Articles: narcotic-antagonists.
-
Comment Randomized Controlled Trial Multicenter Study
Methylnaltrexone for opioid-induced constipation in advanced illness.
Constipation is a distressing side effect of opioid treatment. As a quaternary amine, methylnaltrexone, a mu-opioid-receptor antagonist, has restricted ability to cross the blood-brain barrier. We investigated the safety and efficacy of subcutaneous methylnaltrexone for treating opioid-induced constipation in patients with advanced illness. ⋯ Subcutaneous methylnaltrexone rapidly induced laxation in patients with advanced illness and opioid-induced constipation. Treatment did not appear to affect central analgesia or precipitate opioid withdrawal. (Clinical Trials.gov number, NCT00402038 [ClinicalTrials.gov].).
-
Review Case Reports
Narrative review: buprenorphine for opioid-dependent patients in office practice.
The profile of opioid dependence in the United States is changing. Abuse of prescription opioids is more common than that of illicit opioids: Recent data indicate that approximately 1.6 million persons abuse or are dependent on prescription opioids, whereas 323,000 abuse or are dependent on heroin. Despite this prevalence, nearly 80% of opioid-dependent persons remain untreated. ⋯ Buprenorphine is a partial opioid agonist that can be prescribed by trained physicians and dispensed at pharmacies. This article addresses the clinical presentation of a patient with opioid dependence and describes the relatively new practice of office-based treatment with buprenorphine-naloxone. The different components of treatment; the role of the physician who provides this treatment; and the logistics of treating this growing, multifaceted patient population are also examined.
-
Pediatric dermatology · May 2008
Case ReportsThe use of naltrexone in the management of severe generalized pruritus in biliary atresia: report of a case.
Generalized pruritus secondary to cholestasis is a difficult dermatologic condition to treat. We present a case of a 17-month-old child with congenital biliary atresia with generalized pruritus refractory to treatment with oral antihistamines, topical steroids, cholestyramine, and rifampin but improved remarkably with the addition of naltrexone. Naltrexone is a well-tolerated medication with little adverse effects. We believe that naltrexone may be an effective adjuvant treatment in the management of cholestatic pruritus in the pediatric population.
-
Naloxone distribution to injecting drug users (IDUs) for peer administration is a suggested strategy to prevent fatal heroin overdose. The aim of this study was to explore attitudes of IDUs to administration of naloxone to others after heroin overdose, and preferences for method of administration. A sample of 99 IDUs (median age 35 years, 72% male) recruited from needle and syringe programs in Melbourne were administered a questionnaire. ⋯ There was no association with age, sex, or heroin practice. There appears to be strong support among Australian IDU for naloxone distribution to peers. Intranasal spray is the preferred route of administration.