Search results for "Methadone"
showing 10 items of 48 documents
Therapeutic drug monitoring of drugs for treatment of substance-related disorders
2011
IntroductionThe effect of pharmacotherapy of substance-related disorders is moderate at best.ObjectivesTherapeutic drug monitoring (TDM) could be an instrument to improve the outcomes. TDM is for most of these drugs not established yet.AimsThe authors built a literature based rating scale to evaluate the necessity of TDM for these pharmacological agents.MethodsA literature research was performed for TDM related properties of acamprosate, bupropion, buprenorphine, clomethiazole, disulfiram, methadone, naltrexone, and varenicline. A rating scale was established for evaluation. It included 28 items related to five categories (efficacy, toxicity, pharmacokinetics, patient characteristics and co…
Preliminary Practical Findings on Drug Monitoring by a Transcutaneous Collection Device
1996
A noninvasive and nonocclusive skin patch (Sudormed™) was investigated for the systematic collection of drugs of abuse over a period of several days. First, the applicability and user friendliness were tested by volunteers. The permeability of the polyurethane dressing from the outside to the inside for an aqueous solution was shown by incubating the outside layer with Rhodamine B. No fluorescence could be detected in the cotton pad beneath. A single dose experiment using theophylline as a model compound showed that there was a delay in time before the substance could be determined in the pad. The drug content decreased with increasing time of patch application. When eight volunteers partic…
Detection of 9-Tetrahydrocannabinol and Amphetamine-Type Stimulants in Oral Fluid Using the Rapid Stat Point-of-Collection Drug-Testing Device
2010
The Rapid Stat assay, a point-of-collection drug-testing device for detection of amphetamines, cannabinoids, cocaine, opiates, methadone, and benzodiazepines in oral fluid, was evaluated for cannabis and amphetamine-type stimulants. The Rapid Stat tests (n = 134) were applied by police officers in routine traffic checks. Oral fluid and blood samples were analyzed using gas chromatography-mass spectrometry (GC-MS) for Delta(9)-tetrahydrocannabinol, amphetamine, methamphetamine, methylenedioxymethamphetamine, methylenedioxyethylamphetamine, and methylenedioxyamphetamine. The comparison of GC-MS analysis of oral fluid with the Rapid Stat results for cannabis showed a sensitivity of 85%, a spec…
Pharmacogenetics and Forensic Toxicology: A New Step towards a Multidisciplinary Approach
2021
Pharmacogenetics analyzes the individual behavior of DNA genes after the administration of a drug. Pharmacogenetic research has been implemented in recent years thanks to the improvement in genome sequencing techniques and molecular genetics. In addition to medical purposes, pharmacogenetics can constitute an important tool for clarifying the interpretation of toxicological data in post-mortem examinations, sometimes crucial for determining the cause and modality of death. The purpose of this systematic literature review is not only to raise awareness among the forensic community concerning pharmacogenetics, but also to provide a workflow for forensic toxicologists to follow in cases of unk…
Therapeutic Drug Monitoring for Drugs Used in the Treatment of Substance-Related Disorders: Literature Review Using a Therapeutic Drug Monitoring App…
2011
Background The efficacy of drugs for the treatment of substance-related disorders is moderate at best. Therapeutic drug monitoring (TDM) could be an instrument to improve outcomes. Because TDM for most of those drugs is not established, the authors reviewed the literature and built a rating scale to detect the potential added value of TDM for these pharmacologic agents. Methods A literature search was performed for acamprosate, bupropion, buprenorphine, clomethiazole, disulfiram, methadone, naltrexone, and varenicline. The rating scale included 22 items and was divided in five categories: efficacy, toxicity, pharmacokinetics, patient characteristics, and cost-effectiveness. Three reference …
Palliative Treatment of Dyspnea With Epidural Methadone in Advanced Emphysema
2005
This study investigated whether epidural methadone perfusion at the thoracic level can mitigate dyspnea in patients with advanced emphysema.Open-label clinical trial without a control group.University hospital.The inclusion criteria were a diagnosis of emphysema, basal dyspnea index (Mahler scale)or = 3, FEV(1)or = 35%, and no indication for pneumoreduction or lung transplantation surgery.An epidural catheter was inserted at the thoracic level connected to a perfusion pump for administering methadone (6 mg/24 h). Assessments were made at baseline, 1 week, and 1 month after catheter insertion.Pulmonary function tests were performed, and determinations were made of arterial blood gas levels, …
Switching from morphine to methadone to improve analgesia and tolerability in cancer patients: A prospective study
2001
PURPOSE: To evaluate the clinical benefits of switching from morphine to oral methadone in patients who experience poor analgesia or adverse effects from morphine. PATIENTS AND METHODS: Fifty-two consecutive cancer patients receiving oral morphine but with uncontrolled pain and/or moderate to severe opioid adverse effects were switched to oral methadone administered every 8 hours using different dose ratios. Intensity of pain and adverse effects were assessed daily, and the symptom distress score (DS) was calculated before and after switching. RESULTS: Data were analyzed for 50 patients. Switching was considered effective in 80% of the patients; results were achieved in an average of 3.65 …
Rapid switching from morphine to methadone in cancer patients with poor response to morphine
1999
PURPOSE: The aim of this study was to evidence the clinical effects of an abrupt substitution of morphine with methadone using a fixed ratio of 1:5 in patients for whom limiting adverse effects occurred before adequate analgesia was achieved with oral morphine. PATIENTS AND METHODS: A cross-sectional prospective study was carried out on 24 consecutive patients who were switched from oral morphine to oral methadone because they experienced substantial adverse effects that limited further increase in morphine dose. A fixed conversion morphine-to-methadone ratio of 5:1 was chosen. Subsequently, doses were changed according to clinical need, with frequent visits or phone contacts. Pain and sym…
Sustained-release oral morphine versus transdermal fentanyl and oral methadone in cancer pain management.
2008
The aim of this study was to compare the analgesic and adverse effects, doses, as well as cost of opioid drugs, supportive drug therapy and other analgesic drugs in patients treated with oral sustained-release morphine, transdermal fentanyl, and oral methadone.One hundred and eight cancer patients, no longer responsive to opioids for moderate pain, were selected to randomly receive initial daily doses of 60 mg of oral sustained-release morphine, 15 mg of oral methadone, or 0.6 mg (25 microg/h) of transdermal fentanyl. Oral morphine was used as breakthrough pain medication during opioid titration. Opioid doses, pain intensity, adverse effects, symptomatic drugs, were recorded at week interva…
Determinants of interest in extended-released buprenorphine: A survey among 366 French patients treated with buprenorphine or methadone
2021
International audience; Aim: To explore the factors determining the interest in extended-release buprenorphine (XR-BUP) injections among patients receiving opioid agonist treatment (OAT) in France.Methods: 366 patients receiving OAT for opioid use disorder, recruited in 66 French centers, were interviewed from 12/2018 to 05/2019. A structured questionnaire assessed their interest in XR-BUP using a [1-10] Likert scale. 'More' vs. 'less' interested groups were defined using the median score of interest, and their characteristics were explored using adjusted odds ratios (aORs) and 95 % confidence interval (95 %CI). Independent variables were as follows: sociodemographic characteristics, OAT-re…