Assessment of a comprehensive naloxone education program's impact on community member knowledge and attitudes on a college campus.

Access to naloxone is a priority for reducing opioid overdose deaths. Although participants who receive naloxone training are able to successfully administer it, the impact of training on community member knowledge and attitudes has not been explored. : A total of 105 participants 18 years and older at a medium-sized university completed assessments between August and December 2019.

Naloxone Administration by Untrained Community Members.

Study Objective: Access to naloxone is a priority for reducing opioid deaths. Although community members who complete naloxone training are able to administer nasal naloxone successfully and rapidly, little is known about the ability of community members to administer naloxone without training. The objective of this study was to assess the ability of untrained individuals to administer naloxone successfully in a simulated opioid overdose setting.

Loperamide toxicity: recommendations for patient monitoring and management.

This position statement is a collaborative effort by the American Academy of Clinical Toxicology (AACT) and the American Association of Poison Control Centers (AAPCC) and has been endorsed by the American College of Medical Toxicology (ACMT). The position statement describes loperamide misuse, proposed mechanisms of toxicity, adverse clinical effects, and recommendations for the acute monitoring and management of patients with loperamide toxicity. Use of high-dose loperamide for its euphoric effects and to self-treat opioid use disorder (in place of evidence-based therapies, like buprenorphine or methadone), is increasing.

An assessment of urine THC immunoassay in healthy volunteers receiving an oral proton-pump inhibitor.

Limitations of urine drug-screening (UDS) by immunoassay include false-positive results. Pantoprazole, a proton-pump inhibitor (PPI), is reported to cause false-positive results for THC on UDS. The objective of this study was to determine if oral PPIs cause false-positive THC results using the THC One Step Marijuana Test Strip.

Kratom Use and Toxicities in the United States.

Background: Kratom is an herbal supplement containing alkaloids with opioid properties. This review was conducted to determine toxicities associated with kratom use in the United States in order to provide insight into its safety as a dietary supplement.

Methods: We conducted a retrospective review of kratom exposures reported to the National Poison Data System to determine the toxicities associated with kratom use.

Hospital Observation Upon Reversal (HOUR) With Naloxone: A Prospective Clinical Prediction Rule Validation Study.

Objective: St. Paul's Early Discharge Rule was derived to determine which patients could be safely discharged from the emergency department after a 1-hour observation period following naloxone administration for opiate overdose. The rule suggested that patients could be safely discharged if they could mobilize as usual and had a normal oxygen saturation, respiratory rate, temperature, heart rate, and Glasgow Coma Scale score.

A Critical Assessment of 60 Years of Maize Intragenic Recombination.

Until the mid-1950s, it was believed that genetic crossovers did not occur within genes. Crossovers occurred between genes, the "beads on a string" model. Then in 1956, Seymour Benzer published his classic paper describing crossing over within a gene, intragenic recombination.

A randomized usability assessment of simulated naloxone administration by community members.

Background And Aims: Expanded access to naloxone has been identified as a key intervention for reducing opioid-related morbidity and mortality. It is not known which naloxone device will result in rapid, successful administration when administered by community members. The aims of this study were to estimate and compare (1) the rate of successful administration and (2) time to successful administration for single-step nasal spray, multi-step atomized nasal spray and intramuscular simulated naloxone by community members.

Validation and Clinical Utility of the hERG IC50:C Ratio to Determine the Risk of Drug-Induced Torsades de Pointes: A Meta-Analysis.

Background: Use of the QT interval corrected for heart rate (QTc) on the electrocardiogram (ECG) to predict torsades de pointes (TdP) risk from culprit drugs is neither sensitive nor specific. The ratio of the half-maximum inhibitory concentration of the hERG channel (hERG IC50) to the peak serum concentration of unbound drug (C ) is used during drug development to screen out chemical entities likely to cause TdP.

Purpose: To validate the use of the hERG IC50:C ratio to predict TdP risk from a culprit drug by its correlation with TdP incidence.

Notes from the Field: Cardiac Dysrhythmias After Loperamide Abuse - New York, 2008-2016.

Loperamide is an over-the-counter antidiarrheal with opioid-receptor agonist properties. Recommended over-the-counter doses (range = 2-8 mg daily) do not produce opioid effects in the central nervous system because of poor oral bioavailability and P-glycoprotein efflux* of the medication (1); recent reports suggest that large doses (50-300 mg) of loperamide produce euphoria, central nervous system depression, and cardiotoxicity (2-4). Abuse of loperamide for its euphoric effect or for self-treatment of opioid withdrawal is increasing (5).

Generation Z: Adolescent Xenobiotic Abuse in the 21st Century.

NMDA receptor antagonists include the prescription medication ketamine, the illicit xenobiotics PCP, MXE, and other novel PCP analogs, and the OTC medication DXM. The NMDA receptor antagonist most commonly abused by adolescents in the United States is DXM. These xenobiotics cause dissociative effects by non-competitively inhibiting the action of glutamate at the NMDA receptor.

Loperamide Abuse Associated With Cardiac Dysrhythmia and Death.

Loperamide is an over-the-counter antidiarrheal with μ-opioid agonist activity. Central nervous system opioid effects are not observed after therapeutic oral dosing because of poor bioavailability and minimal central nervous system penetration. However, central nervous system opioid effects do occur after supratherapeutic oral doses.

Chemoprevention of prostate cancer by major dietary phytochemicals.

Prostate cancer continues to be one of the most commonly diagnosed diseases and the second leading cause of cancer-related deaths among men in the United States. Options exist to treat localized disease, including surgery, radiation therapy, and hormonal therapy, but clinical management of advanced prostate cancer is challenging. In the past few decades, chemoprevention involving naturally-occurring compounds has emerged as a promising and cost-effective approach to reduce incidence and morbidity of prostate cancer by inhibiting the precancerous events before the occurrence of clinical disease.