Articles: opioid.
-
Recent studies demonstrated the overprescription of opioids after ambulatory hand surgery in the setting of a national opioid epidemic. Prescriber education has been shown to decrease these practices on a small scale; however, currently no nationally standardized prescriber education or postoperative opioid prescribing guidelines exist. The purpose of this study was to evaluate the effect of prescriber opioid education and postoperative opioid guidelines on prescribing practices after ambulatory hand surgery. ⋯ Therapeutic IV.
-
Purpose: The results of a survey of academic medical centers assessing the presence and description of opioid stewardship activities. Methods: Academic medical centers within the Vizient University Health System Consortium Pharmacy Network were asked to complete a survey related to opioid stewardship activities. The survey consisted of 30 questions aimed at identifying current opioid stewardship practices among hospitals and health systems. ⋯ The majority of respondents have opioid medication policies in place to address range orders, smart pump programming of opioids, limits on meperidine use, and cumulative limits on acetaminophen dosing. Conclusion: There are limited examples of pharmacy services related to opioid stewardship. The authors believe this is a pharmacy practice model that will evolve with the national attention to the opioid epidemic and new Joint Commission Standards.
-
Pain management after anterior cruciate ligament reconstruction (ACLR) may pose a risk of prolonged opioid use. ⋯ Opioid use was unexpectedly low among patients undergoing ACLR after a surgeon-administered circumferential genicular nerve block and fat pad infiltration. With this protocol, the graft choice and patient age did not correlate with increased opioid use. These results could be useful in guiding post-operative opioid prescribing after ACLR.
-
The present study was designed to use blood-oxygen-level dependent (BOLD) imaging to "fingerprint" the change in activity in response to oxycodone (OXY) in drug naïve rats before and after repeated exposure to OXY. It was hypothesized that repeated exposure to OXY would initiate adaptive changes in brain organization that would be reflected in an altered response to opioid exposure. Male rats exposed to OXY repeatedly showed conditioned place preference, evidence of drug-seeking behavior and putative neuroadaptation. ⋯ In the MEMRI study, rats received OXY treatments (2.5 mg/kg, twice daily) for four consecutive days following intraventricular MnCl2. Under isoflurane anesthesia, T1-weighted images were acquired and subsequently analyzed showing activity in the forebrain limbic system, ventral striatum, accumbens, amygdala and hippocampus. These results show brain activity is markedly different when OXY is presented to drug naïve rats versus rats with prior, repeated exposure to drug.
-
Nurse education today · Feb 2019
Undergraduate nursing students' experiences and attitudes towards working with patients with opioid use disorder in the clinical setting: A qualitative content analysis.
With the US facing an opioid epidemic, undergraduate nursing students are increasingly encountering patients with opioid use disorder in the clinical setting. Yet, nursing curriculums have not adapted to meet this need. Previous research indicates students are exposed to negative messages that might influence their views about patients with opioid use disorder. ⋯ Students were most likely to experience bias and internal conflict in maternity clinical rotations. Education should include practical communication strategies to reduce avoidance behaviors among nursing students as well as techniques to manage difficult situations and reduce moral distress. Nurses must be mindful of their power to influence students and should model non-judgmental language and behavior. Students ultimately expressed a desire to provide informed and empathetic care.