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Nonopioid medications for managing opioid withdrawal in acute care settings: A scoping review.
Am J Health Syst Pharm
December 2024
Banner - University Medical Center, Tucson, AZ, USA.
Purpose: There are hospitalized patients with chronic opioid use who will experience signs and symptoms of opioid withdrawal who were not on medications for opioid use disorder (OUD) prior to admission, do not want to start or are unable to start medications for OUD during admission, and want to limit or avoid the use of opioids. The purpose of this scoping review was to assess the potential effectiveness and safety of using non-opioid agents for managing acute opioid withdrawal in acute care settings.
Methods: PubMed (inception to 2024), Embase (inception to 2024), and Cochrane Library (inception to 2024) were the databases evaluated for the literature search.
Development and Preliminary Testing of the Withdrawal Assessment Tool-Alpha 2 Agonist: An Assessment Instrument for Monitoring Iatrogenic Withdrawal Symptoms in Children Receiving an Alpha-2 Agonist.
Pediatr Crit Care Med
January 2025
Department of Family and Community Health; School of Nursing, University of Pennsylvania, Philadelphia, PA.
Objectives: To develop and conduct preliminary testing of the Withdrawal Assessment Tool-Alpha 2 Agonist (WAT-A2A) to monitor dexmedetomidine and clonidine withdrawal symptoms in acutely ill children.
Design: Three-phase instrument development study. Phase 1: retrospective chart review of symptoms exhibited by children with documented dexmedetomidine withdrawal; phase 2: WAT-A2A instrument construction based on phase 1 data; and phase 3: prospective testing of the WAT-A2A in children weaning from alpha 2 agonists (A2As).
Results from a benzodiazepine-minimizing protocol for inpatient management of alcohol withdrawal.
Gen Hosp Psychiatry
November 2024
Psychiatry Residency Spokane, Providence Sacred Heart Medical Center & Children's Hospital, Spokane, WA, USA. Electronic address:
Pharmacokinetic Modeling and Model-Based Hypothesis Generation for Dose Optimization of Clonidine in Neonates With Neonatal Opioid Withdrawal Syndrome.
Clin Pharmacol Ther
November 2024
St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
The No-POPPY study (NCT03396588), a double-blind, randomized trial compared morphine with clonidine therapy for neonatal opioid withdrawal syndrome (NOWS) and found that the duration of treatment was similar across groups. This is significant because perinatal use of morphine has the potential for neurodevelopmental consequences. Still, the clonidine group reached symptom stabilization (Finnegan score (FS) < 8) later than the morphine group and had a more significant number of patients who required adjunct therapy.
View Article and Find Full Text PDFGabapentin for Delirium in Infants in the Neonatal Intensive Care Unit.
J Pediatr Pharmacol Ther
October 2024
Department of Pharmacy: Clinical and Administrative Sciences (JLM, SBN, PNJ, AP), College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City, OK.
Objective: A protocol was developed for neonatal intensive care unit (NICU) delirium: Step 1, gabapentin for pain or melatonin for sleep; Step 2, add on other Step 1 agent; Step 3, antipsychotics. The purpose of this study was to describe the utility and dosing of gabapentin for NICU delirium.
Methods: Retrospective evaluation of NICU patients from January 1, 2021-December 31, 2022 who received >1 dose of gabapentin based on the delirium protocol.
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