scholarly journals Abstract No. 630 Association of patient-specific factors and non-opioid analgesics on opioid use after uterine fibroid embolization

2020 ◽  
Vol 31 (3) ◽  
pp. S272-S273
Author(s):  
C. Ziegler ◽  
H. Desai ◽  
W. Pabon-Ramos
Keyword(s):  
Uterine Fibroid ◽  
Opioid Analgesics ◽  
Patient Specific ◽  
Opioid Use ◽  
Uterine Fibroid Embolization ◽  
Specific Factors

scholarly journals Opioid toxicity due to CNS depressant polypharmacy: A case report

2021 ◽  
Vol 11 (2) ◽  
pp. 70-74
Author(s):  
Christine Lee ◽  
Annabelle Wanson ◽  
Sarah Frangou ◽  
David Chong ◽  
Katelyn Halpape
Keyword(s):  
Respiratory Depression ◽  
Opioid Use Disorder ◽  
Careful Consideration ◽  
Patient Specific ◽  
Chronic Obstructive ◽  
Opioid Use ◽  
Obstructive Pulmonary Disease ◽  
Cns Depressant ◽  
Combined Use ◽  
Specific Factors

Abstract The interaction between methadone and central nervous system depressants can cause serious adverse effects, including profound sedation, respiratory depression, coma, and death. This poses a challenge in the treatment of patients with concurrent psychiatric and substance use disorders as the combined use is often unavoidable. We report a case of a patient with opioid use disorder, mood disorder unspecified, chronic pain, and chronic obstructive pulmonary disease who experienced 2 serious episodes of CNS and respiratory depression due to polypharmacy-induced opioid toxicity. Careful consideration of pharmacokinetics, pharmacodynamics, and patient-specific factors was imperative to identify the suspected contributing medications: methadone, lorazepam, divalproex, gabapentin, and cyclobenzaprine. Cognitive and system factors that contributed to these adverse events and strategies to mitigate risk of recurrence were also identified.

The role of transdermal compounding in opioid safety

2018 ◽  
Vol 14 (1) ◽  
pp. 17
Author(s):  
Caitlin V. Bucher, PharmD ◽  
A.J. Day, PharmD ◽  
Maria Carvalho, PhD
Keyword(s):  
Pain Management ◽  
Healthcare Providers ◽  
Opioid Analgesics ◽  
Opioid Therapy ◽  
Patient Specific ◽  
Therapeutic Effects ◽  
Opioid Use ◽  
Prescribing Practices ◽  
Management Options ◽  
Combination Drug

Since the number of prescriptions for opioid medications have continued to rise, there have been questions about the safety of using opioids in pain management. Traditionally, opioid analgesics were reserved for a few select conditions, such as terminal illness and surgery, but currently opioids have been readily prescribed for multiple conditions. The objective of this manuscript is to clarify the current state of opioid use and to discuss alternative transdermal analgesic therapies in pain management. Transdermal compounded medications are patient-specific and customizable to include different types of drugs, in various dosage strengths, that are to be delivered simultaneously in one application. Due to the different origins and types of pain, treatments may be most beneficial with multiple classes of drugs with various mechanisms of action. In addition, combination drug therapy may include nontraditional pain management options, and has the ability to maximize therapeutic effects of medications through additive or synergistic properties, without increasing the dosage strengths of the drugs. Many of the challenges faced when using oral opioid therapy may be overcome by using transdermal drug delivery since this route of administration reduces adverse effects, increases patient compliance, and limits exposure to potentially abusive drugs. Although prescribing practices surrounding opioids remains to be a controversial topic, the use of compounded pain medications may help healthcare providers effectively treat their patients while avoiding the use of addictive drugs.

scholarly journals Opioid availability statistics from the International Narcotics Control Board do not reflect the medical use of opioids: comparison with sales data from Scandinavia

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Emmanuel Bäckryd ◽  
Markus Heilig ◽  
Mikael Hoffmann
Keyword(s):  
Opioid Analgesics ◽  
Warning Signal ◽  
Control Board ◽  
Opioid Use ◽  
Opioid Prescription ◽  
Sales Data ◽  
Narcotics Control ◽  
Addiction Risk ◽  
The Usa ◽  
Prescription Rates

Abstract Objectives Opioid analgesics are essential in clinical practice, but their excessive use is associated with addiction risk. Increases in opioid prescription rates have fuelled an epidemic of opioid addiction in the USA, making statistics on medical opioid use a critical warning signal. A dramatic 150% increase in Swedish opioid access 2001–2013 was recently reported based on data from the International Narcotics Control Board (INCB; Berterame et al. 2016) in conflict with other studies of opioid use in the Nordic countries. This article aims to analyse to what degree published INCB statistics on opioids in Scandinavia (Denmark, Norway and Sweden) reflect actual medical use and study the methodological reasons for putative discrepancies. Methods Data on aggregated total national sales of opioids for the whole population, including hospitals, were collected from the Swedish e-Health Authority. Total sales data for Denmark and drugs dispensed at pharmacies in Norway are publicly available through the relevant authorities’ websites. Results INCB opioid statistics during the period 2001–2013 were markedly inconsistent with sales data from Scandinavia, calling the reliability of INCB data into question. INCB-data were flawed by (a) over-representing the volume of fentanyl, (b) under-reporting of codeine, and (c) by not including tramadol. Conclusions Opioid availability, as expressed by INCB statistics, does not reflect medical opioid use. It is crucial to underline that INCB statistics are based on the manual compilation of national production, import and export data from manufacturers and drug companies. This is not the same amount that is prescribed and consumed within the health care system. Moreover, there are methodological problems in the INCB reports, in particular concerning fentanyl, codeine and tramadol. We suggest that INCB should carefully review the quality of their data on medical opioids.

Successful recanalization for acute ischemic stroke via the transbrachial approach

2014 ◽  
Vol 8 (2) ◽  
pp. 122-125 ◽  
Author(s):  
Masakazu Okawa ◽  
Satoshi Tateshima ◽  
David Liebeskind ◽  
Latisha K Ali ◽  
Michael L Thompson ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Patient Specific ◽  
Ischemic Stroke Patient ◽  
Transfemoral Approach ◽  
Acute Ischemic Stroke Patient ◽  
Transbrachial Approach ◽  
Stent Retrievers ◽  
Endovascular Approach ◽  
Specific Factors

The recent development of revascularization devices, including stent retrievers, has enabled increasingly higher revascularization rates for arterial occlusions in acute ischemic stroke. Patient-specific factors such as anatomy, however, may occasionally limit endovascular deployment of these new devices via the conventional transfemoral approach. We report three cases of acute ischemic stroke where a transbrachial endovascular approach to revascularization was used, resulting in successful recanalization. These examples suggest that a transbrachial approach may be considered as an alternative in the endovascular treatment of acute ischemic stroke.

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