rural Counties in Illinois Using Wastewater-based Epidemiology (Versailles, Sofitel Philadelphia at Rittenhouse Square) - Feb 13, 2020 - Abstract #ACSSp2020ACS_Sp_17090;
Methcathinone, 5-IT, MAB-CHMINACA, 4-methylamphetamine, 1-(3-chlorophenyl) piperazine (mCPP), 4-methyl pentedrone, 2-methyl-4’(methylthio)-2-morpholinopropiophenone, alpha-ethylaminohexanophenone, carfentanil,methoxyacetyl fentanyl, and valerylfentanyl were the most abundant NPS. The prescription opioids and methamphetamine were more prevalent in communities with per-capita-income whereas the cocaine was found more prevalent in a university town.

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Computational study of THz spectra of fentanyl and its analogs (Versailles, Sofitel Philadelphia at Rittenhouse Square) - Feb 13, 2020 - Abstract #ACSSp2020ACS_Sp_17089;
The substitution of single bond or one aromatic group lead to specific pattern of THz spectra. This study makes it possible to develop a database of spectra and predict the spectrum of fentanyl analog with similar conformation.

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Solid polymer-peroxide complexes for the decomposition of chemical warfare agent and fentanyl analogues (Concerto A/B, Doubletree by Hilton Philadelphia Center City) - Feb 13, 2020 - Abstract #ACSSp2020ACS_Sp_16806;
The powder mixture was further electrospun into fibrous mat and its effectiveness as a self-decontaminating garment was assessed. Finally, we show that this complex react with analogues of fentanyl, and thus can serve as an effective tool against the burgeoning opioid epidemic.

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Combined MM/GBSA and NMR study of fentanyl binding to modified b-cyclodextrins (Exhibit Hall D, Pennsylvania Convention Center) - Feb 13, 2020 - Abstract #ACSSp2020ACS_Sp_12949;
This combination of methods holds promise in the design of artificial receptors with high binding affinity for fentanyls. Additionally, the simulations are able to correctly predict the specific binding orientation of the fentanyl and these finding further validated by two-dimensional Rotating frame nuclear Overhauser Effect SpectroscopY (ROESY).

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Elucidating mu-opioid receptor-agonist interactions and unbinding pathways by weighted ensemble molecular dynamics method (Exhibit Hall D, Pennsylvania Convention Center) - Feb 13, 2020 - Abstract #ACSSp2020ACS_Sp_12939;
Since WE method focuses on sampling rare events, dissociation pathways and rate constants can be determined rapidly. Our intial WE results showed the posibility of multiple unbinding pathways as well as the dependency of kinetics rates on such pathways.

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Fentanyl unbinding pathways and kinetics from a metadynamics study (Exhibit Hall D, Pennsylvania Convention Center) - Feb 13, 2020 - Abstract #ACSSp2020ACS_Sp_12919;
The method expediates the dissociation by orders of magnitude, while recovering the unbiased dissociation times in the range comparable to experimental values. Furthermore, a new high-affinity ligand binding pocket located beneath the orthosteric binding site is identified, providing new insights into receptor desensitization and drug tolerance.

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Tracing illicit fentanyl through synthetic impurities via liquid chromatography tandem mass spectrometry (LC-MS/MS) (Exhibit Hall A, Pennsylvania Convention Center) - Feb 13, 2020 - Abstract #ACSSp2020ACS_Sp_6667;
The identity of the initial impurity mixture based on the identity of impurities and their corresponding concentrations was accomplished. This study can be applied to the tracing of other illicit or counterfeit drugs back to their source.

|||||||||| fentanyl citrate / Generic mfg., methamphetamine / Generic mfg.
Wastewater-based epidemiology methods and analysis of opioids and illicit substances (Exhibit Hall A, Pennsylvania Convention Center) - Feb 13, 2020 - Abstract #ACSSp2020ACS_Sp_6149;
Wastewater-based drug epidemiology has the ability to monitor community use of illicit drugs like methamphetamine, cocaine, as well as prescription opioids such as oxycodone...Instrumental analyses have been developed and optimized on an LC-MS/MS (Waters Xevo G2-XS QtoF) for the target compounds in raw wastewater. These developed methods will be presented along with results from samples from several wastewater treatment plants.

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Machine learning methods for the prediction of spectra and identification of opioids and their derivatives (Strasbourg, Sofitel Philadelphia at Rittenhouse Square) - Feb 13, 2020 - Abstract #ACSSp2020ACS_Sp_381;
THz comparisons are made with recently calculated DFT specta of fentanyl and analogues. Current work will lead to intelligent detection schemes for future opiods and derivatives.

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Strength in numbers: Library of chemical color tests improves presumptive identification of illicit drugs and cutting agents (108A, Pennsylvania Convention Center) - Feb 13, 2020 - Abstract #ACSSp2020ACS_Sp_107;
Through analysing samples collected in 2019 by the Marion County Coroner’s office and the Chicago Recovery Alliance, we have found that heroin/fentanyl mixtures are being replaced by products that contain only fentanyl, inspiring drug users to concoct dangerous “speedball” mixtures of opioids and benzodiazepines or amphetamines. Eliminating this behaviour may be an avenue for harm reduction.

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Rare Dual Diagnosis- Primary Anoxic Brain Injury with Subsequent Idiopathic Spinal Cord Ischemia Resulting in ASIA A Paraplegia: Rehab and Recovery, a Case Report. () - Feb 11, 2020 - Abstract #ISPRM2020ISPRM_1434;
Some studies report as high as 60% of primary diagnosis SCI patient have a concomitant brain injury, however the incidence of primary brain injured patients with secondary idiopathic spinal cord injuries are much less common and are a rare challenge in rehab.Conclusions : This rare dual diagnosis presented a unique challenge to our rehab team. However, through collaboration between PM&R specialists in Brain Injury and Spinal Cord Injury, this patient’s rehab plan was tailored to overcome these challenges.

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Management and Morbidity of Paroxysmal Sympathetic Hyperactivity and Sequelae in Young Female with Anoxic Brain Injury. () - Feb 11, 2020 - Abstract #ISPRM2020ISPRM_1176;
This case demonstrates potential efficacy of benzodiazepine use in PSH maintenance and acute exacerbation management. As seen in our case, patient likely succumbed to gastrointestinal complications, re-enforcing the morbidity of PSH as a multisystem disorder.

|||||||||| fentanyl citrate / Generic mfg., morphine/oxycodone (Q8011) / QRxPharma
Long term use of opioids in patients discharged from an Interdisciplinary Chronic Non Malignant Pain Program () - Feb 11, 2020 - Abstract #ISPRM2020ISPRM_1155;
This study provides evidence that long term adherence to pain clinic medication recommendations are not necessarily followed for different reasons. Therefore, being enrolled in a structured pain program would improve compliance, adherence and follow up with this population thus optimizing pain management and overall quality of life.

|||||||||| Decadron (dexamethasone) / Merck (MSD), Duragesic (fentanyl) / J&J
Iliohypogastric Peripheral Nerve Stimulation for Chronic Cancer Pain () - Feb 11, 2020 - Abstract #ISPRM2020ISPRM_1041;
A diagnostic and therapeutic transversus abdominal plane block targeting the right iliohypogastric nerve was performed with 15 mL of 0.25% bupivicaine and 5 mg dexamethasone resulting in 100% pain relief for 2 days...Conclusions : Our case report is unique in that it demonstrates the use of PNS of the iliohypogastric nerve as a treatment for intractable cancer-related pain. To our knowledge, there have been no case reports describing peripheral nerve stimulation of the iliohypogastric nerve for chronic pain related to colon cancer.

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Clinical, Observational data, Journal: Perioperative noninvasive cardiac output monitoring in parturients with singleton and twin pregnancies undergoing caesarean section under spinal anesthesia with prophylactic phenylephrine drip: A prospective observational cohort study. (Pubmed Central) - Feb 9, 2020
All parturients received standardized spinal solution consisting of 12 mg hyperbaric bupivacaine, 20 µg fentanyl and 100-µg preservative-free morphine...However postoperatively at all three times women with twin pregnancies had higher MAP, lower CO and higher TPR compared with parturients with singleton pregnancies There were significant hemodynamic changes postoperatively but not intraoperatively in parturients with twin pregnancies compared to women with singleton pregnancies. These changes need to be further investigated.

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Journal: Synthesis and biological evaluation of fentanyl analogues modified at phenyl groups with alkyls. (Pubmed Central) - Feb 9, 2020
Compounds 10 and 11 are potent MOP receptor agonists with weak δ-opioid (DOP) receptor agonist activity and moderate KOP receptor antagonist activity as well as weak β-arrestin2 recruitment activity at the MOP receptor. These compounds are promising leads for discovery of potent opioid analgesics with reduced side effects relative to clinically available strong opioid analgesics.

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Journal: The tripping point: The potential role of psychedelic-assisted therapy in the response to the opioid crisis. (Pubmed Central) - Feb 9, 2020
The increasing contamination of the drug supply with illicitly manufactured fentanyl and related analogs in North America has resulted in the most severe drug-overdose crisis in history...Re-emerging clinical research suggests that psychedelic-assisted therapy has potential as an alternative treatment for refractory substance use disorders and related comorbidities. Based on the available evidence, our viewpoint supports advancing research on the potential role of psychedelic-assisted therapy within a multifaceted response to the opioid crisis.

|||||||||| fentanyl citrate / Generic mfg., Duragesic (fentanyl) / J&J
Journal: Evaluation of the fentanyl patch-for-patch program in Ontario, Canada. (Pubmed Central) - Feb 9, 2020
The program had no measurable impact on rates of opioid toxicity-related hospital visits or deaths. Policymakers should consider the use of P4P programs as part of larger opioid strategy.

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Journal: Growth of Microorganisms in Propofol and Mixture of Propofol, Lidocaine and Fentanyl. (Pubmed Central) - Feb 8, 2020
Lidocaine was shown to have antibacterial effect which carries advantage for inhibiting infections due to propofol; but aseptic technique is essential during preparation of propofol infusions. Fentanyl like propofol also promoted the growth at room and body temperatures.

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Clinical, Journal: Combined Oral Fentanyl Citrate and Midazolam as Premedication for Bone Marrow Aspiration and Biopsy in Patients with Hematological Malignancies: A Randomized, Controlled and Patient-Blinded Clinical Trial. (Pubmed Central) - Feb 8, 2020
Finally, histological specimens were higher in quality in the combo group. Sedoanalgesia was highly effective in reducing pain during biopsy, diminished anticipatory anxiety in patients undergoing re-biopsy and led to fewer non-diagnostic specimens being harvested.

|||||||||| fentanyl citrate / Generic mfg., remifentanil / Generic mfg., duloxetine delayed release / Generic mfg.
Journal: Serotonin syndrome triggered by postoperative administration of serotonin noradrenaline reuptake inhibitor (SNRI). (Pubmed Central) - Feb 8, 2020
Sedoanalgesia was highly effective in reducing pain during biopsy, diminished anticipatory anxiety in patients undergoing re-biopsy and led to fewer non-diagnostic specimens being harvested. Anesthesiologists should be aware of the risk of perioperative serotonin syndrome in patients taking antidepressants affecting serotonin metabolism.

|||||||||| Clinical, Journal: Anesthetic management of a patient with chronic inflammatory demyelinating polyneuropathy by combination of total intravenous and regional anesthesia. (Pubmed Central) - Feb 8, 2020
The patient was uneventfully extubated in the operating room after confirming adequate spontaneous breathing. The postoperative course was uneventful without any respiratory complications such as respiratory depression, aspiration pneumonia, or progression of CIPD symptoms.

|||||||||| fentanyl citrate / Generic mfg., Ultane (sevoflurane) / Generic mfg.
Clinical, Journal: Anesthetic management of a pediatric patient with arginase-1 deficiency undergoing strabismus operation: a case report. (Pubmed Central) - Feb 8, 2020
Only a few cases of arginase-1 deficiency had been reported and much remains unknown about its pathology. Therefore, information sharing among medical professionals is essential to customize the plan for the management of this disorder in patients.

|||||||||| Duragesic (fentanyl) / J&J
Clinical, Journal: Therapeutic experience with tramadol for opioid dependence in a patient with chronic low back pain: a case report. (Pubmed Central) - Feb 8, 2020
Therefore, information sharing among medical professionals is essential to customize the plan for the management of this disorder in patients. Our case highlighted that sustained-release tramadol could be effectively applied as a detoxification agent for iatrogenic opioid dependence in patients with chronic non-cancer pain.

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Clinical, Journal: Fentanyl-associated anaphylaxis in an infant with tetralogy of Fallot: a case report. (Pubmed Central) - Feb 8, 2020
Intradermal testing revealed fentanyl anaphylaxis. We were able to manage the patient by using of morphine as an alternative opioid for the subsequent anesthesia.



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