Clinical and economic burden of opioid use for postsurgical pain: focus on ventilatory impairment and ileus.

Abstract:

:Opioid-related adverse drug events (ORADEs) can have a significant impact on patient recovery after surgery. This review investigates the impact of two ORADEs, respiratory depression and postoperative ileus (POI), on clinical and economic outcomes. Opioid-induced ventilatory impairment is a potentially serious ORADE that can result in apnea and even death. The incidence of ventilatory impairment is approximately 1%, even among patients receiving opioids using patient-controlled analgesia. Costs are increased in patients treated with opioids who are at high risk of ventilatory impairment due to the need for more intensive monitoring from nursing staff and the use of alarmed monitoring equipment. Opioids, together with other factors, contribute to the development of POI through a direct effect on gut motility. Postoperative ileus has been shown to significantly increase hospital length of stay and cost of care. A key determinant of ileus development, as well as length of stay and costs, is postsurgical opioid dose. Data from a retrospective analysis show that a daily hydromorphone dose of 2 mg/day markedly increases the risk of POI. In addition, although the incidence of POI is reduced in patients who undergo laparoscopic surgery or hand-assisted laparoscopic surgery compared with open surgery, the reduction of POI can potentially be negated by excessive opioid use. Therefore, multimodal, opioid-sparing strategies should be explored and used to reduce severe ORADEs and improve outcomes in the surgical setting.

journal_name

Pharmacotherapy

journal_title

Pharmacotherapy

authors

Barletta JF

doi

10.1002/j.1875-9114.2012.01178.x

subject

Has Abstract

pub_date

2012-09-01 00:00:00

pages

12S-8S

issue

9 Suppl

eissn

0277-0008

issn

1875-9114

journal_volume

32

pub_type

杂志文章,评审
  • Absence of QTc-interval-prolonging or hemodynamic effects of a single dose of bitter-orange extract in healthy subjects.

    abstract:STUDY OBJECTIVE:To evaluate the hemodynamic and electrocardiographic effects of a single dose of commercially available bitter-orange dried-fruit extract, which is increasingly being used in dietary supplements. DESIGN:Randomized, double-blind, placebo-controlled, crossover study. SETTING:University of Connecticut, S...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章,随机对照试验

    doi:10.1592/phco.2005.25.12.1719

    authors: Min B,Cios D,Kluger J,White CM

    更新日期:2005-12-01 00:00:00

  • Simvastatin-associated memory loss.

    abstract::The statins are widely used to treat dyslipidemias. They are generally associated with mild adverse effects, but rarely, more serious reactions may occur. A 51-year-old man experienced delayed-onset, progressive memory loss while receiving simvastatin for hypercholesterolemia. His therapy was switched to pravastatin, ...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章

    doi:10.1592/phco.21.7.767.34577

    authors: Orsi A,Sherman O,Woldeselassie Z

    更新日期:2001-06-01 00:00:00

  • Psychological and physical impact of anabolic-androgenic steroid dependence.

    abstract:STUDY OBJECTIVE:To contrast the characteristics of two groups of anabolic-androgenic steroid (AAS) users-those with versus those without AAS dependence. DESIGN:Subanalysis of data from the Anabolic 500, a cross-sectional survey. PARTICIPANTS:One hundred twelve male AAS-dependent users and 367 AAS-nondependent users w...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章

    doi:10.1002/j.1875-9114.2012.01123

    authors: Ip EJ,Lu DH,Barnett MJ,Tenerowicz MJ,Vo JC,Perry PJ

    更新日期:2012-10-01 00:00:00

  • Aerosolized ceftazidime for prevention of ventilator-associated pneumonia and drug effects on the proinflammatory response in critically ill trauma patients.

    abstract:STUDY OBJECTIVES:To evaluate the safety and efficacy of aerosolized ceftazidime for prevention of ventilator-associated pneumonia (VAP) and to evaluate the effects of the drug on the proinflammatory response. DESIGN:Prospective, randomized, double-blind, placebo-controlled clinical trial. SETTING:University teaching ...

    journal_title:Pharmacotherapy

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1592/phco.22.12.972.33596

    authors: Wood GC,Boucher BA,Croce MA,Hanes SD,Herring VL,Fabian TC

    更新日期:2002-08-01 00:00:00

  • Case-control study of amphotericin B in a triglyceride fat emulsion versus conventional amphotericin B in patients with AIDS.

    abstract::We evaluated the efficacy and tolerability of amphotericin B triglyceride emulsion in 16 patients with acquired immunodeficiency syndrome-related candidal esophagitis and cryptococcosis, compared with standard amphotericin B in 24 patients. Compared with the conventional formulation, the fat emulsion was administered ...

    journal_title:Pharmacotherapy

    pub_type: 临床试验,杂志文章

    doi:

    authors: Manfredi R,Chiodo F

    更新日期:1998-09-01 00:00:00

  • Prescribing patterns and outcomes of enoxaparin for anticoagulation of atrial fibrillation.

    abstract:STUDY OBJECTIVE:To determine prescribing patterns and clinical outcomes of enoxaparin for anticoagulation of atrial fibrillation. DESIGN:Retrospective analysis. SETTING:A 650-bed, tertiary care, community teaching hospital. SUBJECTS:Two hundred thirteen patients who received enoxaparin for thromboprophylaxis during ...

    journal_title:Pharmacotherapy

    pub_type: 临床试验,杂志文章

    doi:10.1592/phco.23.5.651.32208

    authors: Khazan M,Scheuering S,Adamson R,Mathis AS

    更新日期:2003-05-01 00:00:00

  • Postoperative atrial fibrillation: role of inflammatory biomarkers and use of colchicine for its prevention.

    abstract::Postoperative atrial fibrillation (POAF) is the most common complication following cardiac surgery, occurring in up to 65% of cardiac surgical patients. It is a condition associated with increased morbidity, increased length of hospital stay, and increased health care costs. One of the many potential causes of POAF is...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1002/phar.1485

    authors: Worden JC,Asare K

    更新日期:2014-11-01 00:00:00

  • Appropriateness of iron prescribing: a retrospective study.

    abstract::We retrospectively reviewed the charts of 120 patients who received an initial prescription of iron from a resident physician in internal medicine to determine how accurately house officers diagnose iron-deficiency anemia before initiating iron therapy. Each patient's laboratory records were reviewed for the 3-month p...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章

    doi:

    authors: Abernathy KA,Meuleman JR

    更新日期:1996-05-01 00:00:00

  • Rituximab for the treatment of rheumatoid arthritis.

    abstract::Rituximab has been approved by the United States Food and Drug Administration in combination with methotrexate for the treatment of rheumatoid arthritis in patients who failed to achieve adequate benefit from tumor necrosis factor-alpha inhibitors. Rituximab is a biologic agent that depletes peripheral B cells--an act...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1592/phco.27.12.1702

    authors: Schuna AA

    更新日期:2007-12-01 00:00:00

  • Antimicrobial formulary management: a case study in a teaching hospital.

    abstract::The role of the formulary system for effective cost containment is becoming increasingly important. With antimicrobial agents taking up a large proportion of most pharmaceutical budgets, this group of agents is an obvious target for cost reduction. The responsible interchange of selected antimicrobial agents offers a ...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章

    doi:

    authors: Wright DB

    更新日期:1991-01-01 00:00:00

  • Introduction to immunology.

    abstract::The immune system is a complex network of components functioning to provide host defense. This network consists of immunologic cells and their products (e.g., interleukins and colony-stimulating factors), organs, tissues, complement, and major histocompatibility complex antigens. These components are organized into sp...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章,评审

    doi:

    authors: McIntyre WJ,Tami JA

    更新日期:1992-01-01 00:00:00

  • Population Pharmacokinetics and Pharmacodynamic Target Attainment of Ampicillin in Neonates with Hypoxemic-Ischemic Encephalopathy in the Setting of Controlled Hypothermia.

    abstract:STUDY OBJECTIVE:To describe the population pharmacokinetics and pharmacodynamic target attainment of ampicillin in neonates with hypoxic-ischemic encephalopathy (HIE) undergoing controlled hypothermia (CH). DESIGN:Prospective, open-label pharmacokinetic study. SETTING:A 189-bed, freestanding children's tertiary care ...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章

    doi:10.1002/phar.1916

    authors: Cies JJ,Fugarolas KN,Moore WS 2nd,Mason RW,Menkiti OR

    更新日期:2017-04-01 00:00:00

  • Impact of Stewardship Interventions on Antiretroviral Medication Errors in an Urban Medical Center: A 3-Year, Multiphase Study.

    abstract:BACKGROUND:There is a high prevalence of HIV infection in Newark, New Jersey, with University Hospital admitting approximately 600 HIV-infected patients per year. Medication errors involving antiretroviral therapy (ART) could significantly affect treatment outcomes. The goal of this study was to evaluate the effectiven...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章

    doi:10.1002/phar.1716

    authors: Zucker J,Mittal J,Jen SP,Cheng L,Cennimo D

    更新日期:2016-03-01 00:00:00

  • Effects of buprenorphine on cardiac repolarization in a patient with methadone-related torsade de pointes.

    abstract::Torsade de pointes is a rare but potentially fatal ventricular arrhythmia that is often triggered by drugs that prolong the rate-corrected QT (QTc) interval. This arrhythmia has been attributed to levacetylmethadol and methadone, synthetic opioids used to treat heroin addiction. Levacetylmethadol, a derivative of meth...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章

    doi:10.1592/phco.25.4.611.61020

    authors: Krantz MJ,Garcia JA,Mehler PS

    更新日期:2005-04-01 00:00:00

  • Early Administration of Adjuvant β-Lactam Therapy in Combination with Vancomycin among Patients with Methicillin-Resistant Staphylococcus aureus Bloodstream Infection: A Retrospective, Multicenter Analysis.

    abstract:STUDY OBJECTIVE:To determine whether early administration of adjuvant β-lactam in combination with vancomycin (COMBO) affects clinical outcomes compared to standard vancomycin therapy alone (STAN) among patients with methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection. DESIGN:Retrospective, multic...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章,多中心研究

    doi:10.1002/phar.2034

    authors: Casapao AM,Jacobs DM,Bowers DR,Beyda ND,Dilworth TJ,REACH-ID Study Group.

    更新日期:2017-11-01 00:00:00

  • Updates in hormonal emergency contraception.

    abstract::In recent years, there have been many updates in hormonal emergency contraception. Levonorgestrel emergency contraception has been available for several years to prevent pregnancy when used within 72 hours after unprotected intercourse or contraceptive failure, and it was recently approved for nonprescription status f...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1592/phco.31.9.887

    authors: Shrader SP,Hall LN,Ragucci KR,Rafie S

    更新日期:2011-09-01 00:00:00

  • Active transport of nitrofurantoin into human milk.

    abstract:STUDY OBJECTIVE:To determine the extent to which nitrofurantoin is transferred into human milk. DESIGN:Prospective, single-dose pharmacokinetic study. SETTING:University-affiliated clinical research center. PATIENTS:Four healthy lactating women 8-26 weeks postpartum. INTERVENTION:All subjects received a single, ora...

    journal_title:Pharmacotherapy

    pub_type: 临床试验,杂志文章

    doi:10.1592/phco.21.7.669.34574

    authors: Gerk PM,Kuhn RJ,Desai NS,McNamara PJ

    更新日期:2001-06-01 00:00:00

  • Cost-effectiveness analysis of antithrombotic therapy in nonurgent percutaneous coronary intervention.

    abstract:STUDY OBJECTIVE:To perform a cost-effectiveness analysis comparing three treatment approaches during nonurgent percutaneous coronary intervention (PCI): bivalirudin with provisional glycoprotein (GP) IIb-IIIa inhibitor therapy, unfractionated heparin (UFH) with eptifibatide, and UFH with abciximab. DESIGN:Literature-b...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章

    doi:10.1592/phco.26.5.609

    authors: Summers KM,Holdford DA,Crouch MA

    更新日期:2006-05-01 00:00:00

  • Preparing clinical pharmacy scientists for careers in clinical/translational research: can we meet the challenge?: ACCP Research Affairs Committee Commentary.

    abstract::Developing clinical pharmacists' research skills and their ability to compete for extramural funding is an important component of the American College of Clinical Pharmacy's (ACCP) vision for pharmacists to play a prominent role in generating the new knowledge used to guide patient pharmacotherapy. Given the recent em...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章

    doi:10.1002/phar.1348

    authors: Parker RB,Ellingrod V,DiPiro JT,Bauman JL,Blouin RA,Welage LS

    更新日期:2013-12-01 00:00:00

  • Drug-Induced Ototoxicity: A Comprehensive Review and Reference Guide.

    abstract:OBJECTIVE:In an era of increasing polypharmacy, adverse drug effects such as ototoxicity have significant public health implications. Despite the availability of evidence, many health care professionals may not know the risk of ototoxicity in common medications. Therefore, the aim of this review is to provide a compreh...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章

    doi:10.1002/phar.2478

    authors: Rizk HG,Lee JA,Liu YF,Endriukaitis L,Isaac JL,Bullington WM

    更新日期:2020-12-01 00:00:00

  • Pharmacokinetic evaluation of para-aminosalicylic acid granules.

    abstract:STUDY OBJECTIVE:To determine the bioavailability and renal elimination of para-aminosalicylic acid (PAS) and its inactive metabolite acetyl-para-aminosalicylic acid (AcPAS) from a new PAS formulation. DESIGN:(a) Single-dose pharmacokinetic study in healthy volunteers; (b) Day-1 and day-8 pharmacokinetic comparison in ...

    journal_title:Pharmacotherapy

    pub_type: 临床试验,杂志文章

    doi:10.1002/j.1875-9114.1994.tb02787.x

    authors: Peloquin CA,Henshaw TL,Huitt GA,Berning SE,Nitta AT,James GT

    更新日期:1994-01-01 00:00:00

  • High-performance capillary electrophoresis in the pharmaceutical sciences.

    abstract::High-performance capillary electrophoresis (HPCE) is a new separation technique that is applied in the pharmaceutical sciences. Separations by HPCE occur in a narrow-bore capillary under the influence of an applied electrical field. Components of the sample matrix are separated and migrate at different rates based on ...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章,评审

    doi:

    authors: Brunner LJ,DiPiro JT,Feldman S

    更新日期:1995-01-01 00:00:00

  • Possible antiretroviral therapy-warfarin drug interaction.

    abstract::Highly active antiretroviral therapy (HAART) for human immunodeficiency virus (HIV) has resulted in significant morbidity and mortality reductions. Lifelong antiretroviral therapy must be incorporated into each patient's medical regimen. Patients with HIV may also have simultaneous chronic medical conditions, resultin...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章

    doi:10.1592/phco.28.7.945

    authors: Fulco PP,Zingone MM,Higginson RT

    更新日期:2008-07-01 00:00:00

  • Retrospective analysis of hyperlipidemia management in a transplant population.

    abstract:STUDY OBJECTIVES:To determine the prevalence of hyperlipidemia and the effectiveness of hyperlipidemia management in a large population of transplant recipients. A secondary objective was to assess the effect of the National Cholesterol Education Program (NCEP) Adult Treatment Panel III guidelines on hyperlipidemia man...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章

    doi:10.1592/phco.2005.25.7.918

    authors: Schonder KS,McKaveney TP,Lynch KJ

    更新日期:2005-07-01 00:00:00

  • Treatment of Adults with Idiopathic Recurrent Pericarditis: Novel Use of Immunotherapy.

    abstract::Idiopathic recurrent pericarditis (IRP) can be challenging to treat. Even after guideline-directed first-line treatment consisting of aspirin (ASA) or a nonsteroidal antiinflammatory drug (NSAID) in combination with colchicine therapy, recurrences still occur in greater than 20% of patients. Many patients then require...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1002/phar.1897

    authors: Schwier NC,Hale GM,Davies ML

    更新日期:2017-03-01 00:00:00

  • Etomidate: a new intravenous anesthetic induction agent.

    abstract::Currently available anesthetic induction agents provide adequate hypnosis but are not ideal, particularly in the high risk patient (ASA class III-V), because most cause myocardial and/or respiratory depression and some have other important side effects. Etomidate was recently marketed as an intravenous anesthetic indu...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1002/j.1875-9114.1983.tb03266.x

    authors: Giese JL,Stanley TH

    更新日期:1983-09-01 00:00:00

  • Identifying Subsequent Therapies in Patients with Advanced Non-Small Cell Lung Cancer and Factors Associated with Overall Survival.

    abstract:STUDY OBJECTIVES:To identify subsequent therapies used after first-line therapies in patients with advanced non-small cell lung cancer (NSCLC), compare overall survival (OS) associated with subsequent therapies, and evaluate factors associated with OS in these patients. METHODS:The study was a retrospective cohort ana...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章

    doi:10.1002/phar.1826

    authors: Afanasjeva J,Hui RL,Spence MM,Chang J,Schottinger JE,Millares M,Rashid N

    更新日期:2016-10-01 00:00:00

  • Relationship Between Medication Adherence and Distance to Dispensing Pharmacies and Prescribers Among an Urban Medicaid Population with Diabetes Mellitus.

    abstract:STUDY OBJECTIVE:To determine whether a relationship exists between medication adherence to angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) and distance to dispensing pharmacies and prescribers among an urban public aid population with diabetes mellitus. DESIGN:Retrospective...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章

    doi:10.1002/phar.1757

    authors: Syed ST,Sharp LK,Kim Y,Jentleson A,Lora CM,Touchette DR,Berbaum ML,Suda KJ,Gerber BS

    更新日期:2016-06-01 00:00:00

  • ACCP Clinical Pharmacist Competencies.

    abstract::The purpose of the American College of Clinical Pharmacy (ACCP) is to advance human health by extending the frontiers of clinical pharmacy. Consistent with this mission and its core values, ACCP is committed to ensuring that clinical pharmacists possess the knowledge, skills, attitudes, and behaviors necessary to deli...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章

    doi:10.1002/phar.1923

    authors: Saseen JJ,Ripley TL,Bondi D,Burke JM,Cohen LJ,McBane S,McConnell KJ,Sackey B,Sanoski C,Simonyan A,Taylor J,Vande Griend JP

    更新日期:2017-05-01 00:00:00

  • Implementation and Clinical Outcomes of an Employer-Sponsored, Pharmacist-Provided Medication Therapy Management Program.

    abstract::Our objective was to describe the implementation and clinical outcomes of an employer-sponsored, pharmacist-provided medication therapy management (MTM) program for health plan beneficiaries with diabetes mellitus and/or hypertension. We conducted a single-center retrospective medical record review. The setting was a ...

    journal_title:Pharmacotherapy

    pub_type: 杂志文章

    doi:10.1002/phar.1650

    authors: Theising KM,Fritschle TL,Scholfield AM,Hicks EL,Schymik ML

    更新日期:2015-11-01 00:00:00