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Impact of the blood sampling site on time-concentration drug profiles following intravenous or buccal drug administration.

Pub Med: Keyword Buprenorphine - April 20, 2014 - 2:30pm
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Impact of the blood sampling site on time-concentration drug profiles following intravenous or buccal drug administration.

J Vet Pharmacol Ther. 2014 Apr;37(2):145-50

Authors: Hedges AR, Pypendop BH, Shilo Y, Stanley SD, Ilkiw JE

Abstract
The aim of this study was to examine the effect of the sampling site on the drug concentration-time profile, following intravenous or buccal (often called 'oral transmucosal') drug administration. Buprenorphine (20 μg/kg) was administered IV or buccally to six cats. Blood samples were collected from the carotid artery and the jugular and medial saphenous veins for 24 h following buprenorphine administration. Buprenorphine concentration-time data were examined using noncompartmental analysis. Pharmacokinetic parameters were compared using the Wilcoxon signed rank test, applying the Bonferroni correction. Significance was set at P < 0.05. Following IV administration, no difference among the sampling sites was found. Following buccal administration, maximum concentration [jugular: 6.3 (2.9-9.8), carotid: 3.4 (1.9-4.9), medial saphenous: 2.5 (1.7-4.1) ng/mL], area under the curve [jugular: 395 (335-747), carotid: 278 (214-693), medial saphenous: 255 (188-608) ng·min/mL], and bioavailability [jugular: 47 (34-67), carotid: 32 (20-52), medial saphenous: 23 (16-55)%] were higher in the jugular vein than in the carotid artery and medial saphenous vein. Jugular venous blood sampling is not an acceptable substitute for arterial blood sampling following buccal drug administration.

PMID: 24745064 [PubMed - in process]

10 Must Do's When: Giving Birth to the Blues

MedWorm Addiction Feeds - April 20, 2014 - 12:52pm
A ruby is a jewel, and a ruby is a stone, just as the rapture of solitude lies within the agony of being alone. read more (Source: Psychology Today Depression Center)

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Addiction and the brain

MedWorm Addiction Feeds - April 19, 2014 - 7:00pm
Addiction to nicotine and other drugs is hard to break, but did you know that switching on certain cells in the brain may help break the addiction cycle? Jeremy Shere has more..... (Source: Sound Medicine)

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Insurance coverage for the rehabilitation of opioid addiction

MedWorm Addiction Feeds - April 18, 2014 - 11:00pm
Many people suffering from prescription painkiller addiction are denied insurance coverage for treatment, even though insurance initially paid for the medication that spurred the addiction. Andrew Chambers, M.D., discusses treatment options for opioid addiction as well as the true cost of rehabilitation for both physicians and patients..... (Source: Sound Medicine)

Patterns of cigarillo use among Canadian young adults in two urban settings.

MedWorm Addiction Feeds - April 18, 2014 - 8:00pm
CONCLUSION: These findings highlight the social nature of cigarillo use, and suggest a lack of awareness of the health risks associated with cigarillo and polytobacco use in this small convenience sample of Canadian young adults. Population-level analyses are needed to further investigate cigarillo, polytobacco and concurrent cannabis use patterns and beliefs among Canadian young adults. PMID: 24735690 [PubMed - in process] (Source: Canadian Journal of Public Health)

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Utilizing buprenorphine-naloxone to treat illicit and prescription-opioid dependence.

Pub Med: Keyword Buprenorphine - April 18, 2014 - 6:30am

Utilizing buprenorphine-naloxone to treat illicit and prescription-opioid dependence.

Neuropsychiatr Dis Treat. 2014;10:587-598

Authors: Mauger S, Fraser R, Gill K

Abstract
OBJECTIVES: To review current evidence on buprenorphine-naloxone (bup/nx) for the treatment of opioid-use disorders, with a focus on strategies for clinical management and office-based patient care.
QUALITY OF EVIDENCE: Medline and the Cochrane Database of Systematic Reviews were searched. Consensus reports, guidelines published, and other authoritative sources were also included in this review. Apart from expert guidelines, data included in this review constitute level 1 evidence.
FINDINGS: Bup/nx is a partial μ-opioid agonist combined with the opioid antagonist naloxone in a 4:1 ratio. It has a lower abuse potential, carries less stigma, and allows for more flexibility than methadone. Bup/nx is indicated for both inpatient and ambulatory medically assisted withdrawal (acute detoxification) and long-term substitution treatment (maintenance) of patients who have a mild-to-moderate physical dependence. A stepwise long-term substitution treatment with regular monitoring and follow-up assessment is usually preferred, as it has better outcomes in reducing illicit opioid use, minimizing concomitant risks such as human immunodeficiency virus and hepatitis C transmission, retaining patients in treatment and improving global functioning.
CONCLUSION: Bup/nx is safe and effective for opioid detoxification and substitution treatment. Its unique pharmaceutical properties make it particularly suitable for office-based maintenance treatment of opioid-use disorder.

PMID: 24741316 [PubMed - as supplied by publisher]

Psychological Crutches: Ten Myths and Three Tips

MedWorm Addiction Feeds - April 17, 2014 - 5:22pm
This article ends with three guidelines we intuit matter to sorting good from bad crutches.read more (Source: Psychology Today Addiction Center)

Psychological Crutches: 10 Myths and 3 Tips

MedWorm Addiction Feeds - April 17, 2014 - 5:22pm
This article ends with three guidelines we intuit matter to sorting good from bad crutches.read more (Source: Psychology Today Anxiety Center)

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Mephedrone, Methylone and 3,4‐Methylenedioxypyrovalerone (MDPV) Induce Conditioned Place Preference in Mice

MedWorm Addiction Feeds - April 17, 2014 - 4:21pm
This article is protected by copyright. All rights reserved. (Source: Basic and Clinical Pharmacology and Toxicology)

Acute Care for Addiction

MedWorm Addiction Feeds - April 17, 2014 - 10:58am
The difficulties encountered by both the patient and practitioners related to early recovery and detoxification needs.read more (Source: Psychology Today Addiction Center)

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Post-Surgical Analgesia in Rainbow Trout: Is Reduced Cardioventilatory Activity a Sign of Improved Animal Welfare or the Adverse Effects of an Opioid Drug?

Pub Med: Keyword Buprenorphine - April 17, 2014 - 6:30am

Post-Surgical Analgesia in Rainbow Trout: Is Reduced Cardioventilatory Activity a Sign of Improved Animal Welfare or the Adverse Effects of an Opioid Drug?

PLoS One. 2014;9(4):e95283

Authors: Gräns A, Sandblom E, Kiessling A, Axelsson M

Abstract
The use of fish models in biomedical research is increasing. Since behavioural and physiological consequences of surgical procedures may affect experimental results, these effects should be defined and, if possible, ameliorated. Thus, the use of post-surgical analgesia should be considered after invasive procedures also in fish, but presently, little information exists on the effects of analgesics in fish. This study assessed the effects of an opioid drug, buprenorphine (0.05 mg/kg IM), on resting ventilation and heart rates during 7 days of postsurgical recovery in rainbow trout (Oncorhynchus mykiss) at 10°C by non-invasively recording bioelectric potentials from the fish via electrodes in the water. Baseline ventilation and heart rates were considerably lower compared to previously reported values for rainbow trout at 10°C, possibly due to the non-invasive recording technique. Buprenorphine significantly decreased both ventilation and heart rates further, and the effects were most pronounced at 4-7 days after anaesthesia, surgical procedures and administration of the drug. Somewhat surprisingly, the same effects of buprenorphine were seen in the two control groups that had not been subject to surgery. These results indicate that the reductions in ventilation and heart rates are not caused by an analgesic effect of the drug, but may instead reflect a general sedative effect acting on both behaviour as well as e.g. central control of ventilation in fishes. This resembles what has previously been demonstrated in mammals, although the duration of the drug effect is considerably longer in this ectothermic animal. Thus, before using buprenorphine for postoperative analgesic treatment in fish, these potentially adverse effects need further characterisation.

PMID: 24736526 [PubMed - as supplied by publisher]

Opioid-related mortality and filled prescriptions for buprenorphine and methadone.

Pub Med: Keyword Buprenorphine - April 17, 2014 - 6:30am

Opioid-related mortality and filled prescriptions for buprenorphine and methadone.

Drug Alcohol Rev. 2014 Apr 16;

Authors: Wikner BN, Ohman I, Seldén T, Druid H, Brandt L, Kieler H

Abstract
INTRODUCTION AND AIMS: To assess opioid-related mortality and correlation with filled prescriptions for buprenorphine and methadone.
DESIGN AND METHODS: A register study, including data from the Swedish Forensic Pathology and Forensic Toxicology databases 2003-2010, the Prescribed Drug Register and the National Patient Register.
RESULTS: A total of 1301 deaths, assessed as related to buprenorphine, methadone or heroin, or a combination of them, were studied. The largest number of fatalities was related to intake of heroin (n = 776), followed by methadone (n = 342) and buprenorphine (n = 168). The total annual number of fatal cases related to the studied drugs more than doubled (116 to 255) during the study period. There were increases in mortality related to both buprenorphine and methadone: from 1 to 49 cases for buprenorphine, and from 19 to 81 cases for methadone. Only one-fifth of the fatal cases had a filled prescription for the maintenance drug assessed as the cause of death.
DISCUSSION AND CONCLUSION: This study showed that most fatalities were not related to filled prescriptions of maintenance drugs, and a substantial illicit use of buprenorphine and methadone resulting in deaths was revealed. To prevent opioid toxicity deaths it is important to make efforts not only to reduce drug diversion from maintenance programs, but also to improve the control of drug trafficking and other illegal sources. [Wikner BN, Öhman I, Seldén T, Druid H, Brandt L, Kieler H. Opioid-related mortality and filled prescriptions for buprenorphine and methadone. Drug Alcohol Rev 2014].

PMID: 24735085 [PubMed - as supplied by publisher]

Pharmacokinetic-pharmacodynamic modelling of intravenous buprenorphine in conscious horses.

Pub Med: Keyword Buprenorphine - April 17, 2014 - 6:30am

Pharmacokinetic-pharmacodynamic modelling of intravenous buprenorphine in conscious horses.

Vet Anaesth Analg. 2014 Apr 16;

Authors: Love EJ, Pelligand L, Taylor PM, Murrell JC, Sear JW

Abstract
OBJECTIVE: Describe the pharmacokinetics of buprenorphine and norbuprenorphine in horses and to relate the plasma buprenorphine concentration to the pharmacodynamic effects.
STUDY DESIGN: Single phase non-blinded study.
ANIMALS: Six dedicated research horses, aged 3-10 years and weighing 480-515 kg.
METHODS: Thermal and mechanical nociceptive thresholds, heart and respiratory rates and locomotor activity were measured before and 15, 30, 45 & 60 minutes and 2, 4, 6, 8, 12 & 24 hours post-administration of 10 μg kg(-1) buprenorphine IV. Intestinal motility was measured 1, 6, 12 & 24 hours after buprenorphine administration. Venous blood samples were obtained before administration of buprenorphine 10 μg kg(-1) IV and 1, 2, 4, 6, 10, 15, 30, 45 & 60 minutes, and 2, 4, 6, 8, 12 & 24 hours afterwards. Plasma buprenorphine and norbuprenorphine concentrations were measured using a liquid chromatography-tandem mass spectroscopy (LC-MS/MS) assay with solid-phase extraction. A non-compartmental method was used for analysis of the plasma concentration-time data and plasma buprenorphine concentrations were modelled against two dynamic effects (change in thermal threshold and mechanical threshold) using a simple Emax model.
RESULTS: Plasma buprenorphine concentrations were detectable to 480 minutes in all horses and to 720 minutes in two out of six horses. Norbuprenorphine was not detected. Thermal thresholds increased from 15 minutes post-buprenorphine administration until the 8-12 hour time points. The increase in mechanical threshold ranged from 3.5 to 6.0 Newtons (median: 4.4 N); and was associated with plasma buprenorphine concentrations in the range 0.34-2.45 ng mL(-1) .
CONCLUSIONS AND CLINICAL RELEVANCE: The suitability of the use of buprenorphine for peri-operative analgesia in the horse is supported by the present study.

PMID: 24735059 [PubMed - as supplied by publisher]

[Comment on this case report].

Pub Med: Keyword Buprenorphine - April 17, 2014 - 6:30am
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[Comment on this case report].

J Mycol Med. 2012 Sep;22(3):294-7

Authors: Chiron LM, Pihet M, Rouleau F, de Gentile L, Bouchara JP, Chabasse D

PMID: 23518130 [PubMed - indexed for MEDLINE]

Cocaine use severity and cerebellar gray matter are associated with reversal learning deficits in cocaine‐dependent individuals

MedWorm Addiction Feeds - April 17, 2014 - 4:25am
Abstract Cocaine addiction involves persistent deficits to unlearn previously rewarded response options, potentially due to neuroadaptations in learning‐sensitive regions. Cocaine‐targeted prefrontal systems have been consistently associated with reinforcement learning and reversal deficits, but more recent interspecies research has raised awareness about the contribution of the cerebellum to cocaine addiction and reversal. We aimed at investigating the link between cocaine use, reversal learning and prefrontal, insula and cerebellar gray matter in cocaine‐dependent individuals (CDIs) varying on levels of cocaine exposure in comparison with healthy controls (HCs). Twenty CDIs and 21 HCs performed a probabilistic reversal learning task (PRLT) and were subsequently scanned in a 3‐Tes...

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Does negative affect mediate the relationship between daily PTSD symptoms and daily alcohol involvement in female rape victims? Evidence from 14 days of interactive voice response assessment - Cohn A, Hagman BT, Moore K, Mitchell J, Ehlke S.

MedWorm Addiction Feeds - April 16, 2014 - 10:11pm
The negative reinforcement model of addiction posits that individuals may use alcohol to reduce negative affective (NA) distress. The current study investigated the mediating effect of daily NA on the relationship between daily PTSD symptoms and same-day a... (Source: SafetyLit: All (Unduplicated))

Do You Have an Alcohol or Drug Problem?

MedWorm Addiction Feeds - April 16, 2014 - 7:00pm
(Source: About.com Alcoholism)

Study the epidemiological profile of taxi drivers in the background of occupational environment, stress and personality characteristics

MedWorm Addiction Feeds - April 16, 2014 - 7:00pm
Conclusion: Socio-demographic attributes, work environment, stress and personality significantly influence physical and psychological morbidities in taxi drivers. (Source: Indian Journal of Occupational and Environmental Medicine)

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[DSM-5: important changes in the field of addictive diseases.]

MedWorm Addiction Feeds - April 16, 2014 - 7:00pm
Authors: Heinz A, Friedel E Abstract There are two major changes in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) concerning the field of addiction. Firstly, the previous distinction between abuse and dependence has been abolished and both disorders are now subsumed under the category addiction and related disorders. Secondly, pathological gambling has now been included in the section of addiction with slight changes in diagnostic criteria. Both changes have major implications for the definition and conceptualization of what we call a psychiatric "disease" or "disorder", which have also been addressed in the introductory statement of DSM-5. Concerning the category of abuse that is now part of substance use disorders, there is a concern that a well-defined disord...

Take-Home Induction of Buprenorphine Feasible, SafeTake-Home Induction of Buprenorphine Feasible, Safe

MedWorm Addiction Feeds - April 16, 2014 - 10:07am
Starting opioid-addicted patients on buprenorphine treatment without putting them under close observation appears to be safe and may lower barriers to care. Medscape Medical News (Source: Medscape Psychiatry Headlines)

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