Articles: narcotic-antagonists.
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Acta Anaesthesiol Scand · Jul 2017
Pharmacokinetics after a single dose of naloxone administered as a nasal spray in healthy volunteers.
There is increasing interest in the use of intranasal naloxone to reverse adverse opioid effects during management of procedural pain in children and in adults after overdose. There are limited data on the pharmacokinetics of intranasal naloxone so in this study we aimed to detail the pharmacokinetic profile of the commercially marketed injectable solution of naloxone 0.4 mg/ml when administered as an intranasal spray. ⋯ Our results show a faster uptake of intranasal naloxone to maximum concentration compared with previous studies although with a marked variation in maximum concentration. The findings are consistent with our clinical experience of the time profile for reversing the effects of sufentanil sedation in children.
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The effectiveness and safety of naloxone for the reversal of opioid toxicity are reviewed. A literature search was performed using PubMed, the Cochrane Library, CINAHL, and Medline. ⋯ The inconsistencies in data regarding the relative outcome comparisons between administration methods were likely due to differences in concentrations of naloxone preparations and method of administration for the same route of delivery between different studies. Choice of route depends on the environment in which the opioid toxicity occurs, individual patient characteristics, and provider preference.
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It has taken the tragedy of swelling opioid overdoses to raise addictions to national attention. This past year, a new law called the Comprehensive Addictions Recovery Act has helped to open doors for nurse practitioners and physician assistants to prescribe buprenorphine. ⋯ One treatment option is group therapy, which is effective for individuals with substance use as well as other co-occurring disorders to develop needed skills to remain in recovery. The purpose of this review is to explore the nursing role in group therapy for substance use as well as encourage addictions and psychiatric nurse practitioners to offer recovery-focused group therapy to this population.
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We previously developed a model of opioid-induced neuroplasticity in the peripheral terminal of the nociceptor that could contribute to opioid-induced hyperalgesia, type II hyperalgesic priming. Repeated administration of mu-opioid receptor (MOR) agonists, such as DAMGO, at the peripheral terminal of the nociceptor, induces long-lasting plasticity expressed, prototypically as opioid-induced hyperalgesia and prolongation of prostaglandin E2-induced hyperalgesia. In this study, we evaluated the mechanisms involved in the maintenance of type II priming. ⋯ A second model of priming, latent sensitization, induced by complete Freund's adjuvant was also reversed, in males. In females, the inhibitor combination was only able to inhibit the expression and maintenance of DAMGO-induced priming when knockdown of G-protein-coupled estrogen receptor 30 (GPR30) in the nociceptor was performed. These findings demonstrate that the maintenance of DAMGO-induced type II priming, and latent sensitization is mediated by an interaction between, Src and MAP kinases, which in females is GPR30 dependent.