Search results for: Joseph V. Pergolizzi

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The epidemiology of apnoea of prematurity

Joseph V. Pergolizzi, Prem Fort, Thomas L. Miller, Jo Ann LeQuang, more

Journal of Clinical Pharmacy and Therapeutics > 47 > 5 > 685 - 693

What is known and objective Many premature infants less than 37 weeks gestational age (GA), and almost all infants less than 28 weeks GA, will experience apnoea of prematurity (AOP)—a cessation of respiration for 20 or more seconds (or less than 20 s if accompanied by other signs). Because the treatment options for AOP are so limited, we explore its epidemiology, with the ultimate hope of learning...

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The limited management options for apnoea of prematurity

Joseph V. Pergolizzi, Prem Fort, Thomas L. Miller, Jo Ann LeQuang, more

Journal of Clinical Pharmacy and Therapeutics > 47 > 3 > 396 - 401

What is known and Objective About 10% of all infants are born prematurely. Almost all of those of gestational age less than about 30 weeks, and about half of those of gestational age up to about 35 weeks, are subject to unpredictable interruptions of breathing—known as “apnoea of prematurity” (AOP). We present a synopsis of the problem and point out the limited management options. Comment A basal...

article

Overdoses due to fentanyl and its analogues (F/FAs) push naloxone to the limit

Joseph V. Pergolizzi, Albert Dahan, Jo Ann LeQuang, Robert B. Raffa

Journal of Clinical Pharmacy and Therapeutics > 46 > 6 > 1501 - 1504

What is known and Objective Food and Drug Administration (FDA) risk evaluation and mitigation strategies (REMs) encourage emergency responders, paramedics, law enforcement agents, and even laypeople to be trained in the administration of naloxone with the intent of rescuing individuals from a known or suspected opioid overdose. Comment Although naloxone is generally safe and effective at reversing...

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Wooden Chest syndrome: The atypical pharmacology of fentanyl overdose

Joseph V. Pergolizzi, Lynn R. Webster, Eugene Vortsman, Jo Ann LeQuang, more

Journal of Clinical Pharmacy and Therapeutics > 46 > 6 > 1505 - 1508

What is known and objective A large percentage of opioid overdose fatalities involve fentanyl or one of its legal or illegal analogs (F/FAs). Is there something about the pharmacology of these drugs that make them unusually dangerous in an overdose? Comment Some of the reasons for the dangers of overdose of F/FAs is their high potency and low cost (that leads to wide distribution). But it is rarely...

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The conundrum of polysubstance overdose

Joseph V. Pergolizzi, Albert Dahan, Jo Ann LeQuang, Robert B. Raffa

Journal of Clinical Pharmacy and Therapeutics > 46 > 5 > 1189 - 1193

What is known and objective Treating an opioid overdose using an opioid receptor antagonist (such as naloxone) makes mechanistic sense and can be effective. Unfortunately, the majority of current drug overdose deaths involve polysubstance use (i.e., an opioid plus a non‐opioid). Comment Respiratory depression induced by opioids results from excessive opioid molecules binding to opioid receptors...

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The problem of postoperative respiratory depression

John F. Peppin, Joseph V. Pergolizzi, Tong J. Gan, Robert B. Raffa

Journal of Clinical Pharmacy and Therapeutics > 46 > 5 > 1220 - 1225

What is known and Objective Postsurgical recovery is influenced by multiple pre‐, intra‐ and perioperative pharmacotherapeutic interventions, including the administration of medications that can induce respiratory depression postoperatively. We present a succinct overview of the topic, including the nature and magnitude of the problem, contributing factors, current limited options, and potential...

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Are opioid receptor antagonists adequate for “Opioid” overdose in a changing reality?

John F. Peppin, Joseph V. Pergolizzi, Albert Dahan, Robert B. Raffa

Journal of Clinical Pharmacy and Therapeutics > 46 > 4 > 861 - 866

What is known and Objective Deaths due to opioid‐induced respiratory depression (OIRD) continue to rise despite intense regulatory and professional actions. COVID‐19 has only worsened this situation.¹ An opioid receptor antagonist (ORA) such as naloxone is the most common intervention for OIRD. However, with increasing overdose from highly potent illicit opioids and polysubstance abuse, appraisal...

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Benzodiazepines: Thinking outside the black box

Joseph V. Pergolizzi, Jo Ann LeQuang, Robert B. Raffa

Journal of Clinical Pharmacy and Therapeutics > 46 > 3 > 554 - 559

What is known and Objective The United States Food and Drug Administration (FDA) recently issued a Drug Safety Communication requiring Boxed Warning updating and other changes in order to improve the safe use of the benzodiazepine drug class. These changes were prompted because ‘The current prescribing information for benzodiazepines does not provide adequate warnings about [the] serious risks and...

article

Bone fractures during the time of coronavirus

Sumiyo Umeda‐Raffa, Joseph V. Pergolizzi Jr, Robert B. Raffa

Journal of Clinical Pharmacy and Therapeutics > 46 > 2 > 543 - 546

What is known and Objective In response to rapid spread of coronavirus (SARS‐CoV‐2) and lack of vaccine or effective treatment for COVID‐19 disease, governments imposed measures that resulted in a shift from work and school to isolation at home. Studies from three countries (China, Belgium and the United States) report the consequences on traumatic bone fractures. Comment The coronavirus pandemic...

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Opioid withdrawal symptoms, a consequence of chronic opioid use and opioid use disorder: Current understanding and approaches to management

Joseph V. Pergolizzi, Robert B. Raffa, Melanie H. Rosenblatt

Journal of Clinical Pharmacy and Therapeutics > 45 > 5 > 892 - 903

What is known and objective Opioid use in the United States has reached unprecedented—some would even say crisis—levels. Although many individuals use opioid drugs as part of legitimate pain management plans, a significant number misuse prescription or illicit opioids. With regular opioid use, individuals develop tolerance and physical dependence; both are predictable, physiologic responses to repeated...

article

Towards an Effective and Safe Treatment of Inflammatory Pain: A Delphi-Guided Expert Consensus

Giustino Varrassi, Eli Alon, Michela Bagnasco, Luigi Lanata, more

Advances in Therapy > 2019 > 36 > 10 > 2618-2637

Objective The clinical management of inflammatory pain requires an optimal balance between effective analgesia and associated safety risks. To date, mechanisms associated with inflammatory pain are not completely understood because of their complex nature and the involvement of both peripheral and central mechanisms. This Expert Consensus document is intended to update clinicians about evolving areas...

article

Stopping or Decreasing Opioid Therapy in Patients on Chronic Opioid Therapy

Joseph V. Pergolizzi, Giustino Varrassi, Antonella Paladini, JoAnn LeQuang

Pain and Therapy > 2019 > 8 > 2 > 163-176

With the rising concerns about long-term opioid use, particularly in patients with chronic noncancer pain, more and more patients are being considered for decreased doses or discontinuation of opioid therapy. This is a challenging clinical situation for both patient and clinician and should be presented in a shared decision-making model so that the patient understands the risks of opioid therapy and...

article

e‐Cigarettes for smoking cessation: Do they deliver?

Jan M. Kitzen, Jamie L. McConaha, Megan L. Bookser, Joseph V. Pergolizzi, more

Journal of Clinical Pharmacy and Therapeutics > 44 > 4 > 650 - 655

What is known and objective Electronic nicotine delivery systems (ENDS) are battery‐powered devices that allow nicotine and/or other substances to be inhaled in aerosolized form. e‐Cigarettes (electronic cigarettes), the most commonly used ENDS, have been proposed to be smoking cessation aids. However, despite the rapid surge in their popularity, little is known about long‐term health consequences...

article

Pain Control in Latin America: The Optimized Role of Buprenorphine in the Treatment of Cancer and Noncancer Pain

Joseph V. Pergolizzi, Robert Taylor, Jo Ann LeQuang, Argelia Lara, more

Pain and Therapy > 2019 > 8 > 2 > 187-201

Pain is a terrible health problem that transcends borders and nationalities, although there may be significant differences among regions regarding pain management. In Latin America (LatAm, composed of the many nations of Central America, South America, Mexico, and the Caribbean), access to healthcare, pain management, and opioid analgesics can vary. Despite an international U.S.-led trend toward greater...

article

Three Years Down the Road: The Aftermath of the CDC Guideline for Prescribing Opioids for Chronic Pain

Joseph V. Pergolizzi, Melanie Rosenblatt, Jo Ann LeQuang

Advances in Therapy > 2019 > 36 > 6 > 1235-1240

The 2016 CDC guidelines for opioid prescribing by primary care physicians have exposed some shortfalls in our thinking about opioid use and stranded many chronic pain patients with inadequate analgesia. Opioid prescribing rates started to decline in 2012, but still remain high. The response from providers to the 2016 guidelines have led to unintended consequences. Some of the CDC guidance seems arbitrary...

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Treating opioid‐induced constipation in patients taking other medications: Avoiding CYP450 drug interactions

Robert B. Raffa, Robert Taylor, Joseph V. Pergolizzi

Journal of Clinical Pharmacy and Therapeutics > 44 > 3 > 361 - 371

What is known and objective When patients fail other treatment regimens and still suffer from pain sufficiently severe, opioid analgesics are appropriate and required. Unfortunately, constipation is a common adverse effect of opioids. Opioid‐induced constipation (OIC) can be treated with one of the new peripherally acting µ‐opioid receptor antagonist (PAMORA) agents. We summarize the mechanism of...

article

Sunscreen bans: Coral reefs and skin cancer

Robert B. Raffa, Joseph V. Pergolizzi, Robert Taylor, Jan M. Kitzen, more

Journal of Clinical Pharmacy and Therapeutics > 44 > 1 > 134 - 139

What is known and objective Hawaii will ban two major ingredients of sunscreens. This article reviews the reasons and future directions. Hawaii recently enacted legislation that will ban the use of two major ingredients of the majority of commonly used sunscreens. The reason for the ban is the ingredients’ putative deleterious impact on marine ecosystems, particularly coral reefs. But sunscreens...

article

Discovery of “folded DNA” structures in human cells: Potential drug targets

Robert B. Raffa, Joseph V. Pergolizzi, Robert Taylor, Michael H. Ossipov, more

Journal of Clinical Pharmacy and Therapeutics > 44 > 1 > 125 - 128

What is known and objective The double‐helical conformation of human DNA (hDNA) is so axiomatic that it is called the “canonical” form. Recently, though, intrastrand folds (“I‐motifs” and “G‐quadruplexes”) have been identified in hDNA. These could be targets for novel drug discovery. Comment Any interruption of the canonical form of hDNA fundamentally impacts the normal progression of transduction...

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The Role of Lofexidine in Management of Opioid Withdrawal

Joseph V. Pergolizzi, Hani Annabi, Christopher Gharibo, Jo Ann LeQuang

Pain and Therapy > 2019 > 8 > 1 > 67-78

Fear of withdrawal symptoms has been cited by survey respondents as the main reason that they continued to use opioids. Lofexidine is an α₂-adrenergic agonist that decreases the sympathetic outflow that results in the characteristic symptoms of opioid withdrawal. A structural analog of clonidine, lofexidine has a higher affinity and specificity for the α_2a receptors and does not reinforce opioid dependence...

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Tapentadol Extended Release in the Treatment of Severe Chronic Low Back Pain and Osteoarthritis Pain

Joseph V. Pergolizzi, Robert Taylor, Jo Ann LeQuang, Robert B. Raffa, more

Pain and Therapy > 2018 > 7 > 1 > 37-57

Tapentadol is a novel pain reliever with apparently synergistic dual mechanisms of action, capable of addressing both nociceptive and neuropathic components of chronic pain. As an effective analgesic with good tolerability, tapentadol may be appropriate for patients suffering from severe chronic pain associated with low back pain (LBP) or osteoarthritis (OA). Efficacy studies of tapentadol in populations...

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INFONA - science communication portal

Search results for: Joseph V. Pergolizzi

The epidemiology of apnoea of prematurity

The limited management options for apnoea of prematurity

Overdoses due to fentanyl and its analogues (F/FAs) push naloxone to the limit

Wooden Chest syndrome: The atypical pharmacology of fentanyl overdose

The conundrum of polysubstance overdose

The problem of postoperative respiratory depression

Are opioid receptor antagonists adequate for “Opioid” overdose in a changing reality?

Benzodiazepines: Thinking outside the black box

Bone fractures during the time of coronavirus

Opioid withdrawal symptoms, a consequence of chronic opioid use and opioid use disorder: Current understanding and approaches to management

Towards an Effective and Safe Treatment of Inflammatory Pain: A Delphi-Guided Expert Consensus

Stopping or Decreasing Opioid Therapy in Patients on Chronic Opioid Therapy

e‐Cigarettes for smoking cessation: Do they deliver?

Pain Control in Latin America: The Optimized Role of Buprenorphine in the Treatment of Cancer and Noncancer Pain

Three Years Down the Road: The Aftermath of the CDC Guideline for Prescribing Opioids for Chronic Pain

Treating opioid‐induced constipation in patients taking other medications: Avoiding CYP450 drug interactions

Sunscreen bans: Coral reefs and skin cancer

Discovery of “folded DNA” structures in human cells: Potential drug targets

The Role of Lofexidine in Management of Opioid Withdrawal

Tapentadol Extended Release in the Treatment of Severe Chronic Low Back Pain and Osteoarthritis Pain

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