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Module 2: Pharmacotherapy - UCLA Integrated Substance Abuse
Module 2: Pharmacotherapy - UCLA Integrated Substance Abuse

... Polydrug use is the norm among drug users  Most people who use illicit drugs use a variety of different drugs  Heroin users also are heavy users of alcohol and benzodiazepines  As central nervous system (CNS) depressants, these combinations are especially dangerous and known to be significant con ...
New Drug Update  hydrocodone bitartrate Zohydro ER
New Drug Update hydrocodone bitartrate Zohydro ER

... hydrocodone bitartrate, along with routine monitoring for signs of addiction, abuse, and misuse. Hydrocodone bitartrate is contraindicated in patients with significant respiratory depression, acute or severe bronchial asthma, and hypercarbia. Serious and potential fatal cases of respiratory depressi ...
Relationship between Serum Acetaminophen Concentration and N
Relationship between Serum Acetaminophen Concentration and N

... We further analysed and compared the serum acetaminophen concentration associated with the presence or absence of different types of ADR induced by N-acetylcysteine. Significantly lower serum acetaminophen concentrations were associated with the presence of flushing (p < 0.001), rash (p < 0.001), an ...
Guidance For The Community Management Of Benzodiazepine And
Guidance For The Community Management Of Benzodiazepine And

... • Benzodiazepines and Z-drugs carry a risk of dependence, tolerance and withdrawal effects. They can put patients at increased risk of overdose, especially when combined with other depressant drugs such as methadone, heroin and alcohol. • There is very little evidence to suggest that long-term subst ...
Opioid Complications and Side Effects
Opioid Complications and Side Effects

... medications increases and this public health issue confounds their clinical utility. Also, the extent of their efficacy in the treatment of pain when utilized on a chronic basis has not been definitively proven. Lastly, the role of opioids in the treatment of chronic pain is also influenced by the f ...
Product Monograph
Product Monograph

... hepatic or renal failure, exacerbated respiratory failure, higher doses than tolerated in an older patient, or the patient is actually more severely ill than realized. If it is necessary to reduce the dose, it can be carefully increased again after 3 or 4 days if it is obvious that the pain is not b ...
Fentanyl citrate - Therapeutic Goods Administration
Fentanyl citrate - Therapeutic Goods Administration

... Abstral is indicated for the management of breakthrough pain in adult patients using opioid therapy for chronic cancer pain. Breakthrough pain is a transient exacerbation of otherwise controlled chronic background pain. The dose is to be titrated to individual response and the product is not interch ...
Prescribing Information
Prescribing Information

... Initial U.S. Approval: 1985 WARNING: DEATH RELATED TO ULTRA-RAPID METABOLISM OF CODEINE TO MORPHINE See full prescribing information for complete boxed warning. Respiratory depression and death have occurred in children who received codeine following tonsillectomy and/or adenoidectomy and had eviden ...
WARNING: DEATH RELATED TO ULTRA
WARNING: DEATH RELATED TO ULTRA

... 5.1 Death Related to Ultra-Rapid Metabolism of Codeine to Morphine Respiratory depression and death have occurred in children who received codeine in the postoperative period following tonsillectomy and/or adenoidectomy and had evidence of being ultra-rapid metabolizers of codeine (i.e., multiple c ...
Pediatric Codeine Formularly Restriction
Pediatric Codeine Formularly Restriction

... Like all AHS Provincial Drug Formulary decisions, the decision to restrict codeine in pediatrics was carefully contemplated. The Pediatric Advisory Committee (PAC) is a multi-disciplinary committee made up of pediatric practitioners from across the province. The PAC reports to the Drugs and Therapeu ...
Summary of Product Characteristics
Summary of Product Characteristics

... 4.2 Posology and method of administration Myasthenia gravis Adults Doses of 30 to 120mg are given at intervals throughout the day when maximum strength is needed (for example, on rising and before mealtimes). The usual duration of action of a dose is 3 to 4 hours in the daytime but a longer effect ( ...
Facts about Buprenorphine (Suboxone )  ®
Facts about Buprenorphine (Suboxone )  ®

... buprenorphine is much less likely to cause  overdose and possible death if it’s the only thing  you’re taking. However if you try to override the  blockade effect by using higher doses of opiates  then the risk of overdose is significantly increased.  When the buprenorphine wears off, the effects of ...
first line
first line

...  Supposed to be given on empty stomach but can generally be taken with or without food providing it is tolerated well.  Avoid high fat meals ( Absorption)  Capsules may be opened and added to soft foods. (Peppery taste)  Tablets cannot be crushed. Use generic capsules if child cant swallow table ...
Opioid Pharmacology : new insight and clinical relevance
Opioid Pharmacology : new insight and clinical relevance

... – 1. Tolerance to analgesic or side effect of opioid 2. Specific withdrawal or abstinence syndrome resulting from physiologic dependence 3. Craving for drug from psychological dependence ...
Evaluation of Dependence and Withdrawal in Clinical Trials
Evaluation of Dependence and Withdrawal in Clinical Trials

... amount of it to achieve a certain effect (tolerance) and eliciting drugspecific physical or mental symptoms if drug use is abruptly ceased (withdrawal). - It is associated with the repeated use of both known drugs of abuse and drugs with no abuse potential. (For example, the “propranolol withdrawal ...
Methadone
Methadone

... Buvanendran, A. and J. S. Kroin (2007). "Useful adjuvants for postoperative pain management." Best Pract Res Clin Anaesthesiol 21(1): 31-49. ...
Opioid Analgesics
Opioid Analgesics

... Mosby items and derived items © 2007 by Mosby, Inc., an affiliate of Elsevier Inc. ...
Ibuprofen is a non-steriodal anti-inflammatory drug with established
Ibuprofen is a non-steriodal anti-inflammatory drug with established

... comparator and placebo-controlled studies. The comparator most frequently used is paracetamol. Licensed doses of ibuprofen vary between countries, as they do for paracetamol. For all licensed doses, ibuprofen has been shown to be at least as effective as paracetamol in treating fever. There is evide ...
Experience of the use of Ketamine to manage opioid withdrawal in
Experience of the use of Ketamine to manage opioid withdrawal in

... her life by overdosing on opioid medication. The decision to stop taking opioid painkillers was not a spontaneous request on the part of the patient but a decision she took when she realized that no physician would prescribe her such a high daily dose. In the literature, it has been shown that repla ...
summary of product characteristics
summary of product characteristics

... increased Cmax and AUC of buprenorphine (approximately 70% and 50% respectively) and, to a lesser extent, of the metabolite, norbuprenorphine. Patients receiving buprenorphine should be closely monitored and the dose of buprenorphine should be halved when starting treatment with ketoconazole. Althou ...
PRESCRIBING INFORMATION Entex LA Pseudoephedrine
PRESCRIBING INFORMATION Entex LA Pseudoephedrine

... This product should not be taken by persons who have high blood pressure, peripheral vascular disease, heart or thyroid disease, prostate disease, glaucoma, diabetes, persistent/chronic cough; or by pregnant/nursing women, or by persons taking high blood pressure medication or an antidepressant cont ...
Opioid Withdrawal: A New Look At Medication
Opioid Withdrawal: A New Look At Medication

... withdrawal from heroin or methadone and were more likely to be associated with treatment completion than placebo. The studies conclude that alpha-2 adrenergic agonists may be an alternative in treating opioid withdrawal.12 Sos et al evaluated the effects of the alpha-2 adrenergic agonist tizanidine ...
Sufentanil Citrate Injection USP
Sufentanil Citrate Injection USP

... the human cytochrome CYP 3A4 enzyme. However, no in vivo inhibition by erythromycin (a known cytochrome CYP 3A4 enzyme inhibitor) has been observed. Although clinical data are lacking, other drugs such as ketoconazole, itraconazole, and ritonavir, are also known to be clinically important inhibitors ...
DUROGESIC Transdermal System
DUROGESIC Transdermal System

... The approximate analgesic potency ratio of transdermally administered fentanyl to parenteral morphine ranges from 1:20 to 1:30 in opioid-naive patients with acute pain. Minimum effective analgesic serum concentrations of fentanyl in opioid-naive patients range from 0.3 to 1.5 nanograms/mL and are re ...
How Toxic is Amiodarone to the Liver?
How Toxic is Amiodarone to the Liver?

... the negative effects of alcohol at high doses. Similarly, amiodarone can be shown to have a concentration-response relationship for its hepatic effects with evidence of differing sensitivities to toxicity within the population [6]. When used at low doses, amiodarone, like alcohol, seems to cause tox ...
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Dextropropoxyphene



Dextropropoxyphene is an analgesic in the opioid category, patented in 1955 and manufactured by Eli Lilly and Company. It is an optical isomer of levopropoxyphene. It is intended to treat mild pain and also has antitussive (cough suppressant) and local anaesthetic effects. The drug has been taken off the market in Europe and the US due to concerns of fatal overdoses and heart arrhythmias. Its onset of analgesia (pain relief) is said to be 20–30 minutes and peak effects are seen about 1.5–2 hours after oral administration.Dextropropoxyphene is sometimes combined with acetaminophen or aspirin. Trade names include Darvocet-N and Di-Gesic, Darvon with APAP (for dextropropoxyphene and paracetamol) and Darvon with ASA (for dextropropoxyphene and aspirin). The British approved name (i.e. the generic name of the active ingredient) of the paracetamol/dextropropoxyphene preparation is ""co-proxamol"" (sold under a variety of brand names); however, it has been withdrawn since 2007, and is no longer available to new patients, with exceptions. The paracetamol combination(s) are known as Capadex or Di-Gesic in Australia, Lentogesic in South Africa, and Di-Antalvic in France (unlike co-proxamol, which is an approved name, these are all brand names).Dextropropoxyphene is known under several synonyms, including: Alpha-d-4-dimethylamino-3-methyl-1,2-diphenyl-2-butanol propionate [(2S,3S)-4-(Dimethylamino)-3- methyl-1,2-diphenylbutan-2-yl] propanoate (+)-1,2-Diphenyl-2-propionoxy- 3-methyl-4-di-methylaminobutane Desoxypropiophen↑ 1.0 1.1 1.2 1.3 1.4 ↑ ↑ ↑ ↑ ↑ ↑ ↑
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