Articles: opioid.
-
Obstructive sleep apnea (OSA) is a chronic condition of upper airway obstruction during sleep. It is associated with significant morbidity and mortality and increases the perioperative risks of surgical patients. Thus, it is essential that perianesthesia nurses understand how to identify and manage patients with known or suspected OSA. This continuing education article will review the pathophysiology of OSA, discuss the effects of anesthesia and opioids on the sleep architecture of the OSA patients, describe the effects of OSA on postoperative complications, review the latest evidence on screening for undiagnosed OSA in the adult surgical patient, and review the perioperative management principles for patients with OSA.
-
Drug Alcohol Depend · Dec 2015
Legal changes to increase access to naloxone for opioid overdose reversal in the United States.
Opioid overdose, which has reached epidemic levels in the United States, is reversible by administration of the medication naloxone. Naloxone requires a prescription but is not a controlled substance and has no abuse potential. In the last half-decade, the majority of states have modified their laws to increase layperson access to the medication. ⋯ Most states have now passed laws intended to increase layperson access to naloxone. While these laws will likely reduce overdose morbidity and mortality, the cost of naloxone and its prescription status remain barriers to more widespread access.
-
Access to many controlled medicines is inadequate in a number of European countries. This leads to deficits in the treatment of moderate to severe pain as well as in opioid agonist therapy. ⋯ The challenges identified during outcomes of the workshops were used as the basis for subsequent dissemination and implementation activities in the ATOME project, and in some countries the workshop proceedings already served as a stepping-stone for the first changes in regulations and legislation.
-
Journal of critical care · Dec 2015
Risk factors for discharge on a new antipsychotic medication after admission to an intensive care unit.
Increased awareness of delirium in the intensive care unit (ICU) has led to higher use of antipsychotic medications for treatment of delirium. These medications are often not discontinued at ICU or hospital discharge, which may increase the risk of inappropriate polypharmacy. Our study sought to identify risk factors for being discharged on a new antipsychotic medication after admission to a trauma-surgical ICU or neurocritical care unit. ⋯ Those patients with higher Acute Physiology and Chronic Health Evaluation II scores and more benzodiazepine days are at increased odds of being discharged on a new antipsychotic.
-
Drug Alcohol Depend · Dec 2015
Prescription drug misuse and suicidal ideation: Findings from the National Survey on Drug Use and Health.
Suicide is one of the leading causes of injury-related mortality in the United States and prior research has identified alcohol and other drug use as a major risk factor. In recent years, prescription drug misuse has become a serious public health issue; however, very little research examines the relationship between prescription drug misuse and suicide or suicidal ideation. ⋯ The current research fills an important gap in the literature by examining the relationship between prescription drug misuse and suicidal ideation. Consistent with the extant literature, prescription drug misuse is significantly associated with suicidal ideation among adults.