101 results match your criteria clearance buprenorphine

Clearance of buprenorphine during pregnancy and neonatal outcomes.

Arch Womens Ment Health 2021 Apr 16. Epub 2021 Apr 16.

Department of Psychiatry, University of Wisconsin, Madison, WI, USA.

Buprenorphine is emerging as the preferred pharmacologic treatment for opioid use disorder during pregnancy. We examined the relative plasma clearance of buprenorphine (BUP) across pregnancy. Pregnant women with opioid use disorder participating in a prospective, observational study from 2013 to 2016 on stress in pregnancy who were receiving BUP for opioid use disorder were included. Read More

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Pharmacokinetics of buprenorphine in pregnant sheep after intravenous injection.

Pharmacol Res Perspect 2021 Apr;9(2):e00726

Department of Anesthesia and Intensive Care, Kuopio University Hospital, Kuopio, Finland.

Buprenorphine is a semi-synthetic opioid, widely used in the maintenance treatment for opioid-dependent pregnant women. Limited data exist on the pharmacokinetics of buprenorphine in pregnancy. We conducted a pharmacokinetic study to determine the pharmacokinetics of intravenous buprenorphine in pregnant sheep. Read More

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Pharmacotherapy of neonatal opioid withdrawal syndrome: a review of pharmacokinetics and pharmacodynamics.

Expert Opin Drug Metab Toxicol 2021 Jan 29;17(1):87-103. Epub 2020 Oct 29.

Division of Clinical Pharmacology, Cincinnati Children's Hospital Medical Center , Cincinnati, OH, USA.

Introduction: Neonatal opioid withdrawal syndrome (NOWS) often arises in infants born to mothers who used opioids during pregnancy. Morphine, methadone, and buprenorphine are the most common first-line treatments, whereas clonidine and phenobarbital are generally reserved for adjunctive therapy. These drugs exhibit substantial pharmacokinetic (PK) and pharmacodynamic (PD) variability. Read More

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January 2021

Effect of non-steroidal anti-inflammatory drugs on glomerular filtration rate and urinary N-acetyl-β-D-glucosaminidase activity in cats after dental surgery.

Vet Anaesth Analg 2020 Sep 3;47(5):631-636. Epub 2020 Jun 3.

School of Veterinary Science, Massey University, Palmerston North, New Zealand.

Objective: To compare the effects of meloxicam or carprofen on glomerular filtration rate (GFR), and to evaluate the effect of meloxicam on urinary N-acetyl-β-D-glucosaminidase (NAG) activity, of cats after dental surgery.

Study Design: Randomized, blinded, controlled trial.

Animals: A total of 24 mixed breed cats. Read More

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September 2020

Protracted renal clearance of fentanyl in persons with opioid use disorder.

Drug Alcohol Depend 2020 09 2;214:108147. Epub 2020 Jul 2.

Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21224, USA.

Introduction: The illicit opioid supply in the U.S. is increasingly adulterated with fentanyl. Read More

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September 2020

An Efficient and Smooth Methadone-to-Buprenorphine Transition Protocol Utilizing a Transdermal Fentanyl Bridge and a Pharmacokinetic Inducer: The Stanciu Method.

Cureus 2020 May 27;12(5):e8310. Epub 2020 May 27.

Substance Abuse Counseling, New Hampshire Hospital, Concord, USA.

The traditional method of transitioning from methadone to buprenorphine requires a gradual dose reduction to a low dose of 30 mg daily, followed by cessation, and addressing withdrawal symptoms prior to the initiation of buprenorphine. This process can be time-consuming and is also associated with tremendous patient suffering and adverse outcomes. In recent years, several protocols have emerged based on the notion of blunting the shift from full receptor activation to partial receptor activation via an intermediate "bridge". Read More

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[Opioid therapy in patients with liver cirrhosis].

Ther Umsch 2020 ;77(1):14-19

Abteilung Klinische Pharmakologie und Toxikologie, Universitätsspital Basel.

Opioid therapy in patients with liver cirrhosis There are currently no endogenous markers representing the metabolic activity and the extent of portacaval shunts in patients with liver cirrhosis. The pharmacokinetic properties of the applied drugs must therefore be taken into account when adjusting the dose in patients with liver cirrhosis. For drugs with a high degradation during the first passage across the liver (first-pass metabolism) the bioavailability is going to increase and the clearance to decrease after oral application. Read More

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September 2020

[Opioids in patients with renal impairment].

Ther Umsch 2020 ;77(1):10-13

Abteilung Klinische Pharmakologie und Toxikologie, Universitätsspital Basel.

Opioids in patients with renal impairment Renal impairment can reduce the elimination of certain opioids and their metabolites. Accumulation and toxicity may occur. Due to their pharmacokinetic properties, fentanyl, alfentanil and buprenorphine can be used safely in patients with renal impairment. Read More

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September 2020

Pharmacokinetics and analgesic effects of intravenous, intramuscular or subcutaneous buprenorphine in dogs undergoing ovariohysterectomy: a randomized, prospective, masked, clinical trial.

BMC Vet Res 2020 May 24;16(1):154. Epub 2020 May 24.

Department of Veterinary Biomedical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada.

Background: Buprenorphine is used for canine postoperative pain management. This study aimed to describe the pharmacokinetics and evaluate the analgesic efficacy of buprenorphine (Simbadol, 1.8 mg/mL) administered by different routes in dogs undergoing ovariohysterectomy. Read More

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Pregnant Smokers Receiving Opioid Agonist Therapy Have an Elevated Nicotine Metabolite Ratio: A Replication Study.

Nicotine Tob Res 2020 10;22(10):1923-1927

Center for Interdisciplinary Research on Nicotine Addiction, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.

Introduction: Pregnant women exposed chronically to opioids smoked more cigarettes per day (CPD) and had a higher nicotine metabolite ratio (NMR), 3-hydroxycotinine/cotinine, a biomarker of nicotine metabolism and clearance, than those not receiving opioids. We examined CPD and NMR in a group of pregnant smokers, a quarter of whom were receiving opioid agonist therapy (OAT).

Aims And Methods: Pregnant smokers recruited to participate in a placebo-controlled trial of bupropion for smoking cessation provided a blood sample for measurement of NMR. Read More

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October 2020

Therapeutic Drug Monitoring in Buprenorphine/Naloxone Treatment for Opioid Use Disorder: Clinical Feasibility and Optimizing Assay Precision.

Pharmacopsychiatry 2020 Apr 30;53(3):115-121. Epub 2020 Jan 30.

National Rehabilitation Center, UAE, Shakhbout City, United Arab Emirates.

Introduction: Compliance with sublingual buprenorphine/naloxone (SL-BUP/NX) is associated with higher abstinence from illicit opioid use. Therapeutic drug monitoring (TDM) has been recommended for adherence monitoring of buprenorphine (BUP) maintenance treatment for opioid use disorder (OUD), but to date there have been no reported clinical applications. In this TDM feasibility study, we investigated BUP assay precision in 15 adults with OUD who had been stabilized on buprenorphine/naloxone. Read More

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A comparative study on the effect of addition of intrathecal buprenorphine to 2-chloroprocaine spinal anesthesia in short duration surgeries.

J Anaesthesiol Clin Pharmacol 2019 Oct-Dec;35(4):533-539

Department of Anaesthesiology, MS Ramaiah Medical College, Ramaiah Teaching Hospital, Bengaluru, Karnataka, India.

Background And Aims: Spinal anesthesia is a safe and reliable technique for surgeries on the lower abdomen and lower limbs. Some of its characteristics like delayed ambulation and pain after block regression may limit its use, especially for short duration surgeries. 2-chloroprocaine is an amino-ester local anesthetic with an approximate duration of action of 40 minutes, which is ideal for short duration surgeries. Read More

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January 2020

Clearance of cerebrospinal fluid from the sacral spine through lymphatic vessels.

J Exp Med 2019 11 27;216(11):2492-2502. Epub 2019 Aug 27.

Institute of Pharmaceutical Sciences, Swiss Federal Institute of Technology, ETH Zurich, Zurich, Switzerland

The pathways of circulation and clearance of cerebrospinal fluid (CSF) in the spine have yet to be elucidated. We have recently shown with dynamic in vivo imaging that routes of outflow of CSF in mice occur along cranial nerves to extracranial lymphatic vessels. Here, we use near-infrared and magnetic resonance imaging to demonstrate the flow of CSF tracers within the spinal column and reveal the major spinal pathways for outflow to lymphatic vessels in mice. Read More

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November 2019

Use of naltrexone in treating opioid use disorder in pregnancy.

Am J Obstet Gynecol 2020 01 31;222(1):83.e1-83.e8. Epub 2019 Jul 31.

Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Tennessee Medical Center, Knoxville, TN.

Background: The mainstay of the management of opioid use disorder in pregnancy is with methadone or buprenorphine medication-assisted treatment. Methadone and buprenorphine are opioid agonist drugs. Naltrexone, an opioid antagonist, is also a medication-assisted treatment option; however, to date, only a few retrospective studies have reported its use in pregnancy. Read More

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January 2020

Simultaneous Transdermal Delivery of Buprenorphine Hydrochloride and Naltrexone Hydrochloride by Iontophoresis.

Mol Pharm 2019 06 22;16(6):2808-2816. Epub 2019 May 22.

Department of Pharmacy & Pharmacology , University of Bath , Bath BA2 7AY , U.K.

The opioids buprenorphine hydrochloride (BUP) and naltrexone hydrochloride (NTX) show promise as a combination treatment for addiction, but no means of delivering the two compounds in one medicine currently exist. In this paper, we report sufficient input rates of both these drugs from one iontophoretic transdermal drug delivery system. Experiments were performed using dermatomed pig skin mounted in glass side-bi-side cells. Read More

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Opioids in Breast Milk: Pharmacokinetic Principles and Clinical Implications.

Shinya Ito

J Clin Pharmacol 2018 10;58 Suppl 10:S151-S163

Division of Clinical Pharmacology and Toxicology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.

Safety of maternal drug therapy during breastfeeding may be assessed from estimated levels of drug exposure of the infant through milk. Pharmacokinetic (PK) principles predict that the lower the clearance is, the higher the infant dose via milk will be. Drugs with low clearance (<1 mL/[kg·min]) are likely to cause an infant exposure level greater than 10% of the weight-adjusted maternal dose even if the milk-to-plasma concentration ratio is 1. Read More

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October 2018

Pharmacokinetics and physiologic/behavioral effects of buprenorphine administered sublingually and intravenously to neonatal foals.

J Vet Pharmacol Ther 2019 Jan 21;42(1):26-36. Epub 2018 Sep 21.

Department of Biomedical Sciences and Pathobiology, VA-MD College of Veterinary Medicine, VA Tech, Blacksburg, Virginia.

Buprenorphine is absorbed following sublingual administration, which would be a low-stress delivery route in foals. However, the pharmacokinetics/pharmacodynamics are not described in foals. Six healthy foals <21 days of age participated in a blinded, randomized, 3-period, 5-sequence, 3-treatment crossover prospective study. Read More

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January 2019

Voriconazole greatly increases the exposure to oral buprenorphine.

Eur J Clin Pharmacol 2018 Dec 30;74(12):1615-1622. Epub 2018 Aug 30.

Department of Anaesthesiology and Intensive Care, University of Turku, P.O. Box 52, Kiinamyllynkatu 4-8, FI-20520, Turku, Finland.

Purpose: Buprenorphine has low oral bioavailability. Regardless of sublingual administration, a notable part of buprenorphine is exposed to extensive first-pass metabolism by the cytochrome P450 (CYP) 3A4. As drug interaction studies with buprenorphine are limited, we wanted to investigate the effect of voriconazole, a strong CYP3A4 inhibitor, on the pharmacokinetics and pharmacodynamics of oral buprenorphine. Read More

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December 2018

Pain Management in Pediatric Chronic Kidney Disease.

J Pediatr Pharmacol Ther 2018 May-Jun;23(3):192-202

Pain is a common problem in children with chronic kidney disease (CKD); however, limited data exist regarding its management. Although most pain is managed pharmacologically, in some instances non-pharmacologic management can aid in safely ameliorating discomfort. Because of the accumulation of toxic metabolites, many common pain medications have adverse effects on kidney function or altered pharmacokinetics in the setting of CKD. Read More

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Telemedicine Delivery and Successful Reimbursement in Toxicology.

J Med Toxicol 2018 09 29;14(3):242-247. Epub 2018 May 29.

University of Rochester, Rochester, NY, USA.

Introduction: Telemedicine and its use in medical toxicology have existed for some time. There are varied definitions, but existing ones center on using currently available forms of audio, video, and internet communications to provide "real-time" patient care. Definitions have historically limited reimbursement but recently expanded CMS guidelines have improved this. Read More

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September 2018

Comparison of Dexamethasone and Buprenorphine as Adjuvant in Ultrasound-guided Brachial Plexus Blocks: A Randomized Controlled Trial.

Anesth Essays Res 2018 Jan-Mar;12(1):176-179

Department of Anaesthesiology, Vinayaka Missions Medical College, Karaikal, Puducherry, India.

Introduction: Effective postoperative analgesia is imperative for orthopedic surgeries to enhance recovery and facilitate early ambulation. Various additives have been used as adjuvants with local anesthetics in peripheral nerve blocks to provide postoperative analgesia. The aim of this study is to compare the duration of postoperative analgesia with buprenorphine and dexamethasone when administered as an adjuvant during ultrasound-guided brachial plexus blocks. Read More

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The opioid epidemic and pregnancy: implications for anesthetic care.

Curr Opin Anaesthesiol 2018 Jun;31(3):243-250

Division of Obstetric Anesthesiology, Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Purpose Of Review: This review summarizes evolving knowledge regarding adverse maternal, fetal, and neonatal effects of opioid exposure during pregnancy, and current treatment options for opioid use disorder (OUD). Maternal and fetal implications of maternal opioid maintenance with methadone and buprenorphine are described. Finally, acute and chronic pain management strategies in opioid-tolerant parturients are reviewed. Read More

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The Pharmacokinetics and Pharmacodynamics of Buprenorphine in Neonatal Abstinence Syndrome.

Clin Pharmacol Ther 2018 06 28;103(6):1029-1037. Epub 2018 Apr 28.

Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

Neonatal abstinence syndrome (NAS) is a condition affecting newborns that are exposed to an opioid in utero. In a randomized, controlled trial assessing the efficacy of buprenorphine and morphine in NAS, blood samples were analyzed from a subset of patients receiving buprenorphine along with NAS scores. The data were used to validate and adapt an existing model of buprenorphine in neonates and to identify relationships between buprenorphine or norbuprenorphine pharmacokinetics (PK) and efficacy or safety. Read More

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Pregnancy Increases Norbuprenorphine Clearance in Mice by Induction of Hepatic Glucuronidation.

Drug Metab Dispos 2018 02 20;46(2):100-108. Epub 2017 Nov 20.

Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, Washington

Norbuprenorphine (NBUP) is the major active metabolite of buprenorphine (BUP) that is commonly used to treat opiate addiction during pregnancy; it possesses 25% of BUP's analgesic activity and 10 times BUP's respiratory depression effect. To optimize BUP's dosing regimen during pregnancy with better efficacy and safety, it is important to understand how pregnancy affects NBUP disposition. In this study, we examined the pharmacokinetics of NBUP in pregnant and nonpregnant mice by administering the same amount of NBUP through retro-orbital injection. Read More

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February 2018

The impact of advanced opioid drugs and analgesic adjuvants on murine macrophage oxygen burst.

Folia Med Cracov 2017;57(2):15-30

Department of Immunology, Jagiellonian University Medical College, Czysta 18, Krakow, Poland.

Macrophages (Mf) are a versatile group of phagocytic cells responsible for fulfilling a variety of immune functions, most notably for mounting the initial anti-microbial response and for the clearance of cellular debris and apoptotic bodies. The key processes for fulfilling these functions include the production of reactive oxygen intermediates (ROIs) and nitric oxide (NO). Mf also express a variety of receptors, including opioid, serotonin, and norepinephrine receptors, and thus can react to various substances. Read More

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Converting from Transdermal to Buccal Formulations of Buprenorphine: A Pharmacokinetic Meta-Model Simulation in Healthy Volunteers.

Pain Med 2018 10;19(10):1988-1996

Endo Pharmaceuticals Inc., Malvern, Pennsylvania.

Objective: To develop a model to predict buprenorphine plasma concentrations during transition from transdermal to buccal administration.

Design: Population pharmacokinetic model-based meta-analysis of published data.

Methods: A model-based meta-analysis of available buprenorphine pharmacokinetic data in healthy adults, extracted as aggregate (mean) data from published literature, was performed to explore potential conversion from transdermal to buccal buprenorphine. Read More

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October 2018

Pharmacokinetic and pharmacodynamic modelling after subcutaneous, intravenous and buccal administration of a high-concentration formulation of buprenorphine in conscious cats.

PLoS One 2017 26;12(4):e0176443. Epub 2017 Apr 26.

Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada.

Background: The aim of this study was to describe the joint pharmacokinetic-pharmacodynamic model and evaluate thermal antinociception of a high-concentration formulation of buprenorphine (Simbadol™) in cats.

Methods: Six healthy cats (4.9 ± 0. Read More

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September 2017

Pharmacokinetics of buprenorphine following constant rate infusion for postoperative analgesia in dogs undergoing ovariectomy.

Vet Anaesth Analg 2017 May 11;44(3):435-443. Epub 2017 Jan 11.

Department of Veterinary Medical Sciences, University of Bologna, Ozzano Emilia, Italy.

Objective: To investigate the pharmacokinetics of buprenorphine and its main active metabolite, norbuprenorphine, after administration of an intravenous loading dose followed by constant rate infusion (CRI) in dogs.

Study Design: Prospective, clinical study.

Animals: A total of seven healthy dogs undergoing elective ovariectomy. Read More

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Pharmacokinetics and pharmacodynamics of buprenorphine and sustained-release buprenorphine after administration to adult alpacas.

Am J Vet Res 2017 Mar;78(3):321-329

OBJECTIVE To determine pharmacokinetics and pharmacodynamics of buprenorphine after IV and SC administration and of sustained-release (SR) buprenorphine after SC administration to adult alpacas. ANIMALS 6 alpacas. PROCEDURES Buprenorphine (0. Read More

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Inhibition of glucuronidation and oxidative metabolism of buprenorphine using GRAS compounds or dietary constituents/supplements: in vitro proof of concept.

Biopharm Drug Dispos 2017 Mar 24;38(2):139-154. Epub 2017 Jan 24.

Department of Pharmaceutics, VCU School of Pharmacy, Richmond, VA, 23298-0533, USA.

The present study investigated the potential of generally recognized as safe (GRAS) compounds or dietary substances to inhibit the presystemic metabolism of buprenorphine and to increase its oral bioavailability. Using IVIVE, buprenorphine extraction ratios in intestine and liver were predicted as 96% and 71%, respectively. In addition, the relative fraction of buprenorphine metabolized by oxidation and glucuronidation in these two organs was estimated using pooled human intestinal and liver microsomes. Read More

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