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Russel Roberts – One of the best experts on this subject based on the ideXlab platform.

Steven R Horbal – One of the best experts on this subject based on the ideXlab platform.

  • the effects of alcohol cannabis and cigarette use on the initiation reinitiation and persistence of non medical use of opioids Sedatives and tranquilizers in adults
    Drug and Alcohol Dependence, 2016
    Co-Authors: Brooke J Arterberry, Steven R Horbal
    Abstract:

    Abstract Background Non-medical prescription drug use (NMPDU) has been a growing concern due to increased prevalence and severity of consequences. Epidemiological research has identified alcohol, cannabis, and cigarette use to be associated with NMPDU and initiation. However, studies have not examined stages of NMPDU in relation to other substances, which can highlight salient factors associated with high risk stages of NMPDU, such as reinitiation and persistence. Methods This study used an adult sample from the National Epidemiologic Survey of Alcohol and Related Conditions Wave 1 (2001–2002) and Wave 2 (2004–2005) data. We examined non-users, prior users, and current users of opioids and Sedatives/tranquilizers at risk of initiation, reinitiation, and persistence between Wave 1 and Wave 2 in relation to early-onset and frequency of cannabis, cigarette, and alcohol use, controlling for sociodemographics. Results Early-onset of cigarette and alcohol use increased the odds of opioid use initiation; early-onset of cannabis, cigarette, and alcohol use increased the odds of sedative/tranquilizer use initiation and opioid reinitiation, persistence, while early-onset cannabis increased the odds of sedative/tranquilizer reinitiation and persistence. Frequency of cannabis and cigarette use predicted all three stages of opioid use, initiation/reinitiation of Sedatives/tranquilizers, and frequency of cannabis use alone predicted sedative/tranquilizer persistence. Conclusions This study provided evidence that differentiating among those who have experienced initiation, reinitiation, or persistence of NMPDU via early-onset and frequency of alcohol, cigarettes, and cannabis is vital, as there are specific aspects that influence risk. Therefore, tailoring interventions at different stages to reduce NMPDU is crucial.

  • the effects of alcohol cannabis and cigarette use on the initiation reinitiation and persistence of non medical use of opioids Sedatives and tranquilizers in adults
    Drug and Alcohol Dependence, 2016
    Co-Authors: Brooke J Arterberry, Steven R Horbal
    Abstract:

    Abstract Background Non-medical prescription drug use (NMPDU) has been a growing concern due to increased prevalence and severity of consequences. Epidemiological research has identified alcohol, cannabis, and cigarette use to be associated with NMPDU and initiation. However, studies have not examined stages of NMPDU in relation to other substances, which can highlight salient factors associated with high risk stages of NMPDU, such as reinitiation and persistence. Methods This study used an adult sample from the National Epidemiologic Survey of Alcohol and Related Conditions Wave 1 (2001–2002) and Wave 2 (2004–2005) data. We examined non-users, prior users, and current users of opioids and Sedatives/tranquilizers at risk of initiation, reinitiation, and persistence between Wave 1 and Wave 2 in relation to early-onset and frequency of cannabis, cigarette, and alcohol use, controlling for sociodemographics. Results Early-onset of cigarette and alcohol use increased the odds of opioid use initiation; early-onset of cannabis, cigarette, and alcohol use increased the odds of sedative/tranquilizer use initiation and opioid reinitiation, persistence, while early-onset cannabis increased the odds of sedative/tranquilizer reinitiation and persistence. Frequency of cannabis and cigarette use predicted all three stages of opioid use, initiation/reinitiation of Sedatives/tranquilizers, and frequency of cannabis use alone predicted sedative/tranquilizer persistence. Conclusions This study provided evidence that differentiating among those who have experienced initiation, reinitiation, or persistence of NMPDU via early-onset and frequency of alcohol, cigarettes, and cannabis is vital, as there are specific aspects that influence risk. Therefore, tailoring interventions at different stages to reduce NMPDU is crucial.

Pratik P. Pandharipande – One of the best experts on this subject based on the ideXlab platform.

Paula L. Watson – One of the best experts on this subject based on the ideXlab platform.

John W Devlin – One of the best experts on this subject based on the ideXlab platform.

  • pharmacology of commonly used analgesics and Sedatives in the icu benzodiazepines propofol and opioids
    Anesthesiology Clinics, 2011
    Co-Authors: John W Devlin, Russel Roberts
    Abstract:

    The ideal sedative or analgesic agent should have a rapid onset of activity, a rapid recovery after drug discontinuation, a predictable dose response, a lack of drug accumulation,and no toxicity. Unfortunately, none of the earlier analgesics, the benzodiazepines,or propofol share all of these characteristics. Patients who are critically ill experience numerous physiologic derangements and commonly require high doses and long durations of analgesic and sedative therapy. There is a paucity of well designed clinical trials evaluating the safety and efficacy of earlier sedative and analgesic agents in the ICU. In addition, the ever-changing dynamics of patients who are critically ill makes the use of sedation a continual challenge during the course of each patient’s admission. To optimize care, clinicians should be familiar with the many pharmacokinetic, pharmacodynamic, and pharmacogenetic variables that can affect the safety and efficacy of Sedatives and analgesics.

  • adverse drug events associated with the use of analgesics Sedatives and antipsychotics in the intensive care unit
    Critical Care Medicine, 2010
    Co-Authors: John W Devlin, Stephanie Mallowcorbett, Richard R Riker
    Abstract:

    As critically ill patients frequently receive analgesics, Sedatives, and antipsychotics to optimize patient comfort and facilitate mechanical ventilation, adverse events associated with the use of these agents can affect all organ systems and result in substantial morbidity and mortality. Although many of these adverse effects are common pharmacologic manifestations of the agent, and therefore frequently reversible, others are idiosyncratic and thus unexpected. The critically ill are more susceptible to adverse drug events than nonintensive care unit patients due to the high doses and long periods for which each of these agents are often administered, the frequent use of intravenous formulations that contain adjuvants that may lead to toxicity in some instances, and the high prevalence of end-organ dysfunction that affects the pharmacokinetic and pharmacodynamic response to therapy. This paper will review the most common and serious adverse drug events reported to occur with the use of Sedatives, analgesics, and antipsychotics in the intensive care unit; highlight the pharmacokinetic, pharmacodynamic, and pharmacogenetic factors that can influence analgesic, sedative, and antipsychotic response and safety in the critically ill; and identify strategies that can be used to minimize toxicity with these agents.

  • pharmacology of commonly used analgesics and Sedatives in the icu benzodiazepines propofol and opioids
    Critical Care Clinics, 2009
    Co-Authors: John W Devlin, Russel Roberts
    Abstract:

    Opioids, benzodiazepines, and propofol remain the mainstay by which to optimize patient comfort and facilitate mechanical ventilation in patients who are critically ill. Unfortunately none of these agents share all of the characteristics of the ideal sedative or analgesic agent: rapid onset, rapid recovery, a predictable dose response, a lack of drug accumulation, and no toxicity. To optimize care, critical care clinicians should be familiar with the many pharmacokinetic, pharmacodynamic, and pharmacogenetic variables that can affect the safety and efficacy of these Sedatives and analgesics.