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  1 / 17915 MEDLINE  
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[PMID]:29236368
[Au] Autor:Benhaberou-Brun D
[Ti] Título:Surdose d'opioïdes. La naloxone, un antidote qui peut sauver des vies..
[So] Source:Perspect Infirm;14(2):35-37, 2017 Mar-Apr.
[Is] ISSN:1708-1890
[Cp] País de publicação:Canada
[La] Idioma:fre
[Mh] Termos MeSH primário: Analgésicos Opioides/envenenamento
Overdose de Drogas/tratamento farmacológico
Naloxona/uso terapêutico
Antagonistas de Entorpecentes/uso terapêutico
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Narcotic Antagonists); 36B82AMQ7N (Naloxone)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE


  2 / 17915 MEDLINE  
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[PMID]:27776382
[Au] Autor:Parmar MK; Strang J; Choo L; Meade AM; Bird SM
[Ad] Endereço:MRC Clinical Trials Unit at University College London, London, UK.
[Ti] Título:Randomized controlled pilot trial of naloxone-on-release to prevent post-prison opioid overdose deaths.
[So] Source:Addiction;112(3):502-515, 2017 Mar.
[Is] ISSN:1360-0443
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND AIMS: Naloxone is an opioid antagonist used for emergency resuscitation following opioid overdose. Prisoners with a history of heroin injection have a high risk of drug-related death soon after release from prison. The NALoxone InVEstigation (N-ALIVE) pilot trial (ISRCTN34044390) tested feasibility measures for randomized provision of naloxone-on-release (NOR) to eligible prisoners in England. DESIGN: Parallel-group randomized controlled pilot trial. SETTING: English prisons. PARTICIPANTS: A total of 1685 adult heroin injectors, incarcerated for at least 7 days pre-randomization, release due within 3 months and more than 6 months since previous N-ALIVE release. INTERVENTION: Using 1 : 1 minimization, prisoners were randomized to receive on release a pack containing either a single 'rescue' injection of naloxone or a control pack with no syringe. MEASUREMENTS: Key feasibility outcomes were tested against prior expectations: on participation (14 English prisons; 2800 prisoners), consent (75% for randomization), returned prisoner self-questionnaires (RPSQs: 207), NOR-carriage (75% in first 4 weeks) and overdose presence (80%). FINDINGS: Prisons (16) and prisoners (1685) were willing to participate [consent rate, 95% confidence interval (CI) = 70-74%]; 218 RPSQs were received; NOR-carriage (95% CI = 63-79%) and overdose presence (95% CI = 75-84%) were as expected. We randomized 842 to NOR and 843 to control during 30 months but stopped early, because only one-third of NOR administrations were to the ex-prisoner. Nine deaths within 12 weeks of release were registered for 1557 randomized participants released before 9 December 2014. CONCLUSIONS: Large randomized trials are feasible with prison populations. Provision of take-home emergency naloxone prior to prison release may be a life-saving interim measure to prevent heroin overdose deaths among ex-prisoners and the wider population.
[Mh] Termos MeSH primário: Overdose de Drogas/prevenção & controle
Dependência de Heroína/mortalidade
Naloxona/uso terapêutico
Antagonistas de Entorpecentes/uso terapêutico
Prisioneiros/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Overdose de Drogas/mortalidade
Inglaterra/epidemiologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Projetos Piloto
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Narcotic Antagonists); 36B82AMQ7N (Naloxone)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1111/add.13668


  3 / 17915 MEDLINE  
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[PMID]:28455458
[Au] Autor:Seyani C; Green P; Daniel L; Pegden A
[Ad] Endereço:Great Western Hospital, Swindon, UK.
[Ti] Título:An interesting case of opium tea toxicity.
[So] Source:BMJ Case Rep;2017, 2017 Apr 28.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:We present an unusual cause of respiratory arrest resulting from sole ingestion of home-brewed opium tea. A 64-year-old woman was found unresponsive and in respiratory arrest by a first responder. There were no obvious signs of regular recreational drug use. On presentation to the local district general hospital, the patient was in extremis, with severe physiological and biochemical derangements. A naloxone infusion was commenced and she later made a good recovery. It was subsequently discovered that she had brewed opium tea from opium buds she had picked from a nearby commercial poppy farm, a practice she had learnt while in Afghanistan.
[Mh] Termos MeSH primário: Transtornos Relacionados ao Uso de Opioides/diagnóstico
Ópio/toxicidade
Chá/toxicidade
[Mh] Termos MeSH secundário: Administração Intravenosa
Afeganistão
Coma/diagnóstico
Coma/etiologia
Feminino
Seres Humanos
Meia-Idade
Naloxona/administração & dosagem
Naloxona/uso terapêutico
Antagonistas de Entorpecentes/administração & dosagem
Antagonistas de Entorpecentes/uso terapêutico
Transtornos Relacionados ao Uso de Opioides/epidemiologia
Ópio/administração & dosagem
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Narcotic Antagonists); 0 (Tea); 36B82AMQ7N (Naloxone); 8008-60-4 (Opium)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE


  4 / 17915 MEDLINE  
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[PMID]:29253386
[Au] Autor:Uyei J; Fiellin DA; Buchelli M; Rodriguez-Santana R; Braithwaite RS
[Ad] Endereço:Department of Population Health, New York University School of Medicine, New York, NY, USA. Electronic address: jennifer.uyei@nyumc.org.
[Ti] Título:Effects of naloxone distribution alone or in combination with addiction treatment with or without pre-exposure prophylaxis for HIV prevention in people who inject drugs: a cost-effectiveness modelling study.
[So] Source:Lancet Public Health;2(3):e133-e140, 2017 Mar.
[Is] ISSN:2468-2667
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In the USA, an epidemic of opioid overdose deaths is occurring, many of which are from heroin. Combining naloxone distribution with linkage to addiction treatment or pre-exposure prophylaxis (PrEP) for HIV prevention through syringe service programmes has the potential to save lives and be cost-effective. We estimated the outcomes and cost-effectiveness of five alternative strategies: no additional intervention, naloxone distribution, naloxone distribution plus linkage to addiction treatment, naloxone distribution plus PrEP, and naloxone distribution plus linkage to addiction treatment and PrEP. METHODS: We developed a decision analytical Markov model to simulate opioid overdose, HIV incidence, overdose-related deaths, and HIV-related deaths in people who inject drugs in Connecticut, USA. Model input parameters were derived from published sources. We compared each strategy with no intervention, as well as simultaneously considering all strategies. Sensitivity analysis was done for all variables. Linkage to addiction treatment was referral to an opioid treatment programme for methadone. Endpoints were survival, life expectancy, quality-adjusted life-years (QALYs), number and percentage of overdose deaths averted, number of HIV-related deaths averted, total costs (in 2015 US$) associated with each strategy, and incremental cost per QALY gained. FINDINGS: In the base-case analysis, compared with no additional intervention, the naloxone distribution strategy yielded an incremental cost-effectiveness ratio (ICER) of $323 per QALY, and naloxone distribution plus linkage to addiction treatment was cost saving compared with no additional intervention (greater effectiveness and less expensive). The most efficient strategies (ie, those conferring the greatest health benefit for a particular budget) were naloxone distribution combined with linkage to addiction treatment (cost saving), and naloxone distribution combined with PrEP and linkage to addiction treatment (ICER $95 337 per QALY) at a willingness-to-pay threshold of $100 000. In probabilistic sensitivity analysis, the combination of naloxone distribution, PrEP, and linkage to addiction treatment was the optimal strategy in 37% of iterations and the combination of naloxone distribution and linkage to addiction treatment was the optimal strategy in 34% of iterations. INTERPRETATION: Naloxone distribution through syringe service programmes is cost-effective compared with syringe distribution alone, but when combined with linkage to addiction treatment is cost saving compared with no additional services. A strategy that combines naloxone distribution, PrEP, and linkage to addiction treatment results in greater health benefits in people who inject drugs and is also cost-effective. FUNDING: State of Connecticut Department of Public Health and the National Institute of Mental Health.
[Mh] Termos MeSH primário: Infecções por HIV/prevenção & controle
Naloxona/provisão & distribuição
Profilaxia Pré-Exposição/utilização
Abuso de Substâncias por Via Intravenosa/terapia
[Mh] Termos MeSH secundário: Connecticut
Análise Custo-Benefício
Seres Humanos
Modelos Teóricos
Naloxona/economia
Programas de Troca de Agulhas/economia
Profilaxia Pré-Exposição/economia
Avaliação de Programas e Projetos de Saúde
Abuso de Substâncias por Via Intravenosa/economia
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
36B82AMQ7N (Naloxone)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171219
[St] Status:MEDLINE


  5 / 17915 MEDLINE  
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[PMID]:29215840
[Au] Autor:Richmond NJ
[Ti] Título:Rethinking Naloxone: Overdose drug is only one part of the cycle of narcotic abuse.
[So] Source:JEMS;42(2):63, 2017 02.
[Is] ISSN:0197-2510
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Overdose de Drogas/tratamento farmacológico
Serviços Médicos de Emergência
Naloxona/uso terapêutico
Antagonistas de Entorpecentes/uso terapêutico
Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico
[Mh] Termos MeSH secundário: Seres Humanos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Narcotic Antagonists); 36B82AMQ7N (Naloxone)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE


  6 / 17915 MEDLINE  
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[PMID]:29188963
[Au] Autor:Hamel MG
[Ti] Título:Revisiting Naloxone: A different take on overdose guidelines from Lee County, Fla.
[So] Source:JEMS;41(11):46-8, 2016 11.
[Is] ISSN:0197-2510
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Overdose de Drogas/tratamento farmacológico
Serviços Médicos de Emergência/organização & administração
Tratamento de Emergência
Naloxona/uso terapêutico
Antagonistas de Entorpecentes/uso terapêutico
Guias de Prática Clínica como Assunto
[Mh] Termos MeSH secundário: Florida
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Narcotic Antagonists); 36B82AMQ7N (Naloxone)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE


  7 / 17915 MEDLINE  
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[PMID]:29188938
[Au] Autor:Wirth SR
[Ti] Título:Naloxone Conundrum: Reduce risk in managing the opioid overdose patient.
[So] Source:JEMS;41(11):14-5, 2016 11.
[Is] ISSN:0197-2510
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Analgésicos Opioides/envenenamento
Overdose de Drogas/tratamento farmacológico
Serviços Médicos de Emergência/métodos
Naloxona/uso terapêutico
Antagonistas de Entorpecentes/uso terapêutico
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Narcotic Antagonists); 36B82AMQ7N (Naloxone)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE


  8 / 17915 MEDLINE  
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[PMID]:29181532
[Au] Autor:Chou R; Korthuis PT; McCarty D; Coffin PO; Griffin JC; Davis-O'Reilly C; Grusing S; Daya M
[Ad] Endereço:From Oregon Health & Science University, Portland, Oregon, and San Francisco Department of Public Health, San Francisco, California.
[Ti] Título:Management of Suspected Opioid Overdose With Naloxone in Out-of-Hospital Settings: A Systematic Review.
[So] Source:Ann Intern Med;167(12):867-875, 2017 Dec 19.
[Is] ISSN:1539-3704
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Background: Naloxone is effective for reversing opioid overdose, but optimal strategies for out-of-hospital use are uncertain. Purpose: To synthesize evidence on 1) the effects of naloxone route of administration and dosing for suspected opioid overdose in out-of-hospital settings on mortality, reversal of overdose, and harms, and 2) the need for transport to a health care facility after reversal of overdose with naloxone. Data Sources: Ovid MEDLINE (1946 through September 2017), PsycINFO, Cochrane Central Register of Controlled Trials, CINAHL, U.S. Food and Drug Administration (FDA) materials, and reference lists. Study Selection: English-language cohort studies and randomized trials that compared different doses of naloxone, administration routes, or transport versus nontransport after reversal of overdose with naloxone. Main outcomes were mortality, reversal of overdose, recurrence of overdose, and harms. Data Extraction: Dual extraction and quality assessment of individual studies; consensus assessment of overall strength of evidence (SOE). Data Synthesis: Of 13 eligible studies, 3 randomized controlled trials and 4 cohort studies compared different administration routes. At the same dose (2 mg), 1 trial found similar efficacy between higher-concentration intranasal naloxone (2 mg/mL) and intramuscular naloxone, and 1 trial found that lower-concentration intranasal naloxone (2 mg/5 mL) was less effective than intramuscular naloxone but was associated with decreased risk for agitation (low SOE). Evidence was insufficient to evaluate other comparisons of route of administration. Six uncontrolled studies reported low rates of death and serious adverse events (0% to 1.25%) in nontransported patients after successful naloxone treatment. Limitation: There were few studies, all had methodological limitations, and none evaluated FDA-approved autoinjectors or highly concentrated intranasal formulations. Conclusion: Higher-concentration intranasal naloxone (2 mg/mL) seems to have efficacy similar to that of intramuscular naloxone for reversal of opioid overdose, with no difference in adverse events. Nontransport after reversal of overdose with naloxone seems to be associated with a low rate of serious harms, but no study evaluated risks of transport versus nontransport. Primary Funding Source: Agency for Healthcare Research and Quality. (PROSPERO: CRD42016053891).
[Mh] Termos MeSH primário: Analgésicos Opioides/toxicidade
Serviços Médicos de Emergência/métodos
Naloxona/uso terapêutico
Antagonistas de Entorpecentes/uso terapêutico
[Mh] Termos MeSH secundário: Administração Intranasal
Analgésicos Opioides/antagonistas & inibidores
Overdose de Drogas/tratamento farmacológico
Seres Humanos
Injeções Intramusculares
Naloxona/administração & dosagem
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Narcotic Antagonists); 36B82AMQ7N (Naloxone)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE
[do] DOI:10.7326/M17-2224


  9 / 17915 MEDLINE  
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[PMID]:29194445
[Au] Autor:Raleigh MD; Peterson SJ; Laudenbach M; Baruffaldi F; Carroll FI; Comer SD; Navarro HA; Langston TL; Runyon SP; Winston S; Pravetoni M; Pentel PR
[Ad] Endereço:Minneapolis Medical Research Foundation, Minneapolis, MN, United States of America.
[Ti] Título:Safety and efficacy of an oxycodone vaccine: Addressing some of the unique considerations posed by opioid abuse.
[So] Source:PLoS One;12(12):e0184876, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Among vaccines aimed at treating substance use disorders, those targeting opioids present several unique medication development challenges. 1) Opioid overdose is a common complication of abuse, so it is desirable for an opioid vaccine to block the toxic as well as the addictive effects of opioids. 2) It is important that an opioid vaccine not interfere with the action of opioid antagonists used to reverse opioid overdose or treat addiction. 3) Some opioids are immunosuppressive and chronic ongoing opioid use could interfere with vaccine immunogenicity. 4) Although antibody-bound oxycodone is unable to enter the brain because of its size, it might still be able to activate peripheral opioid receptors. To assess vaccine impact on opioid toxicity, rats vaccinated with oxycodone conjugated to keyhole limpet hemocyanin subunit dimer (OXY-dKLH) adsorbed to alum or controls vaccinated with dKLH were compared with regard to oxycodone-induced hotplate analgesia and oxycodone-induced respiratory depression and bradycardia. Vaccination shifted the dose-response curves to the right, representing protection, for each of these endpoints. Naloxone was equally effective in both OXY-dKLH and control groups, providing complete and rapid reversal of respiratory depression. The administration of a long-acting naltrexone formulation during vaccination did not impair vaccine immunogenicity in mice. Similarly, serum anti-oxycodone antibody titers were not altered by continuous morphine infusion during vaccination compared to opioid-naïve controls. Competitive ELISA assay showed negligible or low affinity of immune antiserum for endogenous opioids or opioid antagonists. In vitro receptor binding assays showed that antibody-bound oxycodone does not activate mu opioid receptors. These data support further study of OXY-dKLH as a potential treatment for oxycodone abuse and suggest that vaccination might also reduce the severity of oxycodone overdose.
[Mh] Termos MeSH primário: Transtornos Relacionados ao Uso de Opioides/terapia
Oxicodona/imunologia
Vacinas/uso terapêutico
[Mh] Termos MeSH secundário: Animais
Antídotos/administração & dosagem
Masculino
Camundongos
Naloxona/administração & dosagem
Ratos
Vacinas/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antidotes); 0 (Vaccines); 36B82AMQ7N (Naloxone); CD35PMG570 (Oxycodone)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171226
[Lr] Data última revisão:
171226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0184876


  10 / 17915 MEDLINE  
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[PMID]:28450608
[Au] Autor:O'Neil K
[Ti] Título:S&T Policy Forum examines evolving opioid epidemic.
[So] Source:Science;356(6336):390, 2017 Apr 28.
[Is] ISSN:1095-9203
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Overdose de Drogas/epidemiologia
Epidemias
Dependência de Heroína/epidemiologia
Transtornos Relacionados ao Uso de Opioides/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Overdose de Drogas/tratamento farmacológico
Heroína/administração & dosagem
Heroína/efeitos adversos
Dependência de Heroína/tratamento farmacológico
Seres Humanos
Naloxona/administração & dosagem
Naloxona/uso terapêutico
Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico
Estados Unidos/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
36B82AMQ7N (Naloxone); 70D95007SX (Heroin)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171219
[Lr] Data última revisão:
171219
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1126/science.356.6336.390-a



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