Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jan 2016
Ritonavir Use in Human Immunodeficiency Virus-Positive Surgical Patients Is Not Associated with an Increase in Postoperative Critical Respiratory Events.
This study evaluated whether highly active antiretroviral therapy for human immunodeficiency virus (HIV) including ritonavir is independently associated with increased critical respiratory events after general anesthesia with opioid analgesia. The impact of ritonavir on hepatic microsomal enzymes was considered due to the effect of these enzymes on opioid metabolism. Medical records of over 1900 patients were reviewed, and those of 941 patients met inclusion criteria and were analyzed. Chronic treatment with ritonavir was not associated with critical respiratory events in HIV-positive patients.
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It is often said that a hospice is much more than just a place providing supportive care for the terminally ill. This narrative describes Neha, a young mother who found her solace in the hospice and spent her last days there by choice. It reinforces the fact that the hospice is truly a philosophy of care where powerful and contrasting emotions do coexist.
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J Pain Palliat Care Pharmacother · Jan 2016
Relationship Between Buprenorphine Dosing and Triglyceride Lowering and creatine kinase [corrected] Elevation in Felines: Possible Human Implications.
Recently published feline data suggest that high doses of buprenorphine can elevate creatine kinase (CK) [corrected] and profoundly influence triglyceride levels in an inverted dose versus effect relationship. This intriguing observation in felines, hitherto not documented for buprenorphine, should be considered in human situations for any trends of translatability. The report evaluates the observed effects in domestic cats and what is known about buprenorphine in human subjects. Based on the objective assessment, the following are deduced: (a) although elevated CK levels is a nonissue in humans, one needs to pay attention especially when buprenorphine is used at the high end of therapeutic dose range in the presence of drugs that can impair the hepatic metabolism of buprenorphine; and (b) the potential for triglyceride lowering can be easily confirmed in human trials, and since it may occur at the relevant therapeutic doses of buprenorphine, it may be beneficial in such patients who may have added cardiovascular risk factors.