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Naloxone

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1. Cost Coverage of Naloxone and Take-Home Naloxone Kits: Briefing Note

Cost Coverage of Naloxone and Take-Home Naloxone Kits: Briefing Note First Do No Harm, National Advisory Council • S'abstenir de faire du mal, Conseil consultatif national Page 1 Briefing Note: Cost Coverage of Naloxone and Take-Home Naloxone Kits Issue Deaths related to opioids are a serious public health problem in Canada. During 2013 in Ontario alone, there were 577 opioid overdose deaths, continuing the upward trend in overall opioid deaths (Centre for Addiction and Mental Health, 2015 (...) ). Researchers have found that many individuals who have died from prescription opioid poisoning had received a prescription for the medication in the months prior to death (Dhalla et al., 2009), illustrating the significant harms associated with prescription opioids. Furthermore, most opioid-related fatalities have been found to be accidental (Dhalla et al., 2009), highlighting an important role for prevention interventions. Providing take-home naloxone (THN) kits to individuals at high risk of death due

2016 Canadian Centre on Substance Abuse

2. Naloxone for opioid-exposed newborn infants. (PubMed)

Naloxone for opioid-exposed newborn infants. Naloxone, a specific opioid antagonist, is available for the treatment of newborn infants with cardiorespiratory or neurological depression that may be due to intrauterine exposure to opioid. It is unclear whether newborn infants may benefit from this therapy and whether naloxone has any harmful effects.To determine the effect of naloxone on the need for and duration of neonatal unit stay in infants of mothers who received opioid analgesia prior (...) Clinical Trials Register. We checked the reference lists of relevant articles to identify further potentially relevant studies.Randomised controlled trials comparing the administration of naloxone versus placebo, or no drug, or another dose of naloxone to newborn infants with suspected or confirmed in utero exposure to opioid.We extracted data using the standard methods of Cochrane Neonatal with separate evaluation of trial quality and data extraction by two review authors and synthesis of data using

2018 Cochrane

3. Angiotensin converting enzyme inhibitor intoxication: Naloxone to the rescue? Naloxone for ACE inhibitor intoxication. (PubMed)

Angiotensin converting enzyme inhibitor intoxication: Naloxone to the rescue? Naloxone for ACE inhibitor intoxication. We report here the case of a patient with perindopril intoxication inducing severe bradycardia together with a profound hypotension. Initiation of a naloxone infusion completely resolved those symptoms. As a consequence, we could recommend as a first step the use of naloxone in order to prevent the use of more invasive therapeutic tools.Copyright © 2019. Published by Elsevier

2019 American Journal of Emergency Medicine

4. Funding and Management of Naloxone Programs in Canada

Funding and Management of Naloxone Programs in Canada Funding and Management of Naloxone Programs in Canada | CADTH.ca Find the information you need Funding and Management of Naloxone Programs in Canada Funding and Management of Naloxone Programs in Canada Published on: March 13, 2018 Project Number: ES0319-000 Product Line: Research Type: Drug Result type: Report This Environmental Scan presents how naloxone is made available in Canadian provinces and territories. The key objectives (...) of this Environmental Scan are to answer the following questions: How are take-home naloxone programs managed and funded? How are take-home naloxone kits distributed? What are the contents of publicly funded take-home naloxone kits? How are public drug plans involved in the coverage and distribution of naloxone? Which first responders carry and administer naloxone? This Environmental Scan does not provide a comprehensive review of the naloxone programs, nor does it appraise the effectiveness of these programs

2017 Canadian Agency for Drugs and Technologies in Health - Environmental Scanning

5. Buprenorphine/naloxone (Suboxone) film versus buprenorphine/naloxone tablets for the treatment of opioid addiction: comparative safety

Buprenorphine/naloxone (Suboxone) film versus buprenorphine/naloxone tablets for the treatment of opioid addiction: comparative safety Buprenorphine/naloxone (Suboxone) film versus buprenorphine/naloxone tablets for the treatment of opioid addiction: comparative safety Buprenorphine/naloxone (Suboxone) film versus buprenorphine/naloxone tablets for the treatment of opioid addiction: comparative safety CADTH Record Status This is a bibliographic record of a published health technology assessment (...) from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation CADTH. Buprenorphine/naloxone (Suboxone) film versus buprenorphine/naloxone tablets for the treatment of opioid addiction: comparative safety. Ottawa: Canadian Agency for Drugs and Technologies in Health (CADTH). Rapid Response - Summary of Abstracts. 2014 Authors' conclusions One randomized controlled trial was identified regarding the comparative safety of buprenorphine/naloxone

2014 Health Technology Assessment (HTA) Database.

6. Buprenorphine-Naloxone (Suboxone) for Pharmaceutical Opioid Use Disorder

Buprenorphine-Naloxone (Suboxone) for Pharmaceutical Opioid Use Disorder Tools for Practice is proudly sponsored by the Alberta College of Family Physicians (ACFP). ACFP is a provincial, professional voluntary organization, representing more than 4,800 family physicians, family medicine residents, and medical students in Alberta. Established over sixty years ago, the ACFP strives for excellence in family practice through advocacy, continuing medical education and primary care research (...) . www.acfp.ca November 5, 2018 Buprenorphine-Naloxone (Suboxone ? ) for Pharmaceutical Opioid Use Disorder Clinical Question: Is buprenorphine (with or without naloxone) effective as maintenance therapy in pharmaceutical opioid use disorder? Bottom Line: Retention in treatment at 15 weeks was seen in 75% taking buprenorphine compared to 26% in detoxification and/or counselling, with 37% reporting ongoing substance use compared to 60% in control. Outcomes between buprenorphine and methadone

2018 Tools for Practice

7. Chest compressions and rescue breathing when administering naloxone in opioid overdose

Chest compressions and rescue breathing when administering naloxone in opioid overdose Chest compressions and rescue breathing when administering naloxone in opioid overdose | The Ontario HIV Treatment Network The Ontario HIV Treatment Network Chest compressions and rescue breathing when administering naloxone in opioid overdose Chest compressions and rescue breathing when administering naloxone in opioid overdose Questions What does the evidence say about the use of chest compressions (...) and/or the use of rescue breathing when responding to an opioid overdose and administering naloxone? Key take-home messages • Opioid overdoses cause respiratory failure (a reduction or stop in breathing), which can lead to cardiac arrest (1, 2). In the event of a suspected opioid overdose, bystanders should call 911 and administer naloxone before any attempts at resuscitation (3-5). Various expert groups have differing opinions on the appropriateness of using chest compressions only, rescue breathing only

2016 Ontario HIV Treatment Network

8. Intranasal and Intramuscular Naloxone for Opioid Overdose in the Pre-Hospital Setting: Comparative Clinical Effectiveness and Cost-Effectiveness

Intranasal and Intramuscular Naloxone for Opioid Overdose in the Pre-Hospital Setting: Comparative Clinical Effectiveness and Cost-Effectiveness Intranasal and Intramuscular Naloxone for Opioid Overdose in the Pre-Hospital Setting: Comparative Clinical Effectiveness and Cost-Effectiveness | CADTH.ca Find the information you need Intranasal and Intramuscular Naloxone for Opioid Overdose in the Pre-Hospital Setting: Comparative Clinical Effectiveness and Cost-Effectiveness Intranasal (...) and Intramuscular Naloxone for Opioid Overdose in the Pre-Hospital Setting: Comparative Clinical Effectiveness and Cost-Effectiveness Published on: September 7, 2016 Project Number: RA0863-000 Product Line: Research Type: Drug Report Type: Reference List Result type: Report Question What is the comparative clinical effectiveness of pre-filled intranasal naloxone versus intramuscular naloxone? What is the comparative clinical effectiveness of pre-filled intranasal naloxone versus naloxone administered

2016 Canadian Agency for Drugs and Technologies in Health - Rapid Review

9. Buprenorphine/Naloxone Versus Methadone for the Treatment of Opioid Dependence: A Review of Comparative Clinical Effectiveness, Cost-Effectiveness and Guidelines

Buprenorphine/Naloxone Versus Methadone for the Treatment of Opioid Dependence: A Review of Comparative Clinical Effectiveness, Cost-Effectiveness and Guidelines Buprenorphine/Naloxone Versus Methadone for the Treatment of Opioid Dependence: A Review of Comparative Clinical Effectiveness, Cost-Effectiveness and Guidelines | CADTH.ca Find the information you need Buprenorphine/Naloxone Versus Methadone for the Treatment of Opioid Dependence: A Review of Comparative Clinical Effectiveness, Cost (...) -Effectiveness and Guidelines Buprenorphine/Naloxone Versus Methadone for the Treatment of Opioid Dependence: A Review of Comparative Clinical Effectiveness, Cost-Effectiveness and Guidelines Published on: September 2, 2016 Project Number: RD0032-000 Product Line: Research Type: Drug Report Type: Peer-reviewed summary with critical appraisal Result type: Report Question What is the clinical effectiveness of buprenorphine/naloxone compared with methadone for the treatment of patients with opioid dependence

2016 Canadian Agency for Drugs and Technologies in Health - Rapid Review

10. Crushed Buprenorphine or Buprenorphine-Naloxone for Opioid Dependency: A Review of the Clinical Effectiveness and Guidelines

Crushed Buprenorphine or Buprenorphine-Naloxone for Opioid Dependency: A Review of the Clinical Effectiveness and Guidelines Crushed Buprenorphine or Buprenorphine-Naloxone for Opioid Dependency: A Review of the Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Crushed Buprenorphine or Buprenorphine-Naloxone for Opioid Dependency: A Review of the Clinical Effectiveness and Guidelines Crushed Buprenorphine or Buprenorphine-Naloxone for Opioid Dependency: A Review (...) of the Clinical Effectiveness and Guidelines Published on: July 18, 2016 Project Number: RC0794-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness and safety of sublingual crushed buprenorphine for treating opioid dependency? What is the clinical effectiveness and safety of sublingual crushed buprenorphine-naloxone for treating opioid dependency? What are the evidence-based guidelines regarding the administration

2016 Canadian Agency for Drugs and Technologies in Health - Rapid Review

11. Pharmacokinetic and pharmaceutical properties of a novel buprenorphine/naloxone sublingual tablet for opioid substitution therapy versus conventional buprenorphine/naloxone sublingual tablet in healthy volunteers. (PubMed)

Pharmacokinetic and pharmaceutical properties of a novel buprenorphine/naloxone sublingual tablet for opioid substitution therapy versus conventional buprenorphine/naloxone sublingual tablet in healthy volunteers. A novel sublingual buprenorphine/naloxone rapidly-dissolving tablet (BNX-RDT) for opioid substitution therapy has been developed for improved bioavailability, rapid disintegration and improved taste masking. We compared the bioavailability and pharmaceutical properties of BNX-RDT (...) with conventional buprenorphine/naloxone sublingual tablets (BNX).Fasting, open-label, randomized, single-dose, two-cohort crossover study in healthy volunteers under naltrexone block. Cohort 1 (high-dose, N = 64) received BNX-RDT 11.4/2.9 mg and BNX 16/4 mg. Cohort 2 (low-dose, N = 61) received BNX-RDT 2.9/0.71 mg and BNX 4/1 mg. Plasma samples were collected over 72 h. Relative systemic exposures of buprenorphine and naloxone were assessed using standard statistical models for bioequivalence analysis

2018 European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences

12. Naloxone Nasal Spray Compared With Naloxone Injection for Opioid Overdoses Outside the Hospital

Naloxone Nasal Spray Compared With Naloxone Injection for Opioid Overdoses Outside the Hospital Naloxone Nasal Spray Compared With Naloxone Injection for Opioid Overdoses Outside the Hospital - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one (...) or more studies before adding more. Naloxone Nasal Spray Compared With Naloxone Injection for Opioid Overdoses Outside the Hospital (NINA-1) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03518021 Recruitment Status

2018 Clinical Trials

13. Naloxone single dose nasal spray for opioid overdose

Naloxone single dose nasal spray for opioid overdose Naloxone single dose nasal spray for opioid overdose Naloxone single dose nasal spray for opioid overdose NIHR HSRIC Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation NIHR HSRIC. Naloxone single dose nasal spray for opioid overdose. Birmingham: NIHR Horizon Scanning Research&Intelligence Centre. Horizon Scanning (...) . Symptoms of opioid overdose include drowsiness, muscle spasms and slow, shallow breathing. Naloxone hydrochloride single dose nasal spray is a new drug for the emergency treatment of opioid overdose that is given as a nasal spray. At the moment, naloxone usually has to be injected by a health professional. If naloxone hydrochloride nasal spray is licensed for use in the UK, it could be a new treatment option for patients with opioid overdose that may be more convenient than current treatments. Final

2016 Health Technology Assessment (HTA) Database.

14. Hospital Observation Upon Reversal (HOUR) With Naloxone: A Prospective Clinical Prediction Rule Validation Study

Hospital Observation Upon Reversal (HOUR) With Naloxone: A Prospective Clinical Prediction Rule Validation Study St. Paul's Early Discharge Rule was derived to determine which patients could be safely discharged from the emergency department after a 1-hour observation period following naloxone administration for opiate overdose. The rule suggested that patients could be safely discharged if they could mobilize as usual and had a normal oxygen saturation, respiratory rate, temperature, heart (...) rate, and Glasgow Coma Scale score. Validation of the St. Paul's Early Discharge Rule is necessary to ensure that these criteria are appropriate to apply to patients presenting after an unintentional presumed opioid overdose in the context of emerging synthetic opioids and expanded naloxone access.In this prospective, observational validation study, emergency medicine providers assessed patients 1 hour after administration of prehospital naloxone. Unlike in the derivation study the threshold

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2019 EvidenceUpdates

15. Naloxone and the Inner City Youth Experience (NICYE): a community-based participatory research study examining young people’s perceptions of the BC take home naloxone program (PubMed)

Naloxone and the Inner City Youth Experience (NICYE): a community-based participatory research study examining young people’s perceptions of the BC take home naloxone program Take home naloxone (THN) programs reduce mortality by training bystanders to respond to opioid overdoses. Clinical observation by the health care team at the Inner City Youth (ICY) program indicated that young adults appeared to enthusiastically participate in the THN program and developed improved relationships

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2017 Harm Reduction Journal

16. Comparison of a New Intranasal Naloxone Formulation to Intramuscular Naloxone: Results from Hypothesis‐generating Small Clinical Studies (PubMed)

Comparison of a New Intranasal Naloxone Formulation to Intramuscular Naloxone: Results from Hypothesis‐generating Small Clinical Studies Easy-to-use naloxone formulations are needed to help address the opioid overdose epidemic. The pharmacokinetics of i.v., i.m., and a new i.n. naloxone formulation (2 mg) were compared in six healthy volunteers. Relative to i.m. naloxone, geometric mean (90% confidence interval [CI]) absolute bioavailability of i.n. naloxone was modestly lower (55%; 90% CI (...) , 43-70% vs. 41%; 90% CI, 27-62%), whereas average (±SE) mean absorption time was substantially shorter (74 ± 8.8 vs. 6.7 ± 4.9 min). The opioid-attenuating effects of i.n. naloxone were compared with i.m. naloxone (2 mg) after administration of oral alfentanil (4 mg) to a separate group of six healthy volunteers pretreated with 240 mL of water or grapefruit juice. The i.m. and i.n. naloxone attenuated miosis by similar extents after water (40 ± 15 vs. 41 ± 21 h*%) and grapefruit juice (49 ± 18 vs

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2017 Clinical and translational science

17. Intranasal naloxone is a viable alternative to intravenous naloxone for prehospital narcotic overdose. (PubMed)

Intranasal naloxone is a viable alternative to intravenous naloxone for prehospital narcotic overdose. To compare the prehospital time intervals from patient contact and medication administration to clinical response for intranasal (IN) versus intravenous (IV) naloxone in patients with suspected narcotic overdose.This was a retrospective review of emergency medical services (EMS) and hospital records, before and after implementation of a protocol for administration of intranasal naloxone (...) to clinical response. Secondary variables included numbers of doses administered and rescue doses given by an alternate route. Between-group comparisons were accomplished using t-tests and chi-square tests as appropriate.One hundred fifty-four patients met the inclusion criteria, including 104 treated with IV and 50 treated with IN naloxone. Clinical response was noted in 33 (66%) and 58 (56%) of the IN and IV groups, respectively (p = 0.3). The mean time between naloxone administration and clinical

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2017 Prehospital emergency care

18. Naloxone Costing Tool

Naloxone Costing Tool application/vnd.openxmlformats-officedocument.spreadsheetml.sheet

2016 Canadian Centre on Substance Abuse

19. The Availability of Take-Home Naloxone in Canada: CCENDU Bulletin

The Availability of Take-Home Naloxone in Canada: CCENDU Bulletin www.ccsa.ca • www.cclt.ca CCENDU Bulletin, March 2016 Canadian Centre on Substance Abuse • Centre canadien de lutte contre les toxicomanies Page 1 CCENDU Bulletin The Availability of Take-Home Naloxone in Canada Summary In response to increasing numbers of fatal and non-fatal opioid poisonings in Canada, there has been a great deal of effort invested in increasing the availability of naloxone, a drug that temporarily reverses (...) the effects of opioids and can save lives in opioid overdose situations. Efforts to increase the availability of naloxone have followed several different trajectories: ? Establishing take-home naloxone programs to increase access to naloxone among people who use opioids and their friends or family; ? Encouraging or permitting accessibility and use of naloxone by first responders (e.g., paramedics, firefighters, law enforcement, etc.); and ? Encouraging authorities to change the prescription-only status

2016 Canadian Centre on Substance Abuse

20. Can early oral prolonged-release oxycodone with or without naloxone reduce the duration of epidural analgesia after cystectomy? A 3-arm, randomized, double-blind, placebo-controlled trial

Can early oral prolonged-release oxycodone with or without naloxone reduce the duration of epidural analgesia after cystectomy? A 3-arm, randomized, double-blind, placebo-controlled trial Thoracic epidural analgesia (TEA) enhances recovery after bowel surgery. Early postoperative prolonged-release oral formulation of oxycodone or oxycodone/naloxone is potentially useful as a second analgesic step to reduce the duration of TEA. We hypothesized that oxycodone would decrease the duration of TEA (...) and combined with naloxone preserve gastrointestinal function. Ninety patients undergoing open cystectomy and urinary diversion were enrolled in this randomized double-blind, three-arm, parallel-group, placebo-controlled single-center trial between September 2015 and February 2017. Exclusion criteria were known allergy to oxycodone/naloxone, pulmonary diseases, hepatopathy, and analgesics nonnaïve patients. From postoperative day 3, patients received batches with oxycodone, oxycodone/naloxone, or placebo

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2018 EvidenceUpdates

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