American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
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Am J Health Syst Pharm · Sep 2014
ReviewThe opioid abuse and misuse epidemic: implications for pharmacists in hospitals and health systems.
The current epidemic of prescription opioid abuse and misuse in the United States is discussed, with an emphasis on the pharmacist's role in ensuring safe and effective opioid use. ⋯ Pharmacists in hospitals and health systems can play a key role in recognizing the various forms of opioid toxicity and in preventing inappropriate prescribing and diversion of opioids.
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Am J Health Syst Pharm · Sep 2014
Adverse drug events among patients receiving postsurgical opioids in a large health system: risk factors and outcomes.
Results of a study of postsurgical opioid-related adverse drug events (ORADEs) within a large health system are reported. ⋯ Analysis of information from a large database demonstrated that opioid-treated postsurgical inpatients who had multiple risk factors for ORADEs were more likely to have higher mean costs, greater readmission rates, and longer LOS than patients with fewer risk factors.
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The implementation and outcomes of a pharmacy technician medication history program are described. ⋯ A defined medication history based on a medication history standard served as an effective foundation for a pharmacy technician medication history program, which helped improve provider compliance with discharge medication reconciliation.
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Off-label uses of the peripheral μ-opioid receptor antagonists alvimopan and methylnaltrexone are reviewed. ⋯ Trials of alvimopan in the FDA-approved use of methylnaltrexone (OIC) indicate potentially serious cardiovascular safety concerns and conflicting findings of efficacy. Similarly, trials of methylnaltrexone in the FDA-approved use of alvimopan (postoperative ileus) consistently showed no benefit. Evaluations of both drugs in their labeled conditions in populations not endorsed in their product labeling have been limited and largely unreplicated.