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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. Dissolution Techniques for Buprenorphine and Buprenorphine-Naloxone: Clinical Effectiveness and Guidelines

Dissolution Techniques for Buprenorphine and Buprenorphine-Naloxone: Clinical Effectiveness and Guidelines Dissolution Techniques for Buprenorphine and Buprenorphine-Naloxone: Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Dissolution Techniques for Buprenorphine and Buprenorphine-Naloxone: Clinical Effectiveness and Guidelines Dissolution Techniques for Buprenorphine and Buprenorphine-Naloxone: Clinical Effectiveness and Guidelines Last updated: September 24 (...) , 2019 Project Number: RA1074-000 Product Line: Research Type: Devices and Systems Report Type: Reference List Result type: Report Question What is the comparative clinical effectiveness of sublingual buprenorphine tablets administered using dissolution practices versus standard administration of buprenorphine for the treatment of opioid use disorder or dependency? What is the comparative clinical effectiveness of sublingual buprenorphine-naloxone tablets administered using dissolution practices

2019 Canadian Agency for Drugs and Technologies in Health - Rapid Review

3. Buprenorphine-Naloxone Tablet Versus Methadone for the Treatment of Patients with Opioid Use Disorder: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines

Buprenorphine-Naloxone Tablet Versus Methadone for the Treatment of Patients with Opioid Use Disorder: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines Buprenorphine-Naloxone Tablet Versus Methadone for the Treatment of Patients with Opioid Use Disorder: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines | CADTH.ca Find the information you need Buprenorphine-Naloxone Tablet Versus Methadone for the Treatment of Patients with Opioid Use Disorder (...) : A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines Buprenorphine-Naloxone Tablet Versus Methadone for the Treatment of Patients with Opioid Use Disorder: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines Last updated: July 31, 2019 Project Number: RC1150-000 Product Line: Research Type: Drug Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of buprenorphine-naloxone tablets compared with methadone

2019 Canadian Agency for Drugs and Technologies in Health - Rapid Review

4. 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

5. Spread the Word: Widespread Distribution of Naloxone to Decrease Opioid-Related Deaths

Spread the Word: Widespread Distribution of Naloxone to Decrease Opioid-Related Deaths September 16, 2019 (en français) Love Tools for Practice? Want to see it in conference format? You're in luck! Visit the ACFP website for more information. Spread the Word: Widespread Distribution of Naloxone to Decrease Opioid-Related Deaths Clinical Question: Does population-based or programmatic provision of naloxone kits decrease the risk of opioid- related deaths in people who use opioids? Bottom Line (...) : Offering naloxone kits and overdose related education for people who use opioids and their community may decrease opioid related deaths by ~7 per 100,000 population over one year. Effectiveness is likely influenced by magnitude of opioid problem in a given community and other confounders (like co-ingestions, co- morbidities, type and dose of opioid used). Evidence: • Randomized controlled trial: o 1676 inmates being released from prison were randomized to kit with single dose naloxone versus

2019 Tools for Practice

6. Buprenorphine/Naloxone (Suboxone) Film versus Buprenorphine/Naloxone Tablets for the Treatment of Opioid Addiction

Buprenorphine/Naloxone (Suboxone) Film versus Buprenorphine/Naloxone Tablets for the Treatment of Opioid Addiction TITLE: Buprenorphine/Naloxone (Suboxone) Film versus Buprenorphine/Naloxone Tablets for the Treatment of Opioid Addiction: Comparative Safety DATE: 27 January 2014 RESEARCH QUESTION What is the comparative safety of buprenorphine/naloxone (Suboxone) film versus buprenorphine/naloxone tablets for the treatment of prescription opioid addiction in adult patients? KEY MESSAGE One (...) randomized controlled trial was identified regarding the comparative safety of buprenorphine/naloxone film versus buprenorphine/naloxone tablets for the treatment of prescription opioid addiction in adult patients. METHODS A limited literature search was conducted on key resources including PubMed, The Cochrane Library (2014, Issue 1), University of York Centre for Reviews and Dissemination (CRD) databases, Canadian and major international health technology agencies, as well as a focused Internet search

2014 Canadian Agency for Drugs and Technologies in Health - Rapid Review

7. Retrospective Review of Need for Delayed Naloxone or Oxygen in Emergency Department Patients Receiving Naloxone for Heroin Reversal. (PubMed)

Retrospective Review of Need for Delayed Naloxone or Oxygen in Emergency Department Patients Receiving Naloxone for Heroin Reversal. Emergency departments (EDs) are experiencing an increasing number of heroin overdose visits. Currently, there is no generally agreed upon ED observation period for heroin overdose patients who receive naloxone.We aimed to determine the safety of a 2-h observation period for heroin overdose patients who receive naloxone.We performed a chart review of all patients (...) who presented with any opioid-related complaint between 2009 and 2014 to our urban academic trauma center. Subset analysis of patients with isolated heroin overdose who received naloxone was performed, with the intent of excluding patients intoxicated with long-acting/enteral opioids. The primary outcome was the number of patients who required delayed intervention-specifically, additional naloxone or supplemental oxygen.Between 2009 and 2014, we recorded 806 visits to our ED for heroin use after

2019 Journal of Emergency Medicine

8. 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

9. Availability of Naloxone in Pharmacies and Knowledge of Pharmacy Staff Regarding Dispensing Naloxone to Younger Adolescents. (PubMed)

Availability of Naloxone in Pharmacies and Knowledge of Pharmacy Staff Regarding Dispensing Naloxone to Younger Adolescents. This study assessed the immediate availability of naloxone in pharmacies and the knowledge of pharmacy staff regarding naloxone dispensing protocols, especially as it relates to younger adolescents.The primary sample included pharmacies in the 10 states with the highest number of opioid-related overdose deaths in 2016; in addition, pharmacies in the 2 states (...) with the highest prevalence of opioid-related overdose deaths in 2016 were also contacted. Researchers simulated a routine conversation between pharmacy staff and a potential customer about the immediate availability of and requirements to purchase naloxone.The primary sample included 120 pharmacies (82.5% chain pharmacies; 50.8% rural). The majority (80.3%) had at least one form of naloxone in stock. Pharmacy staff were knowledgeable about prescription and third-party purchasing requirements. However, almost

2019 The Journal of Adolescent Health

10. 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

11. 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.

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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.

20. 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

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