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[PMID]:28526155
[Au] Autor:Vadivelu N; Chang D; Helander EM; Bordelon GJ; Kai A; Kaye AD; Hsu D; Bang D; Julka I
[Ad] Endereço:Department of Anesthesiology, Yale University School of Medicine, 333 Cedar Street, PO Box 208051, New Haven, CT 06520-8051, USA. Electronic address: Nalini.vadivelu@yale.edu.
[Ti] Título:Ketorolac, Oxymorphone, Tapentadol, and Tramadol: A Comprehensive Review.
[So] Source:Anesthesiol Clin;35(2):e1-e20, 2017 Jun.
[Is] ISSN:1932-2275
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Pain remains a tremendous burden on patients and for the health care system, with uncontrolled pain being the leading cause of disability in this country. There are a variety of medications that can be used in the treatment of pain, including ketorolac, oxymorphone, tapentadol, and tramadol. Depending on the clinical situation, these drugs can be used as monotherapy or in conjunction with other types of medications in a multimodal approach. A strong appreciation of pharmacologic properties of these agents and potential side effects is warranted for clinicians.
[Mh] Termos MeSH primário: Analgésicos Opioides/uso terapêutico
Anti-Inflamatórios não Esteroides/uso terapêutico
Cetorolaco/uso terapêutico
Oximorfona/uso terapêutico
Dor/tratamento farmacológico
Fenóis/uso terapêutico
Tramadol/uso terapêutico
[Mh] Termos MeSH secundário: Analgésicos Opioides/efeitos adversos
Anti-Inflamatórios não Esteroides/efeitos adversos
Seres Humanos
Cetorolaco/efeitos adversos
Oximorfona/efeitos adversos
Medição da Dor
Fenóis/efeitos adversos
Tramadol/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Anti-Inflammatory Agents, Non-Steroidal); 0 (Phenols); 39J1LGJ30J (Tramadol); 9VXA968E0C (Oxymorphone); H8A007M585 (tapentadol); YZI5105V0L (Ketorolac)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170521
[St] Status:MEDLINE


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[PMID]:28257549
[Au] Autor:Wilson MW; Bonnecaze AK; Dharod A; Miller PJ
[Ad] Endereço:From the Departments of Internal Medicine and Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
[Ti] Título:Analysis of Intensive Care Unit Admission and Sequelae in Patients Intravenously Abusing Extended-Release Oral Oxymorphone.
[So] Source:South Med J;110(3):217-222, 2017 Mar.
[Is] ISSN:1541-8243
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Prescription drug abuse is a major public health problem in the United States, with the rate of opioid-related deaths nearly quadrupling between 2000 and 2014. Extended-release oral oxymorphone hydrochloride (Opana ER) is a long-acting opioid prescribed for chronic pain; however, it also has the potential to be abused via intravenous injection. This retrospective review sought to analyze specific complications and sequelae requiring intensive care unit resources for patients intravenously abusing extended-release oral oxymorphone. METHODS: We retrospectively reviewed the medical records of patients identified for drug abuse between January 2012 and December 2015, identifying patients who intravenously abused extended-release oral oxymorphone. Medical charts were reviewed to identify associated sequelae and patients requiring an intensive care unit level of care. RESULTS: We identified 53 patients who required treatment in an intensive care unit setting as a consequence of intravenously abusing extended-release oral oxymorphone. Twenty-eight patients (52.8%) required endotracheal intubation with mechanical ventilation for either acute hypoxic respiratory failure or protection of airway. Acute kidney injury developed in 48 patients (90.6%); 28.3% of these patients failed to regain renal function and required renal replacement therapy. Bacteremia was diagnosed in 36 patients (67.9%) and 30 patients (56.6%) were diagnosed as having acute infective bacterial endocarditis. CONCLUSIONS: Our patients demonstrated a great need for critical care resources and severe sequelae related to intravenous drug abuse. Clinicians should be vigilant for the possibility for clinical decompensation when initially evaluating patients reporting intravenous abuse of extended-release oral oxymorphone.
[Mh] Termos MeSH primário: Analgésicos Opioides/efeitos adversos
Unidades de Terapia Intensiva/utilização
Transtornos Relacionados ao Uso de Opioides/epidemiologia
Oximorfona/efeitos adversos
Admissão do Paciente/estatística & dados numéricos
Uso Indevido de Medicamentos sob Prescrição/estatística & dados numéricos
Abuso de Substâncias por Via Intravenosa/epidemiologia
[Mh] Termos MeSH secundário: Abscesso/induzido quimicamente
Abscesso/epidemiologia
Lesão Renal Aguda/induzido quimicamente
Lesão Renal Aguda/epidemiologia
Adulto
Bacteriemia/epidemiologia
Celulite (Flegmão)/induzido quimicamente
Celulite (Flegmão)/epidemiologia
Preparações de Ação Retardada
Endocardite Bacteriana/epidemiologia
Feminino
Seres Humanos
Intubação Intratraqueal/estatística & dados numéricos
Masculino
Meia-Idade
North Carolina/epidemiologia
Transtornos Relacionados ao Uso de Opioides/complicações
Terapia de Substituição Renal/utilização
Respiração Artificial/estatística & dados numéricos
Insuficiência Respiratória/induzido quimicamente
Insuficiência Respiratória/terapia
Estudos Retrospectivos
Abuso de Substâncias por Via Intravenosa/complicações
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Delayed-Action Preparations); 9VXA968E0C (Oxymorphone)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170525
[Lr] Data última revisão:
170525
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170304
[St] Status:MEDLINE
[do] DOI:10.14423/SMJ.0000000000000624


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[PMID]:28080998
[Au] Autor:Pantano F; Brauneis S; Forneris A; Pacifici R; Marinelli E; Kyriakou C; Pichini S; Busardò FP
[Ad] Endereço:.
[Ti] Título:Determination of oxycodone and its major metabolites noroxycodone and oxymorphone by ultra-high-performance liquid chromatography tandem mass spectrometry in plasma and urine: application to real cases.
[So] Source:Clin Chem Lab Med;55(9):1324-1331, 2017 Aug 28.
[Is] ISSN:1437-4331
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Oxycodone is a narcotic drug widely used to alleviate moderate and severe acute and chronic pain. Variability in analgesic efficacy could be explained by inter-subject variations in plasma concentrations of parent drug and its active metabolite, oxymorphone. To evaluate patient compliance and to set up therapeutic drug monitoring (TDM), an ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) assay was developed and validated for the parent drug and its major metabolites noroxycodone and oxymorphone. METHODS: Extraction of analytes from plasma and urine samples was obtained by simple liquid-liquid extraction. The chromatographic separation was achieved with a reversed phase column using a linear gradient elution with two solvents: acetic acid 1% in water and methanol. The separated analytes were detected with a triple quadrupole mass spectrometer operated in multiple reaction monitoring (MRM) mode via positive electrospray ionization (ESI). RESULTS: Separation of analytes was obtained in less than 5 min. Linear calibration curves for all the analytes under investigation in urine and plasma samples showed determination coefficients (r2) equal or higher than 0.990. Mean absolute analytical recoveries were always above 86%. Intra- and inter-assay precision (measured as coefficient of variation, CV%) and accuracy (measured as % error) values were always better than 13%. Limit of detection at 0.06 and 0.15 ng/mL and limit of quantification at 0.2 and 0.5 ng/mL for plasma and urine samples, respectively, were adequate for the purpose of the present study. CONCLUSIONS: Rapid extraction, identification and quantification of oxycodone and its metabolites both in urine and plasma by UHPLC-MS/MS assay was tested for its feasibility in clinical samples and provided excellent results for rapid and effective drug testing in patients under oxycodone treatment.
[Mh] Termos MeSH primário: Morfinanos/sangue
Morfinanos/urina
Oxicodona/sangue
Oxicodona/urina
Oximorfona/sangue
Oximorfona/urina
Espectrometria de Massas em Tandem
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Cromatografia Líquida de Alta Pressão
Feminino
Seres Humanos
Masculino
Meia-Idade
Morfinanos/metabolismo
Oxicodona/metabolismo
Oximorfona/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Morphinans); 95Q949779D (noroxycodone); 9VXA968E0C (Oxymorphone); CD35PMG570 (Oxycodone)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170113
[St] Status:MEDLINE


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[PMID]:28011222
[Au] Autor:Healy JR; Bezawada P; Griggs NW; Devereaux AL; Matsumoto RR; Traynor JR; Coop A; Cunningham CW
[Ad] Endereço:Department of Basic Pharmaceutical Sciences, West Virginia University School of Pharmacy, 2036 Health Sciences North, Morgantown, WV 26506, USA; Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, 1170 Main Bldg., 132 S. 10th St., Philadelphia, PA 19107, USA.
[Ti] Título:Benzylideneoxymorphone: A new lead for development of bifunctional mu/delta opioid receptor ligands.
[So] Source:Bioorg Med Chem Lett;27(3):666-669, 2017 02 01.
[Is] ISSN:1464-3405
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Opioid analgesic tolerance remains a considerable drawback to chronic pain management. The finding that concomitant administration of delta opioid receptor (DOR) antagonists attenuates the development of tolerance to mu opioid receptor (MOR) agonists has led to interest in producing bifunctional MOR agonist/DOR antagonist ligands. Herein, we present 7-benzylideneoxymorphone (6, UMB 246) displaying MOR partial agonist/DOR antagonist activity, representing a new lead for designing bifunctional MOR/DOR ligands.
[Mh] Termos MeSH primário: Analgésicos/química
Ligantes
Oximorfona/análogos & derivados
Oximorfona/química
Receptores Opioides delta/metabolismo
Receptores Opioides mu/metabolismo
[Mh] Termos MeSH secundário: Analgésicos/síntese química
Analgésicos/uso terapêutico
Animais
Compostos de Benzilideno/química
Camundongos
Oximorfona/síntese química
Oximorfona/uso terapêutico
Dor/tratamento farmacológico
Receptores Opioides delta/antagonistas & inibidores
Receptores Opioides mu/agonistas
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (7-benzylideneoxymorphone); 0 (Analgesics); 0 (Benzylidene Compounds); 0 (Ligands); 0 (Receptors, Opioid, delta); 0 (Receptors, Opioid, mu); 9VXA968E0C (Oxymorphone)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:171124
[Lr] Data última revisão:
171124
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161225
[St] Status:MEDLINE


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[PMID]:27864296
[Au] Autor:Hunt R; Yalamanoglu A; Tumlin J; Schiller T; Baek JH; Wu A; Fogo AB; Yang H; Wong E; Miller P; Buehler PW; Kimchi-Sarfaty C
[Ad] Endereço:Division of Plasma Protein Therapeutics, Office of Tissues and Advanced Therapies and.
[Ti] Título:A mechanistic investigation of thrombotic microangiopathy associated with IV abuse of Opana ER.
[So] Source:Blood;129(7):896-905, 2017 Feb 16.
[Is] ISSN:1528-0020
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Since 2012, a number of case reports have described the occurrence of thrombotic microangiopathy (TMA) following IV abuse of extended-release oxymorphone hydrochloride (Opana ER), an oral opioid for long-term treatment of chronic pain. Here, we present unique clinical features of 3 patients and investigate IV exposure to the tablet's inert ingredients as a possible causal mechanism. Guinea pigs were used as an animal model to understand the hematopathologic and nephrotoxic potential of the inert ingredient mixture (termed here as PEO+) which primarily contains high-molecular-weight polyethylene oxide (HMW PEO). Microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury were found in a group of 3 patients following recent injection of adulterated extended-release oxymorphone tablets. Varying degrees of cardiac involvement and retinal ischemia occurred, with TMA evident on kidney biopsy. A TMA-like state also developed in guinea pigs IV administered PEO+. Acute tubular and glomerular renal injury was accompanied by nonheme iron deposition and hypoxia-inducible factor-1α upregulation in the renal cortex. Similar outcomes were observed following dosing with HMW PEO alone. IV exposure to the inert ingredients in reformulated extended-release oxymorphone can elicit TMA. Although prescription opioid abuse shows geographic variation, all physicians should be highly inquisitive of IV drug abuse when presented with cases of TMA.
[Mh] Termos MeSH primário: Analgésicos Opioides/efeitos adversos
Oximorfona/efeitos adversos
Microangiopatias Trombóticas/induzido quimicamente
Microangiopatias Trombóticas/patologia
[Mh] Termos MeSH secundário: Lesão Renal Aguda/sangue
Lesão Renal Aguda/induzido quimicamente
Lesão Renal Aguda/complicações
Lesão Renal Aguda/patologia
Analgésicos Opioides/administração & dosagem
Animais
Preparações de Ação Retardada/administração & dosagem
Preparações de Ação Retardada/efeitos adversos
Feminino
Cobaias
Seres Humanos
Rim/efeitos dos fármacos
Rim/patologia
Masculino
Oximorfona/administração & dosagem
Polietilenoglicóis/efeitos adversos
Microangiopatias Trombóticas/sangue
Microangiopatias Trombóticas/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Delayed-Action Preparations); 30IQX730WE (Polyethylene Glycols); 9VXA968E0C (Oxymorphone)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170816
[Lr] Data última revisão:
170816
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161120
[St] Status:MEDLINE
[do] DOI:10.1182/blood-2016-08-736579


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[PMID]:27723230
[Au] Autor:Pypendop BH; Shilo-Benjamini Y; Ilkiw JE
[Ad] Endereço:Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, USA. bhpypendop@ucdavis.edu.
[Ti] Título:Effect of morphine, methadone, hydromorphone or oxymorphone on the thermal threshold, following intravenous or buccal administration to cats.
[So] Source:Vet Anaesth Analg;43(6):635-642, 2016 Nov.
[Is] ISSN:1467-2995
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To determine the effects of morphine, methadone, hydromorphone or oxymorphone on the thermal threshold in cats, following buccal and intravenous (IV) administration. STUDY DESIGN: Randomized crossover study. ANIMALS: Six healthy adult female ovariohysterectomized cats weighing 4.5 ± 0.4 kg. METHODS: Morphine sulfate (0.2 mg kg IV or 0.5 mg kg buccal), methadone hydrochloride (0.3 mg kg IV or 0.75 mg kg buccal), hydromorphone hydrochloride (0.1 mg kg IV or 0.25 mg kg buccal) or oxymorphone hydrochloride (0.1 mg kg IV or 0.25 mg kg buccal) were administered. All cats were administered all treatments. Skin temperature and thermal threshold were measured in duplicate prior to drug administration, and at various times up to 8 hours after drug administration. The difference between thermal threshold and skin temperature (ΔT) was analyzed. RESULTS: Administration of methadone and hydromorphone IV resulted in significant increases in ΔT at 40 minutes after drug administration. Buccal administration of methadone resulted in significant increases in thermal threshold, although no significant difference from baseline measurement was detected at any time point. IV administration of morphine and oxymorphone, and buccal administration of morphine, hydromorphone and oxymorphone did not cause significant thermal antinociception. CONCLUSION AND CLINICAL RELEVANCE: At the doses used in this study, IV administration of methadone and hydromorphone, and buccal administration of methadone resulted in transient thermal antinociception. The results of this study do not allow us to predict the usefulness of these drugs for providing analgesia in clinical patients.
[Mh] Termos MeSH primário: Analgésicos Opioides/farmacologia
Gatos
Hidromorfona/farmacologia
Metadona/farmacologia
Morfina/farmacologia
Oximorfona/farmacologia
Limiar da Dor/efeitos dos fármacos
[Mh] Termos MeSH secundário: Administração Bucal
Administração Intravenosa
Analgésicos Opioides/administração & dosagem
Animais
Estudos Cross-Over
Feminino
Hidromorfona/administração & dosagem
Metadona/administração & dosagem
Morfina/administração & dosagem
Oximorfona/administração & dosagem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Analgesics, Opioid); 76I7G6D29C (Morphine); 9VXA968E0C (Oxymorphone); Q812464R06 (Hydromorphone); UC6VBE7V1Z (Methadone)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170408
[Lr] Data última revisão:
170408
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161011
[St] Status:MEDLINE
[do] DOI:10.1111/vaa.12356


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[PMID]:27702939
[Au] Autor:Sitasuwan P; Melendez C; Marinova M; Mastrianni KR; Darragh A; Ryan E; Lee LA
[Ad] Endereço:Integrated Micro-Chromatography Systems, LLC, Columbia, SC 29208, USA.
[Ti] Título:Degradation of Opioids and Opiates During Acid Hydrolysis Leads to Reduced Recovery Compared to Enzymatic Hydrolysis.
[So] Source:J Anal Toxicol;40(8):601-607, 2016 Oct.
[Is] ISSN:1945-2403
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Drug monitoring laboratories utilize a hydrolysis process to liberate the opiates from their glucuronide conjugates to facilitate their detection by tandem mass spectrometry (MS). Both acid and enzyme hydrolysis have been reported as viable methods, with the former as a more effective process for recovering codeine-6-glucuronide and morphine-6-glucuronide. Here, we report concerns with acid-catalyzed hydrolysis of opioids, including a significant loss of analytes and conversions of oxycodone to oxymorphone, hydrocodone to hydromorphone and codeine to morphine. The acid-catalyzed reaction was monitored in neat water and patient urine samples by liquid chromatography-time-of-flight and tandem MS. These side reactions with acid hydrolysis may limit accurate quantitation due to loss of analytes, possibly lead to false positives, and poorly correlate with pharmacogenetic profiles, as cytochrome P450 enzyme (CYP2D6) is often involved with oxycodone to oxymorphone, hydrocodone to hydromorphone and codeine to morphine conversions. Enzymatic hydrolysis process using the purified, genetically engineered ß-glucuronidase (IMCSzyme ) addresses many of these concerns and demonstrates accurate quantitation and high recoveries for oxycodone, hydrocodone, oxymorphone and hydromorphone.
[Mh] Termos MeSH primário: Analgésicos Opioides/urina
Alcaloides Opiáceos/urina
[Mh] Termos MeSH secundário: Cromatografia Líquida
Codeína/análogos & derivados
Codeína/urina
Citocromo P-450 CYP2D6/metabolismo
Glucuronidase/metabolismo
Seres Humanos
Hidrocodona/urina
Hidrólise
Hidromorfona/urina
Morfina/urina
Derivados da Morfina/urina
Oxicodona/urina
Oximorfona/urina
Manejo de Espécimes
Espectrometria de Massas em Tandem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Morphine Derivatives); 0 (Opiate Alkaloids); 64Y9KYM60R (morphine-6-glucuronide); 6YKS4Y3WQ7 (Hydrocodone); 76I7G6D29C (Morphine); 9VXA968E0C (Oxymorphone); CD35PMG570 (Oxycodone); E2M937KY47 (codeine-6-glucuronide); EC 1.14.14.1 (Cytochrome P-450 CYP2D6); EC 3.2.1.31 (Glucuronidase); Q812464R06 (Hydromorphone); Q830PW7520 (Codeine)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161006
[St] Status:MEDLINE


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[PMID]:27487158
[Au] Autor:Pimentel CB; Gurwitz JH; Tjia J; Hume AL; Lapane KL
[Ad] Endereço:Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts.
[Ti] Título:New Initiation of Long-Acting Opioids in Long-Stay Nursing Home Residents.
[So] Source:J Am Geriatr Soc;64(9):1772-8, 2016 Sep.
[Is] ISSN:1532-5415
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To estimate the prevalence of new initiation of long-acting opioids since introduction of national efforts to increase prescriber and public awareness on safe use of transdermal fentanyl patches. DESIGN: Cross-sectional. SETTING: U.S. nursing homes (NHs). PARTICIPANTS: Medicare-enrolled long-stay NH residents (N = 22,253). MEASUREMENTS: Minimum Data Set 3.0 was linked with Medicare enrollment, hospital claims, and prescription drug transaction data (January-December 2011) and used to determine the prevalence of new initiation of a long-acting opioid prescribed to residents in NHs. RESULTS: Of NH residents prescribed a long-acting opioid within 30 days of NH admission (n = 12,278), 9.4% (95% confidence interval = 8.9-9.9%) lacked a prescription drug claim for a short-acting opioid in the previous 60 days. The most common initial prescriptions of long-acting opioids were fentanyl patch (51.9% of opioid-naïve NH residents), morphine sulfate (28.1%), and oxycodone (17.2%). CONCLUSION: New initiation of long-acting opioids-especially fentanyl patches, which have been the subject of safety communications-persists in NHs.
[Mh] Termos MeSH primário: Analgésicos Opioides/administração & dosagem
Dor Crônica/tratamento farmacológico
Fentanila/administração & dosagem
Fentanila/efeitos adversos
Instituição de Longa Permanência para Idosos
Morfina/administração & dosagem
Casas de Saúde
Oxicodona/administração & dosagem
[Mh] Termos MeSH secundário: Administração Cutânea
Idoso
Idoso de 80 Anos ou mais
Analgésicos Opioides/efeitos adversos
Buprenorfina/administração & dosagem
Buprenorfina/efeitos adversos
Preparações de Ação Retardada
Relação Dose-Resposta a Droga
Uso de Medicamentos/estatística & dados numéricos
Feminino
Seres Humanos
Assistência de Longa Duração
Masculino
Morfina/efeitos adversos
Oxicodona/efeitos adversos
Oximorfona/administração & dosagem
Oximorfona/efeitos adversos
Padrões de Prática Médica/estatística & dados numéricos
Padrões de Prática Médica/tendências
Rhode Island
Tramadol/administração & dosagem
Tramadol/efeitos adversos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Delayed-Action Preparations); 39J1LGJ30J (Tramadol); 40D3SCR4GZ (Buprenorphine); 76I7G6D29C (Morphine); 9VXA968E0C (Oxymorphone); CD35PMG570 (Oxycodone); UF599785JZ (Fentanyl)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170902
[Lr] Data última revisão:
170902
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160804
[St] Status:MEDLINE
[do] DOI:10.1111/jgs.14306


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[PMID]:27468059
[Au] Autor:Peters PJ; Pontones P; Hoover KW; Patel MR; Galang RR; Shields J; Blosser SJ; Spiller MW; Combs B; Switzer WM; Conrad C; Gentry J; Khudyakov Y; Waterhouse D; Owen SM; Chapman E; Roseberry JC; McCants V; Weidle PJ; Broz D; Samandari T; Mermin J; Walthall J; Brooks JT; Duwve JM; Indiana HIV Outbreak Investigation Team
[Ad] Endereço:From the Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta (P.J.P., K.W.H., M.R.P., R.R.G., M.W.S., W.M.S., Y.K., S.M.O., V.M., P.J.W., D.B., T.S., J.M., J.T.B.); and the Indiana State Department of
[Ti] Título:HIV Infection Linked to Injection Use of Oxymorphone in Indiana, 2014-2015.
[So] Source:N Engl J Med;375(3):229-39, 2016 Jul 21.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In January 2015, a total of 11 new diagnoses of human immunodeficiency virus (HIV) infection were reported in a small community in Indiana. We investigated the extent and cause of the outbreak and implemented control measures. METHODS: We identified an outbreak-related case as laboratory-confirmed HIV infection newly diagnosed after October 1, 2014, in a person who either resided in Scott County, Indiana, or was named by another case patient as a syringe-sharing or sexual partner. HIV polymerase (pol) sequences from case patients were phylogenetically analyzed, and potential risk factors associated with HIV infection were ascertained. RESULTS: From November 18, 2014, to November 1, 2015, HIV infection was diagnosed in 181 case patients. Most of these patients (87.8%) reported having injected the extended-release formulation of the prescription opioid oxymorphone, and 92.3% were coinfected with hepatitis C virus. Among 159 case patients who had an HIV type 1 pol gene sequence, 157 (98.7%) had sequences that were highly related, as determined by phylogenetic analyses. Contact tracing investigations led to the identification of 536 persons who were named as contacts of case patients; 468 of these contacts (87.3%) were located, assessed for risk, tested for HIV, and, if infected, linked to care. The number of times a contact was named as a syringe-sharing partner by a case patient was significantly associated with the risk of HIV infection (adjusted risk ratio for each time named, 1.9; P<0.001). In response to this outbreak, a public health emergency was declared on March 26, 2015, and a syringe-service program in Indiana was established for the first time. CONCLUSIONS: Injection-drug use of extended-release oxymorphone within a network of persons who inject drugs in Indiana led to the introduction and rapid transmission of HIV. (Funded by the state government of Indiana and others.).
[Mh] Termos MeSH primário: Surtos de Doenças
Infecções por HIV/epidemiologia
HIV-1/genética
Oximorfona/administração & dosagem
Abuso de Substâncias por Via Intravenosa/complicações
[Mh] Termos MeSH secundário: Adolescente
Adulto
Coinfecção
Busca de Comunicante
Infecções por HIV/transmissão
Hepatite C/epidemiologia
Seres Humanos
Indiana/epidemiologia
Masculino
Meia-Idade
Uso Comum de Agulhas e Seringas/efeitos adversos
Filogenia
Apoio Social
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.
[Nm] Nome de substância:
9VXA968E0C (Oxymorphone)
[Em] Mês de entrada:1608
[Cu] Atualização por classe:160729
[Lr] Data última revisão:
160729
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160729
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMoa1515195


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Fotocópia
[PMID]:27405370
[Au] Autor:DePriest AZ; Heltsley R; Black DL; Mitchell JM; LoDico C; Flegel R; Cone EJ
[Ad] Endereço:Aegis Sciences Corporation, 515 Great Circle Road, Nashville, TN University of Tennessee Health Science Center, College of Pharmacy, Memphis, TN annedepriest@gmail.com.
[Ti] Título:Prescription Opioids. V. Metabolism and Excretion of Oxymorphone in Urine Following Controlled Single Dose Administration.
[So] Source:J Anal Toxicol;40(8):566-574, 2016 Oct.
[Is] ISSN:1945-2403
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Oxymorphone (OM), a prescription opioid and metabolite of oxycodone, was included in the recently published proposed revisions to the Mandatory Guidelines for Federal Workplace Drug Testing Programs. To facilitate toxicological interpretation, this study characterized the time course of OM and its metabolite, noroxymorphone (NOM), in hydrolyzed and non-hydrolyzed urine specimens. Twelve healthy subjects were administered a single 10 mg controlled-release OM dose, followed by a periodic collection of pooled urine specimens for 54 h following administration. Analysis for free and total OM and NOM was conducted by liquid chromatography tandem mass spectrometry (LC-MS-MS), at a 50 ng/mL limit of quantitation (LOQ). Following enzymatic hydrolysis, OM and NOM were detected in 89.9% and 13.5% specimens, respectively. Without hydrolysis, OM was detected in 8.1% specimens, and NOM was not detected. The mean ratio of hydrolyzed OM to NOM was 41.6. OM was frequently detected in the first pooled collection 0-2 h post-dose, appearing at a mean of 2.4 h. NOM appeared at a mean of 8.3 h. The period of detection at the 50 ng/mL threshold averaged 50.7 h for OM and 11.0 h for NOM. These data support that OM analysis conducted using a 50 ng/mL threshold should include hydrolysis or optimize sensitivity for conjugated OM.
[Mh] Termos MeSH primário: Analgésicos Opioides/urina
Oximorfona/urina
Detecção do Abuso de Substâncias/métodos
[Mh] Termos MeSH secundário: Adulto
Analgésicos Opioides/administração & dosagem
Cromatografia Líquida de Alta Pressão
Creatinina/urina
Preparações de Ação Retardada/administração & dosagem
Feminino
Seres Humanos
Masculino
Morfinanos/urina
Oxicodona/urina
Oximorfona/administração & dosagem
Espectrometria de Massas em Tandem
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Delayed-Action Preparations); 0 (Morphinans); 9NZ7111A9O (noroxymorphone); 9VXA968E0C (Oxymorphone); AYI8EX34EU (Creatinine); CD35PMG570 (Oxycodone)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170331
[Lr] Data última revisão:
170331
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160714
[St] Status:MEDLINE



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