Articles: narcotic-antagonists.
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Fatal opioid overdose in the United States is at epidemic levels. Naloxone, an effective opioid antidote, is commonly administered by advanced emergency medical services (EMS) personnel in the prehospital setting. While states are rapidly moving to increase access to naloxone for community bystanders, the EMS system remains the primary source for out-of-hospital naloxone access. Many communities have limited advanced EMS response capability and therefore may not have prehospital access to the medication indicated for opioid overdose reversal. The goal of this research was to determine the authority of different levels of EMS personnel to administer naloxone for the reversal of opioid overdose in the United States, Guam, and Puerto Rico. ⋯ Naloxone administration is standard for paramedic and intermediate-level EMS personnel, but most states do not allow basic life support (BLS) personnel to administer this medication. Standards consistent with available medical evidence for naloxone administration, dosing, and route of administration should be implemented at each EMS level of certification.
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Journal of critical care · Oct 2014
Enteral naloxone for the treatment of opioid-induced constipation in the medical intensive care unit.
To determine the safety and efficacy of enteral naloxone for the treatment of opioid-induced constipation in the medical intensive care unit (MICU). ⋯ Enteral naloxone appears safe for the treatment of opioid-induced constipation in the MICU. Enteral naloxone may be effective in treating opioid-induced constipation; however, further studies are warranted.
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Aliment. Pharmacol. Ther. · Oct 2014
Randomized Controlled Trial Multicenter StudyRandomised clinical trial: the long-term safety and tolerability of naloxegol in patients with pain and opioid-induced constipation.
Opioid-induced constipation (OIC) is a common adverse effect of opioid therapy. ⋯ In patients with noncancer pain and opioid-induced constipation, naloxegol 25 mg/day up to 52 weeks was generally safe and well tolerated.
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The challenge of addressing the epidemic of opioid overdose in Rhode Island, and nationwide, is only possible through collaborative efforts among a wide breadth of stakeholders. This article describes the range of efforts by numerous partners that have come together to facilitate community, and treatment-related approaches to address opioid-involved overdose and substance use disorder. Strategies to address this crisis have largely focused on increasing access both to the opioid overdose antidote naloxone and to high quality and timely treatment and recovery services. [Full text available at http://rimed.org/rimedicaljournal-2014-10.asp, free with no login].
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Journal of anesthesia · Oct 2014
Potentiation of [Met(5)]enkephalin-induced antinociception by mixture of three peptidase inhibitors in rat.
Previous in vitro studies have shown that degradation of opioid peptides during incubation with cerebral membrane preparations is almost completely prevented by a mixture of three peptidase inhibitors (PIs), namely, amastatin, captopril, and phosphoramidon. In the present in vivo study, we evaluate the effects of intrathecal administration of these PIs on antinociception by [Met(5)]enkephalin (ME) or PIs themselves. ⋯ The present data, together with those of earlier studies, clearly demonstrate that amastatin-, captopril-, and phosphoramidon-sensitive enzymes play an important role in inactivation of opioid peptides at the spinal level.