Abstract:
BACKGROUND:Prescription opioids have substantial abuse potential. This study compared the positive subjective drug effects of a newly developed extended-release (ER) oxycodone (OC)/acetaminophen (acetyl-para-aminophenol [APAP]) formulation with those of immediate-release (IR) OC/APAP. METHODS:This randomized, double-blind, active- and placebo-controlled, 7-way crossover study enrolled healthy volunteers who were recreational prescription opioid users. The protocol was approved by an institutional review board and all participants provided written informed consent. Participants received single doses of intact ER and IR OC/APAP 15/650 mg, intact ER and IR OC/APAP 30/1300 mg, crushed ER and IR OC/APAP 30/1300 mg, and placebo. Peak subjective effects (Emax), time to Emax, and area under the drug-effect curves for drug liking, drug high, and good drug effects were measured using visual analogue scales. Least squares means with 95% confidence interval were compared using analysis of variance. RESULTS:Among completers (N = 55), intact ER OC/APAP produced delayed and lower peak effects versus IR OC/APAP. Comparing intact tablets, the drug liking Emax (least squares means [95% confidence interval]) was significantly lower for OC/APAP 30/1300 mg (76.4 [72.8 to 80.0]) than for IR OC/APAP 30/1300 mg (85.6 [81.9 to 89.2]; difference, -9.2 [-13.1 to -5.2]; P < 0.001). Similar results were observed for intact ER and IR OC/APAP (15 mg/650 mg). Crushing ER OC/APAP 30/1300 mg further delayed these effects compared with the same dose of crushed IR OC/APAP and intact ER OC/APAP. CONCLUSIONS:Extended-release OC/APAP produced lower subjective drug effects than IR OC/APAP. Crushing ER OC/APAP further delayed onset of subjective effects compared with intact ER OC/APAP. The ER OC/APAP may be less attractive for abuse than IR OC/APAP. CLINICAL TRIAL REGISTRATION:This phase 1 study conducted in the United States was not registered.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Morton T,Kostenbader K,Montgomery J,Devarakonda K,Barrett T,Webster Ldoi
10.3810/pgm.2014.07.2780subject
Has Abstractpub_date
2014-07-01 00:00:00pages
20-32issue
4eissn
0032-5481issn
1941-9260journal_volume
126pub_type
杂志文章,随机对照试验abstract:OBJECTIVE:To describe the efficacy and safety of adjunctive aripiprazole, olanzapine, and quetiapine for major depressive disorder. DATA SOURCES:Published registration study reports, supplemented by clinical trial synopses as disclosed by manufacturers and product labeling. STUDY SELECTION:All available reports of st...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2010.07.2174
更新日期:2010-07-01 00:00:00
abstract::With prostate cancer being diagnosed and treated in more than 300,000 men each year, the pool of long-term survivors is dramatically increasing. Because these patients are usually elderly, they are often receiving follow-up care for unrelated problems in a primary care setting. This offers the physician an excellent o...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1996.09.73
更新日期:1996-09-01 00:00:00
abstract::Catecholamine stimulation increases the heart rate and the force of cardiac contraction. Cardiac output then increases, with a decrease occurring in total peripheral resistance due to smooth muscle dilation in the vascular beds of the muscle and heart, though there is constriction of the skin and viscera; this leads t...
journal_title:Postgraduate medicine
pub_type: 临床试验,杂志文章,评审
doi:
更新日期:1988-02-29 00:00:00
abstract::More than one half of middle-aged Americans have undesirably high serum lipid levels. Diets high in fiber and carbohydrate and low in fat reduce serum lipid levels two to four times more than the widely recognized American Heart Association diet. High intake of soluble fiber is especially effective for lowering serum ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1987.11699970
更新日期:1987-09-15 00:00:00
abstract::The dose and dosing interval for leukotriene receptor antagonists montelukast and zafirlukast in adult asthmatic patients were determined by bronchoprovocation with exercise or leukotriene D4 inhalation. Subsequent dose-ranging studies confirmed that once-daily ingestion of a 10-mg dose of montelukast was effective an...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.09.15.2000.suppl7.40
更新日期:2000-09-15 00:00:00
abstract::Primary care physicians play an important role in the outpatient evaluation of proteinuria, a common finding in everyday medical practice. Therefore, it is important to recognize which symptoms and signs signal the need for further evaluation. A simple urine dipstick test usually is the first step, but factors leading...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1997.04.201
更新日期:1997-04-01 00:00:00
abstract::Although the incidence of measles has reached record low levels in the United States, measles continues to occur in young adults. No single public health measure can ensure immunity for young adults, as school immunization laws do for young children. Therefore, to eliminate measles in this age-group, clinicians must t...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1985.11698856
更新日期:1985-01-01 00:00:00
abstract::Broncholithiasis, a disease that is probably much more common than has been reported, is most often associated with pulmonary infections, for example, tuberculosis and histoplasmosis. Stones originate from calcified peribronchial lymph nodes that erode into the tracheobronchial tree, but lithoptysis occurs infrequentl...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1988.11700166
更新日期:1988-02-15 00:00:00
abstract:OBJECTIVES:Naloxone is indicated for reversal of opioid-induced respiratory depression. The objective of this study is to evaluate patterns of naloxone use in hospitalized patients. METHODS:Retrospective chart review at the University of California, San Diego Health. Subjects included adults ≥18 years old who were adm...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2017.1263139
更新日期:2017-01-01 00:00:00
abstract::The sexual addiction model enables physicians to understand the self-destructive behavior of patients whose actions may otherwise appear inexplicable. When a person is preoccupied with sex and continues to engage in compulsive sexual activity despite adverse consequences (eg, loss of marriage, job, health, freedom), h...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1991.11701111
更新日期:1991-11-01 00:00:00
abstract::Transgenderism and gender dysphoria are becoming more prevalent diagnoses and the patient population is increasing. Primary care practitioners, endocrinologists, and mental health professionals are all part of the medical care team that treats these patients, but family and internal medicine physicians continue to del...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2014.11.2840
更新日期:2014-11-01 00:00:00
abstract::Joint and soft-tissue aspiration and injection procedures are relatively easy to master once the physician has acquired an understanding of the techniques and subtleties of performing these procedures at certain sites. These techniques can be used to diagnose and treat many painful joint and soft-tissue conditions and...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2001.03.879
更新日期:2001-03-01 00:00:00
abstract::Nitroglycerin and long-acting nitrates are the pharmacologic mainstays of antianginal therapy, both for acute attacks and for prophylaxis. Propranolol is often effective for prophylaxis in patients incompletely helped by nitrates. A holistic approach is stressed. Appropriate drug use will effect marked improvement in ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1977.11714674
更新日期:1977-11-01 00:00:00
abstract::Auscultation is the core of pediatric cardiovascular evaluation and should be performed according to a routine. The four heart sounds should be sought in order at their usual locations, with particular attention to the second sound because of its important diagnostic role in congenital cyanotic heart disease. The next...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1982.11716128
更新日期:1982-07-01 00:00:00
abstract::With increased survival of increasing numbers of cancer patients as a result of therapy, the consequences, early and late, of the therapies must be realized. It is the treating physician's duty to preserve as much reproductive potential as possible for patients, consistent with adequate care. With radiotherapy this me...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1979.11715159
更新日期:1979-05-01 00:00:00
abstract:BACKGROUND:This study aimed to determine if there is an association between lipid levels, serum albumin, and C-reactive protein (CRP) levels in patients on dialysis. METHODS:Lipid profiles, albumin, and CRP levels were collected after a 12-hour fast from patients with end-stage renal disease (N = 105) who were on chro...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2010.05.2158
更新日期:2010-05-01 00:00:00
abstract::Patient Notes are indexed alphabetically and by subject. The number immediately following the title is the number of the Patient Note, and the number in parentheses is the date of publication. This index includes all 82 Patient Notes published so far, from February 1, 1988, through this issue. ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1993.11701589
更新日期:1993-01-01 00:00:00
abstract::Although Charcot's disease and its association with diabetes have been described many times in the literature, it is still often misdiagnosed and incorrectly treated as osteomyelitis, arthritis, or gout. The best safeguard is a high index of suspicion. A warm, swollen foot in a diabetic patient with long-standing neur...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1991.11700869
更新日期:1991-03-01 00:00:00
abstract::While the appropriateness of giving medical advice on the telephone could be debated, this discussion is based on the assumption that few physicians can avoid providing this service to their patients. In fact, most physicians must respond often to telephone requests for advice. A large portion of these "emergency" cal...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1987.11699699
更新日期:1987-02-01 00:00:00
abstract::Primary prophylaxis is advisable for all patients with moderate-sized or large esophageal varices. After the first episode of bleeding, secondary prophylaxis should be initiated to prevent rebleeding. Multiple treatment modalities are available for each circumstance. Optimal regimens have not yet been established but ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2006.11446045
更新日期:2006-09-01 00:00:00
abstract::Healthcare providers usually assess glycemic control in diabetic patients by measuring fasting plasma glucose and preprandial glucose levels, as well as hemoglobin A1c (HbA1c). Evidence now suggests that elevated postprandial glucose concentrations may contribute to suboptimal glycemic control. Several medications and...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.12.2001.suppl17.93
更新日期:2001-12-01 00:00:00
abstract::Preview In most patients with stable angina pectoris, symptoms can be controlled successfully with drug therapy. Revascularization procedures should be reserved for those at high risk for cardiac events and those who do not respond to optimal therapy with any of the three classes of antianginal agents. In this article...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1995.11946093
更新日期:1995-12-01 00:00:00
abstract::Over the past decade, despite the controversies surrounding prostate cancer screening, significant refinements have improved its application. PSA screening, although it has been questioned, appears to confer a mortality benefit and remains the most effective way to identify the possible presence of prostate cancer. Me...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2020.1822067
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVES:As the prevalence of peripheral artery disease (PAD) increases there is growing concern about the associated healthcare burden. This burden has not been well-characterized in high-risk patients with concurrent diabetes and/or acute coronary syndrome (ACS). The objective of this analysis was to assess comorbi...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2016.1144447
更新日期:2016-01-01 00:00:00
abstract::Male factors play a role in up to half of subfertile couples, contrary to the myth that male factors rarely play a role. In this article, Dr Sandlow counters this and other myths about male infertility and suggests that primary care physicians can increase a couple's chance of conceiving by evaluating for male as well...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2000.02.902
更新日期:2000-02-01 00:00:00
abstract::The chronic pain syndrome differs from chronic pain. The syndrome is a psychologic stress state that can produce physical-type illness, often with musculoskeletal manifestations. It tends to strike the "worried well," by nature hysterical, depressed, hypochondriacal, and dependent. Standard medical, surgical, and psyc...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1981.11715917
更新日期:1981-11-01 00:00:00
abstract::When a patient presents with involuntary weight loss, the etiologic considerations can be overwhelming. To plan a cost-effective workup, physicians need to be aware of the most common causes of weight loss and the tests that yield the most pertinent data. Drs Wise and Craig review the clinical studies on unintentional...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1994-03-01 00:00:00
abstract::Pulmonary artery hypertension (PAH) refers to several subgroups of disease in which the mean pulmonary artery pressure (mPAP) is elevated to more than 25 mm Hg, pulmonary artery wedge pressure (PAWP) ≤ 15 mmHg, and an elevated pulmonary vascular resistance (PVR) > 3 Wood units as confirmed by right heart catheterizati...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2016.1188664
更新日期:2016-06-01 00:00:00
abstract::During the last few years, the number, variety, and complexity of nuclear medical examinations that can be performed in children have increased impressively, due partly to recent accomplishments in radiopharmaceutical development and the availability of gamma scintillation cameras and computer systems for acquisition,...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1975.11713991
更新日期:1975-03-01 00:00:00
abstract::Treatment of hypertension in African Americans has special challenges, including a lack of objective trial data on which to base decisions and differing benefits and responses than with other patients. However, adequate control is possible and should be the goal of treating physicians. This article describes current "...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2002.10.1333
更新日期:2002-10-01 00:00:00