- |||||||||| fentanyl citrate / generics
Clinical, Journal: Effect of magnesium and lignocaine on post-craniotomy pain: A comparative, randomized, double blind, placebo-controlled study. (Pubmed Central) - Oct 3, 2019
We carried out this study to evaluate the effect of magnesium and lignocaine on postoperative pain as assessed using the visual analog scale (VAS) and fentanyl consumption...However, a significant decline was noted in the levels of S100 B in the magnesium group. Intraoperative infusion of lignocaine and magnesium results in lower VAS score and decreases the postoperative opioid requirement in patients undergoing craniotomy for excision of supratentorial tumors.
- |||||||||| morphine/oxycodone (Q8011) / QRxPharma
Journal: Opioid Rotation in Cancer Pain Treatment. (Pubmed Central) - Oct 2, 2019
Tables of equianalgesic doses should be considered no more than a rough guide for determining the dose of the new drug. Rotations to methadone should be carried out under clinical supervision in experienced hands.
- |||||||||| fentanyl citrate / generics
Journal: Activity-Based Concept to Screen Biological Matrices for Opiates and (Synthetic) Opioids. (Pubmed Central) - Oct 2, 2019
The MOR reporter assay allows rapid identification of opioid activity in blood. Although the cooccurrence of opioid antagonists is currently a limitation, the bioassay's high detection capability, specificity, and untargeted nature may render it a useful first-line screening tool to investigate potential opioid intoxications.
- |||||||||| Instanyl (fentanyl) / Takeda
Clinical, Journal: Combined nitrous oxide 70% with intranasal fentanyl for procedural analgosedation in children: a prospective, randomised, double-blind, placebo-controlled trial. (Pubmed Central) - Oct 2, 2019
P3
Initiatives to improve the delivery of prolonged sedatives and analgesic infusions should be informed by PK parameters (Vd, context-sensitive t, and elimination t) and data derived from critically ill patients. Combining NO 70% with INF resulted in no differences with regard to FLACC scale score, self-reported pain, MBPS score, patient and parental satisfaction rate, sedation depth, and adverse events.
- |||||||||| NLS-11 - NLS / 1 Pharma
Nurse Led Sedation: The Clinical and Echocardiographic Outcomes of the 7-Year Emory Experience () - Oct 1, 2019 - Abstract #TCT2019TCT_220;
Background Our center has developed protocols for nurse-led sedation (NLS) in which nonanesthetist heart team nurses directly provide sedation with fentanyl and midazolam...Mean gradients were similar between groups (NLS 11.3 ± 46 mm Hg vs. MAC 11.8 ± 5.0 mm Hg; p = 0.47)...There are no clinically significant differences in post-deployment hemodynamic status or valve area with NLS compared with anesthetist-led moderate sedation. NLS is associated with significantly shorter procedure room time and contrast volume than anesthetist-led moderate sedation.
- |||||||||| fentanyl citrate / generics
Journal: Connecting the dots: an association between opioids and acute hippocampal injury. (Pubmed Central) - Sep 28, 2019
This observation suggests an association between opioids and acute hippocampal injury. With particular attention to the Massachusetts cluster and data on fentanyl and its congeners, the epidemiological and pathophysiological evidence that supports this hypothesis is presented, as are potential underlying mechanisms.
- |||||||||| fentanyl citrate / generics
Clinical, Journal: Electric stimulation-guided epidural analgesia for vaginal delivery: A randomized prospective study. (Pubmed Central) - Sep 28, 2019
Intravenous sedation is a better choice than inhaled nitrous oxide for pain control in second-trimester abortion. Although limited by lack of blinding, small study size and inclusion of pilot study data, this study suggests epidural electric stimulation improves the success rate of subsequent labor analgesia.
- |||||||||| dexamethasone / generics
Clinical, Journal: Opioid Free Anesthesia for Laparotomic Hemicolectomy: A Case Report. (Pubmed Central) - Sep 28, 2019
VAS score 2 hours after surgery was 6/10 and 1 gr of paracetamol was given and the patient was transferred to the Department. Over the next 3 days, the patient had a VAS score of 4-6/10 and only received paracetamol 3x1g and novalgetol 3x1 gr daily, every four hours.
- |||||||||| fentanyl citrate / generics
Clinical, Journal: Non-invasive patient-controlled analgesia in the management of acute postoperative pain in the hospital setting. (Pubmed Central) - Sep 26, 2019
Evidence-based guidelines for acute postoperative pain management support the use of multimodal regimens in many situations. As effective and safe alternatives to conventional PCA, and with the added benefits of being non-invasive, easy to use and allowing early patient mobilization, the newer PCA systems may complement multimodal approaches, or potentially replace certain regimens, in hospitalized patients with acute postoperative pain.
- |||||||||| fentanyl citrate / generics
Journal: Protection from fentanyl exposure: New resources from NIOSH. (Pubmed Central) - Sep 26, 2019
As effective and safe alternatives to conventional PCA, and with the added benefits of being non-invasive, easy to use and allowing early patient mobilization, the newer PCA systems may complement multimodal approaches, or potentially replace certain regimens, in hospitalized patients with acute postoperative pain. No abstract available
- |||||||||| Duragesic (fentanyl) / J&J
Clinical, Journal: Factors Affecting Opioid Treatment in Cancer Patients. (Pubmed Central) - Sep 26, 2019
This knowledge may help person-center care in moderate to severe cancer pain. This article is open to POST-PUBLICATION REVIEW. Registered readers (see "For Readers") may comment by clicking on ABSTRACT on the issue's contents page.
- |||||||||| fentanyl citrate / generics, methadone / generics
Clinical, Journal: A case report of sweating caused by hydromorphone. (Pubmed Central) - Sep 26, 2019
Under-recognition of this medication side-effect may lead to patient discomfort as well as a potentially unnecessary work-up to determine the etiology of the sweating. Here, we discuss severe sweating caused by hydromorphone that resolved upon the medication's discontinuation.
- |||||||||| Duragesic (fentanyl) / J&J
ACUTE LEUKOENCEPHALOPATHY DUE TO HEROIN ABUSE (Ernest N. Morial Convention Center - Exhibit Hall - Poster Area 4) - Sep 25, 2019 - Abstract #CHEST2019CHEST_3534;
Clinical Implications: We believe that our reported experience may influence others to consider evaluating this feature in spontaneously breathing patients thus potentially eliminating the need for general anesthesia. There are case reports of leukoencephalopathy related to fentanyl patches...Given the rising opioid epidemic, one needs to be cognisant of this condition with it's distinct imaging on MRI for early recognition, management and prognosis.
- |||||||||| tacrolimus / Generic Mfg., quetiapine / Generic Mfg.
FENTANYL ACCUMULATION IN RENAL DISEASE CAUSING SEROTONIN SYNDROME (Ernest N. Morial Convention Center - Exhibit Hall - Poster Area 4) - Sep 25, 2019 - Abstract #CHEST2019CHEST_3515;
These patients are often on numerous medications and are at risk for interaction with drugs required in the intensive care setting. Use of alternative agents like remifentanil, alfentanil which have shorter half lives or use of intermittent pushes of fentanyl is a simple measure which can decrease the burden of this complication.
- |||||||||| Duragesic (fentanyl) / J&J, quetiapine / Generic Mfg.
MEDICAL MANAGEMENT OF BILATERAL FLAIL CHEST CAUSED BY PROLONGED CPR (Ernest N. Morial Convention Center - Exhibit Hall - Poster Area 2) - Sep 25, 2019 - Abstract #CHEST2019CHEST_3445;
Pain control, pulmonary toilet, and volume expansion measures are critical to reducing complications and further M&M. While surgical fixation continues to be controversial, medical management of even the most severe cases of flail chest can be successful.
- |||||||||| ketamine / generics
KETAMINE IN THE ICU: TREATMENT OF POLYPHARMACY WITHDRAWAL SYNDROME (Ernest N. Morial Convention Center - Exhibit Hall - Poster Area 4) - Sep 25, 2019 - Abstract #CHEST2019CHEST_3436;
High doses of propofol, midazolam, fentanyl, and dexmedetomidine were needed to control severe agitation while on the ventilator. This case shows that ketamine may have utility for control of severe agitation that is associated with withdrawal from high doses of sedatives and opiates required for the critically ill patient on mechanical ventilatory support with history of psychiatric illness and polysubstance drug use.
- |||||||||| PROLONGED LYSERGIC ACID DIETHYLMIDE INDUCED SEROTONIN SYNDROME (Ernest N. Morial Convention Center - Exhibit Hall - Poster Area 5) - Sep 25, 2019 - Abstract #CHEST2019CHEST_3332;
This case shows that ketamine may have utility for control of severe agitation that is associated with withdrawal from high doses of sedatives and opiates required for the critically ill patient on mechanical ventilatory support with history of psychiatric illness and polysubstance drug use. Severe cases often require aggressive intervention in the Intensive Care Unit (ICU) to manage hyperthermia, ventilation, seizures, delirium, rhabdomyolysis, and autonomic instability; however, frequently used analgesics in the ICU such as Fentanyl also contribute to increasing serotonergic levels, thereby, prolonging SS².Case Presentation:A 28 year old male visiting from Europe with an unknown medical history was brought in to the hospital after sudden onset of diaphoresis, agitation, and confusion at a restaurant...Our case demonstrates a unique presentation of SS with a favorable outcome due to early suspicion of the diagnosis, recognition of serotonergic agents, and aggressive intervention.
- |||||||||| fentanyl citrate / generics
ACUTE PARASPINAL COMPARTMENT SYNDROME SECONDARY TO POLYSUBSTANCE ABUSE AND SEIZURES (Ernest N. Morial Convention Center - Exhibit Hall - Poster Area 5) - Sep 25, 2019 - Abstract #CHEST2019CHEST_3322;
Urine toxicology screen in the ED was positive for cocaine and the urine fentanyl drip test was positive...Although rare, it is prudent to consider the paraspinal area as a potential site for acute compartment syndrome in patients with a history of substance abuse and significantly elevated CK. By doing appropriate interventions, potentially serious consequences can be avoided.
- |||||||||| Instanyl (fentanyl) / Takeda
A RARE CASE OF INTRANASAL FENTANYL-INDUCED DIFFUSE ALVEOLAR HEMORRHAGE (Ernest N. Morial Convention Center - Exhibit Hall - Poster Area 2) - Sep 25, 2019 - Abstract #CHEST2019CHEST_2826;
To the best of our knowledge, there would be less than 4 cases ever reported before. Clinicians should be aware of this dangerous complication in the battle of the ongoing opiate epidemic.
- |||||||||| ketamine / generics
AN INSTITUTIONAL EXPERIENCE WITH KETAMINE INFUSION FOR ANALGOSEDATION IN THE MEDICAL ICU (Ernest N. Morial Convention Center - Exhibit Hall - Poster Area 2) - Sep 25, 2019 - Abstract #CHEST2019CHEST_1834;
However, retrospective design and lack of a comparison group were major limitations to our study. Future studies are needed to assess these findings in a prospective randomized fashion.Clinical Implications:This study supports the use of ketamine infusion for analgosedation in mechanically ventilated MICU patients.
- |||||||||| fluoxetine / generics
TAKOTSUBO CARDIOMYOPATHY SECONDARY TO BENZODIAZEPINE TAPERING: AN UNDERREPORTED COMPLICATION (Ernest N. Morial Convention Center - Exhibit Hall - Poster Area 2) - Sep 25, 2019 - Abstract #CHEST2019CHEST_1393;
There are approximately four published cases of TCM following abrupt cessation or tapering of either clonazepam, delorazepam, or lorazepam [1-3]...Her home medications consisted of alprazolam, lisinopril, and inhaled albuterol...She was intubated then started on midazolam and fentanyl drips...This clonazepam taper also included a concurrent fluoxetine taper [3]...TCM is known to be precipitated by a variety of stressors and should be considered in patients on benzodiazepine therapy. Until future studies provide further insight, it would be prudent for physicians tapering benzodiazepine regimens to follow a conservative approach.
- |||||||||| Duragesic (fentanyl) / J&J
TCAS-ASSOCIATED WITH PERSISTENT WIDE COMPLEX VENTRICULAR TACHYCARDIA (Ernest N. Morial Convention Center - Exhibit Hall - Poster Area 4) - Sep 25, 2019 - Abstract #CHEST2019CHEST_1383;
Until future studies provide further insight, it would be prudent for physicians tapering benzodiazepine regimens to follow a conservative approach. Pertinent home medications included Amitriptyline, fentanyl patch, and hydromorphone...Patient was started on bicarbonate gtt and Ativan gtt...Early recognition and aggressive intervention is warranted in patients presenting with TCA overdose in order to improve patient outcomes.
- |||||||||| fentanyl citrate / generics
Clinical, Journal: Randomized, Crossover Study of Immersive Virtual Reality to Decrease Opioid Use During Painful Wound Care Procedures in Adults. (Pubmed Central) - Sep 22, 2019
Total opioid administration during the dressing procedures with IVR was significantly less than when no IVR was used, 17.9 ± 6.0 and 29.2 ± 4.5 mcg/kg fentanyl, respectively (t = -2.7; df = 14; P = 0.02)...IVR significantly reduced the amount of opioid medication administered during painful wound care procedures when IVR was used compared with no IVR. Since pain scores were similar before and after the wound procedures with IVR and without IVR, the 39% reduction in opioid medication during IVR supports its use as a pain distraction therapy during painful procedures.
- |||||||||| fentanyl citrate / generics, methadone / generics
Journal: Neurobiology of Opioid Use Disorder and Comorbid Traumatic Brain Injury. (Pubmed Central) - Sep 22, 2019
His treatment is described in a neurobiological framework of 6 opioid action principles. The 6 principles are (1) coactivation of neuronal and inflammatory immune receptors (Toll-like receptor 4), (2) 1 receptor activating cyclic adenosine monophosphate and β-arrestin second messenger systems, (3) convergence of opioid and adrenergic receptor types on 1 second messenger, (4) antagonist (eg, naltrexone)-induced receptor trafficking, (5) genetic μ-opioid receptor variants influencing analgesia and tolerance, and (6) cross-tolerance vs receptor antagonism as the basis of OUD pharmacotherapy with methadone or buprenorphine vs naltrexone.
- |||||||||| morphine/oxycodone (Q8011) / QRxPharma
Clinical, Journal: Trends and Outcomes Associated With Using Long-Acting Opioids During Delivery Hospitalizations. (Pubmed Central) - Sep 22, 2019
Increased use of methadone and buprenorphine in this study supports the feasibility of use of these medications during pregnancy and uptake of clinical recommendations for women with opioid use disorder. Use of methadone and buprenorphine is associated with decreased maternal morbidity, although causation cannot be presumed from this study model.
- |||||||||| fentanyl citrate / generics
Clinical, Journal: Use of rapid fentanyl test strips among young adults who use drugs. (Pubmed Central) - Sep 22, 2019
Use of methadone and buprenorphine is associated with decreased maternal morbidity, although causation cannot be presumed from this study model. Young adults reported high uptake and acceptability of fentanyl test strips to detect IMF in illicit drugs.
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