Articles: opioid.
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Randomized Controlled Trial
Pharmacokinetics of concentrated naloxone nasal spray over first 30 minutes post-dosing: analysis of suitability for opioid overdose reversal.
Lack of non-injectable naloxone formulations has impeded widespread take-home provision for the prevention of heroin/opioid overdose deaths. For non-injectable formulations that are finally being investigated, rapid onset of action and sufficient bioavailability will be vital. We present analysis of data from a study of concentrated naloxone nasal spray formulations. Our aims are: to assess (1) pharmacokinetic properties and (2) suitability for overdose reversal in terms of naloxone absorption within 30 minutes post-dosing. ⋯ Concentrated naloxone nasal spray has a promising pharmacokinetic profile, with substantial bioavailability. Its early absorption time-course suggests that concentrated nasal naloxone is suitable for emergency administration in the community, where rapid restoration of respiratory function is essential for opioid overdose reversal.
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We attempted to describe the opioid prescribing patterns for ambulatory pediatric surgery in the United States from 2007 to 2014. ⋯ Substantial variability in analgesic prescribing at the level of the procedure performed, both in terms of the probability of receiving a prescription and in which drugs were prescribed. We observed significant age and procedure-based variability in opioid prescribing following pediatric ambulatory surgery.
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Clinical therapeutics · Sep 2017
The Role of Continuing Medical Education in Increasing Enrollment in Prescription Drug Monitoring Programs.
Opioid diversion, misuse, and abuse are rapidly growing problems in the United States; >60% of all drug overdose deaths involve an opioid. At least 49 states now have fully operational prescription drug monitoring programs (PDMPs) to support legitimate medical use of controlled substances; however, there is considerable underutilization of such programs. ⋯ Continuing medical education is effective for improving clinician knowledge and confidence related to opioid misuse, abuse, and diversion and effective use of a PDMP; however, the education did not result in a significant increase in enrollment in state PDMPs.
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Politicians in both parties and at all levels of government have raised what many call the opioid crisis to a level of public attention it has never seen before. This article reviews the approaches, including prevention, treatment, and medication-assisted therapy, being taken by federal and state authorities to combat the abuse of opioids.
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To examine the risk to heroin users of also using gabapentin or pregabalin (gabapentoids). ⋯ For heroin users, the combination of opioids with gabapentin or pregabalin potentially increases the risk of acute overdose death through either reversal of tolerance or an additive effect of the drugs to depress respiration.