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101. Managing opioid use disorder in primary care: PEER simplified guideline

creating recommen- dations on their use. 22 Management of comorbid conditions in patients with OUD Management of comorbidities in patients taking OAT can be challenging. Unfortunately, randomized con- trolled evidence in this area is severely lacking. With regard to the management of acute pain in patients taking OAT, 1 RCT reported morphine was superior to meperidine in an emergency setting. 22 This is not always applicable in an ambulatory setting, and nonopioid options were not explored. Similarly

2019 CPG Infobase

103. Canadian guidelines on opioid use disorder among older adults

, oxycodone, meperidine, tapentadol, fentanyl, remifentanil, sufentanil, methadone, and buprenorphine . Opioids with mixed kappa receptor agonism and mu receptor antagonism that are available to treat pain include pentazocine, butorphanol, and nalbuphine . Medications to treat OUD encompass both opioid agonists and antagonists . Several opioid agonist treatments are authorized for OUD in Canada . Liquid methadone is most common and has the longest history of use . Sublingual buprenorphine is also approved

2019 CPG Infobase

105. Is there any benefit to increasing the dose of tamsulosin from 0.4 mg to 0.8 mg for the treatment of benign prostatic hypertrophy?

the higher dose of tamsulosin more likely to discontinue tamsulosin due to adverse events References: Fentanyl, a phenylpiperidine opioid (in the same class as meperidine, tramadol, and dextromethorphan), has been shown in case reports to induce serotonin syndrome. The mechanism is not entirely clear, but fentanyl may function as a weak serotonin reuptake inhibitor and also may enhance serotonin release. Thus in patients who develop signs of serotonin syndrome, clinicians must be vigilant in considering

2020 Clinical Correlations

107. Management of Cancer Medication-Related Infusion Reactions

, urticaria • 1st generation H1-receptor antagonist (e.g. diphenhydramine 25-50 mg IV) x 1 2,95,96,98-101 • Ranitidine 50 mg IV 95,96,101 or Famotidine 20 mg IV x1 98 • Hydrocortisone 100 mg IV x 1 98-100 Fever • Antipyretic (e.g. acetaminophen 650 mg PO x 1 98-100 ) Rigors/chills † • Meperidine 25-50 mg IV x 1 97,98 Nausea and/or vomiting • Dimenhydrinate 25-50 mg IV x 1 99,100 Hypotension • Normal saline as per hospital policy Wheezing/SOB • Salbutamol 2.5-5 mg nebules inh q 20 min x 3 doses, then q1-4h

2019 Cancer Care Ontario

108. Trastuzumab (Ogivri) - breast cancer or stomach cancer

be used to reduce risk of occurrence of these events. The majority of these events occur during or within 2.5 hours of the start of the first infusion. Should an infusion reaction occur the infusion should be discontinued or the rate of infusion slowed and the patient should be monitored until resolution of all observed symptoms (see section 4.2). These symptoms can be treated with an analgesic/antipyretic such as meperidine or paracetamol, or an antihistamine such as diphenhydramine. The majority

2019 European Medicines Agency - EPARs

109. Labor Dystocia

Spinal Epidural Analgesia 98 Epidural Analgesia Versus Patient-Controlled Intravenous Analgesia 106 Epidural Analgesia Versus Intravascular Tramadol 112 Early Versus Late Epidural Analgesia 112 Routine Epidural Analgesia Versus Analgesia on Request 114 Combined Spinal Epidural Analgesia Versus Nonpharmacologic Pain Relief 115 Epidural Analgesia Versus Intravenous Meperidine 117 Epidural Analgesia Versus Low-Dose Infusion Epidural Analgesia 119 Epidural Analgesia Versus Acupuncture 119 Epidural (...) 55. Epidural analgesia versus intravascular tramadol: Evidence profile in women of mixed parity 112 Table 56. Early versus late epidural analgesia: Evidence profile in nulliparous women a 113 Table 57. Routine epidural analgesia versus analgesia on request: Evidence profile in women of mixed parity 115 Table 58. Strength of evidence for combined spinal epidural analgesia versus nonpharmacologic pain relief in women of mixed parity 116 Table 59. Epidural analgesia versus intravenous meperidine

2020 Effective Health Care Program (AHRQ)

110. Diazepam

). Behavior during local anesthesia, application of rubber dam, cavity preparation, restorative procedures was evaluated, considering the degree of sleep, body movement, crying 2007 12. Intra-articular lidocaine versus intravenous meperidine/ diazepam in anterior shoulder dislocation: a randomised clinical trial. 18434457 2008 04 24 2008 05 19 2013 11 21 1472-0213 25 5 2008 May Emergency medicine journal : EMJ Emerg Med J Intra-articular lidocaine versus intravenous meperidine/ diazepam in anterior (...) shoulder dislocation: a randomised clinical trial. 262-4 10.1136/emj.2007.051060 Anterior shoulder dislocation is one of the most common complaints of patients referred to emergency (...) departments. Intravenous opiates and benzodiazepines are traditionally prescribed in order to relieve the pain in this group of patients; however, complications always pose a problem. To compare the pain relief and complications following intra-articular lidocaine and intravenous meperidine/ diazepam in patients

2018 Trip Latest and Greatest

111. Promethazine

received either placebo or midazolam or promethazine 5 minutes before appendectomy. All episodes of vomiting and nausea within 24 hours after surgery were 2011 19. Ketorolac versus meperidine-plus- promethazine treatment of migraine headache: evaluations by patients. 7893296 1995 04 27 1995 04 27 2013 11 21 0735-6757 13 2 1995 Mar The American journal of emergency medicine Am J Emerg Med Ketorolac versus meperidine-plus- promethazine treatment of migraine headache: evaluations by patients. 146-50 (...) This study was designed to compare and contrast the speed and efficacy of meperidine (75 mg)/ promethazine (25 mg) intramuscularly to ketorolac (60 mg (...) ketorolac (60 mg) or meperidine (75 mg)/ promethazine (25 mg). Sixty-eight percent of patients given meperidine/ promethazine responded whereas 55% of patients given ketorolac responded. The responder group showed a statistically significant reduction in headache within 30 minutes with both drug regimens. There was no statistically significant

2018 Trip Latest and Greatest

113. Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Acute Headache

%) and in the hydromorphone arm by 26 of 64 patients (41%) 398 (difference 19%, 95% CI 2% to 36%; number needed to treat 6, 95% CI 3 to 52). The authors concluded that 399 intravenous hydromorphone is substantially less effective than intravenous prochlorperazine for the treatment of 400 acute migraine in the ED and should not be used as first-line therapy. 401 In a 2008 Class II systematic review, Friedman et al 34 performed a meta-analysis of randomized controlled 402 trials comparing meperidine versus several other (...) regimens (dihydroergotamine [DHE], ketorolac, or an antiemetic) 403 in the treatment of headache. In this study the authors looked at 899 citations and identified 19 trials for inclusion. 404 Within the review’s analysis, 11 studies were determined to have appropriate and available data. Four trials 405 compared meperidine with DHE, 4 compared meperidine with an antiemetic, and 3 compared meperidine with 406 ketorolac. The authors showed that meperidine was not superior to the other regimens

2019 American College of Emergency Physicians

115. Peripartum Analgesia and Anesthesia for the Breastfeeding Mother

and neo- natal neurobehavioral organization is also controversial and inconclusive in its long-term effects on breast- feeding outcomes. There may be depressed hand mas- sage and suckling behavior in neonates exposed to neuraxial analgesia, but some of the neonates studied were also exposed to oxytocin and/or meperidine/ pethidine during the course of labor, which were not accounted for in statistical analysis. There were no long-term differences in breastfeeding outcomes or these outcomes were (...) . Remifentanil is potent and has rapid onset and offset, but can be associated with a high incidence of maternal apnea, requiring in- creased monitoring 26 (IIB-III). Remifentanil has also been shown to result in a number of cases of neonatal depression in a recent survey in academic centers across the United States. 27 Evidence on breastfeeding outcomes is lacking. • Longer-acting opioids with active metabolites such as meperidine/pethidine or morphine should be used with caution and administered less than

2019 Academy of Breastfeeding Medicine

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