Articles: opioid.
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Assess whether patients with chronic pain receiving 80 to 220 mg oral morphine sulfate equivalent of a full Μ: -opioid agonist could be transitioned to buccal buprenorphine at approximately 50% of their full dose without inducing opioid withdrawal or sacrificing analgesic efficacy. ⋯ Chronic pain patients treated with around-the-clock full Μ: -opioid agonist therapy can be switched to buccal buprenorphine (a partial Μ: -opioid agonist) at approximately 50% of the full Μ: -opioid agonist dose without an increased risk of opioid withdrawal or loss of pain control.
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There is an epidemic of opioid abuse. This article discusses the history of opioid use. ⋯ Naloxone has made a profound impact in the care of these patients if they present for medical care early enough. This paper discusses naloxone pharmacodynamics, its use in the medical setting, and how its use is now being expanded to include nontraditional providers with take home naloxone programs.
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Equianalgesic conversion methods are commonly used to switch patients from one opioid to another due to suboptimal pain relief or adverse events. There is no universally accepted opioid conversion method, however, and there is often significant variability between conversion resources. As a result, patients are at risk for undertreated pain and serious adverse events. The purpose of this survey was to compare the equianalgesic conversion estimates between nurse practitioners, pharmacists, and physicians for commonly prescribed opioids. ⋯ As evidenced by large standard deviations, there was significant variation in mean opioid conversions to MEQ doses within each profession type, particularly for fentanyl and methadone. The median MEQ doses provided for opioid conversions were the same among each profession. No universal method exists that allows each of the five studied opioids to be accurately and consistently converted to another opioid (i.e., morphine).
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Pharmacoepidemiol Drug Saf · May 2016
The extent and correlates of community-based pharmaceutical opioid utilisation in Australia.
There has been concern regarding the increasing use of opioids and related harm. We present data on opioid utilisation across Australia and consider sociodemographic factors that may affect utilisation rates. ⋯ Substantial geographic variation in opioid utilisation was identified, with areas outside of major cities having higher rates of utilisation of all types of opioids. Prescription monitoring and best practice interventions aimed at improving opioid use need to have a particular focus on areas outside of major cities. Copyright © 2016 John Wiley & Sons, Ltd.
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The use of opioids for chronic pain has increased significantly due to a combination of the high patient burden of pain and the more widespread availability of a range of long-acting opioid preparations. This increased opioid use has translated into the care of many patients with fibromyalgia. ⋯ There is no evidence that pure opioids are effective in fibromyalgia but there is some evidence that opioids with additional actions on the norepinephrine-related pain modulatory pathways, such as tramadol, can be clinically useful in some patients. Novel actions of low-dose opioid antagonists may lead to better understanding of the role of opioid function in fibromyalgia.