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We Need to Change Our Approach to Substance Abuse in EMS
Diversion policies may be thought of as the downstream side of a system's approach to controlled substance management. The upstream side, including human resources and occupational health processes for recognizing and testing individuals at risk, may be worth some attention, too. Long-term Consequences Discovering and reporting drug diversions may result in career-ending consequences for our friends and colleagues. However, closing our eyes to this problem may result in even more devastating consequences, including loss of life. It may also lead to potential injury and death of partners, patients, and bystanders, when emer...
Source: JEMS Operations - October 4, 2017 Category: Emergency Medicine Authors: Neal Richmond, MD Tags: Columns Operations Source Type: news

Safe driving after propofol sedation - Summerlin-Grady L, Austin PN, Gabaldon DA.
PURPOSE: Propofol is a short-acting medication with fast cognitive and psychomotor recovery. However, patients are usually instructed not to drive a motor vehicle for 24  hours after receiving propofol. The purpose of this article was to review the evidenc... (Source: SafetyLit)
Source: SafetyLit - September 30, 2017 Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news

Ketamine Alone Is Best Sedative for Children's Emergencies Ketamine Alone Is Best Sedative for Children's Emergencies
Ketamine alone was associated with fewer serious adverse events and interventions in children compared with propofol alone or ketamine combined with propofol or fentanyl, a study found.Medscape Medical News (Source: Medscape Medical News Headlines)
Source: Medscape Medical News Headlines - August 21, 2017 Category: Consumer Health News Tags: Emergency Medicine News Source Type: news

Dexmedetomidine and Propofol in Monitored Anesthesia Care Dexmedetomidine and Propofol in Monitored Anesthesia Care
Does the combined use of propofol and dexmedetomidine provide cardiovascular stability with a safer profile than either drug used alone?BMC Anesthesiology (Source: Medscape Today Headlines)
Source: Medscape Today Headlines - May 31, 2017 Category: Consumer Health News Tags: Anesthesiology Journal Article Source Type: news

Protective Effect of Sevoflurane vs Propofol in HVR Surgery Protective Effect of Sevoflurane vs Propofol in HVR Surgery
This study compared the cardioprotective effect of anesthesia with intravenous propofol versus inhaled sevoflurane in patients undergoing mitral, aortic or tricuspid valve replacement surgery.BMC Anesthesiology (Source: Medscape Today Headlines)
Source: Medscape Today Headlines - May 24, 2017 Category: Consumer Health News Tags: Anesthesiology Journal Article Source Type: news

Sedation After Cardiac Surgery: Is One Drug Preferable? Sedation After Cardiac Surgery: Is One Drug Preferable?
This review compares the use of propofol and dexmedetomidine as adjuncts to fast track the recovery of patients undergoing cardiac surgery. What are their respective advantages and disadvantages?Anesthesia & Analgesia (Source: Medscape Today Headlines)
Source: Medscape Today Headlines - May 19, 2017 Category: Consumer Health News Tags: Anesthesiology Journal Article Source Type: news

Propofol as suicidal agent or drug of abuse - Hantson P, Bonbled F.
Propofol is a sedative-hypnotic drug that is now widely prescribed for general anaesthesia, long-term sedation, and conscious sedation. Among its main advantages, propofol is a short-acting drug, with predictable pharmacokinetics, and is particularly safe ... (Source: SafetyLit)
Source: SafetyLit - April 21, 2017 Category: Global & Universal Tags: Alcohol and Other Drugs Source Type: news

Ivaoes Animal Health Launches New Anesthetic Product, Rapanofal(TM) (Propofol Emulsion Injection), the only FDA-approved Propofol Product Formulation Indicated for Use in Cats and Dogs
Rapanofal™ (Propofol Emulsion Injection, 10mg/ml) is the first product of many to come in the Ivaoes Animal Health pipeline of companion animal specialty products, to be launched in the US veterinary healthcare market MIAMI, April 17, 2017 -- (Healthcar... Biopharmaceuticals, Product Launch Ivaoes Animal Health, Tri-Source Pharma, Rapanofal, Propofol (Source: HSMN NewsFeed)
Source: HSMN NewsFeed - April 17, 2017 Category: Pharmaceuticals Source Type: news

Is Propofol Injection Pain Really Important to Patients? Is Propofol Injection Pain Really Important to Patients?
Pain on injection of propofol is a common occurrence, but do patients generally recall it, and does it negatively impact their experience?BMC Anesthesiology (Source: Medscape General Surgery Headlines)
Source: Medscape General Surgery Headlines - April 5, 2017 Category: Surgery Tags: Anesthesiology Journal Article Source Type: news

Anesthesia Impact on Arterial O2 During Thoracoscopic Surgery Anesthesia Impact on Arterial O2 During Thoracoscopic Surgery
Is either desflurane-remifentanil or propofol-remifentanil anesthesia preferable in terms of oxygenation during one-lung ventilation for thoracoscopic surgery?BMC Anesthesiology (Source: Medscape General Surgery Headlines)
Source: Medscape General Surgery Headlines - March 15, 2017 Category: Surgery Tags: Anesthesiology Journal Article Source Type: news

Do We Need New Targets for Developing I.V. Anaesthetics? Do We Need New Targets for Developing I.V. Anaesthetics?
Development of new I.V. anesthetic agents has been stagnant since propofol was introduced. In this commentary, the author highlights the need for a renewed focus on novel, tailored I.V. anesthetics.British Journal of Anaesthesia (Source: Medscape Today Headlines)
Source: Medscape Today Headlines - February 10, 2017 Category: Consumer Health News Tags: Anesthesiology Journal Article Source Type: news

Deaths from propofol abuse : survey of institutes of forensic medicine in Germany, Austria and Switzerland - Maier C, Iwunna J, Tsokos M, Mu ßhoff F.
Previous references suggesting a  high mortality of propofol addiction in medical personnel were mostly based on surveys of the heads of medical departments or case reports; therefore, a questionnaire was sent to 48 forensic medicine departments in German... (Source: SafetyLit)
Source: SafetyLit - January 19, 2017 Category: Global & Universal Tags: Alcohol and Other Drugs Source Type: news

Diprivan (Propofol) - updated on RxList
(Source: RxList - New and Updated Drug Monographs)
Source: RxList - New and Updated Drug Monographs - January 18, 2017 Category: Drugs & Pharmacology Source Type: news

Propofol (Propofol Injectable Emulsion) - updated on RxList
(Source: RxList - New and Updated Drug Monographs)
Source: RxList - New and Updated Drug Monographs - January 18, 2017 Category: Drugs & Pharmacology Source Type: news

Flight Shift
This article does not represent the views or opinions of the USAF, DoD, or the US Government. They are wholly the opinion of the author. Dr. Novak is a former F-15C pilot and current emergency physician in Ohio. Have questions about how combat aviation training could be used in the ED? Email editor@epmonthly.com. The post Flight Shift appeared first on Emergency Physicians Monthly. (Source: EPMonthly.com)
Source: EPMonthly.com - December 31, 2016 Category: Emergency Medicine Authors: Logan Plaster Tags: Uncategorized Source Type: news

Flight Shift
This article does not represent the views or opinions of the USAF, DoD, or the US Government. They are wholly the opinion of the author. Dr. Novak is a former F-15C pilot and current emergency physician in Ohio. Have questions about how combat aviation training could be used in the ED? Email editor@epmonthly.com. The post Flight Shift appeared first on Emergency Physicians Monthly. (Source: EPMonthly.com)
Source: EPMonthly.com - November 21, 2016 Category: Emergency Medicine Authors: Logan Plaster Tags: Uncategorized Source Type: news

Measuring The Cardiovascular Effects of Propofol Anaesthesia Measuring The Cardiovascular Effects of Propofol Anaesthesia
What is the effect of increasing doses of propofol during surgery on global hemodynamics?British Journal of Anaesthesia (Source: Medscape General Surgery Headlines)
Source: Medscape General Surgery Headlines - September 30, 2016 Category: Surgery Tags: Anesthesiology Journal Article Source Type: news

Flight Shift
This article does not represent the views or opinions of the USAF, DoD, or the US Government. They are wholly the opinion of the author. Dr. Novak is a former F-15C pilot and current emergency physician in Ohio. Have questions about how combat aviation training could be used in the ED? Email editor@epmonthly.com. The post Flight Shift appeared first on Emergency Physicians Monthly. (Source: EPMonthly.com)
Source: EPMonthly.com - September 27, 2016 Category: Emergency Medicine Authors: Matt McGahen Tags: Uncategorized Source Type: news

Propofol and Fentanyl Dosing During Colonoscopy in the ElderlyPropofol and Fentanyl Dosing During Colonoscopy in the Elderly
This study examines the pharmacodynamic interaction between fentanyl and propofol when used in combination for colonoscopy in elderly patients. What is the optimal dosing regimen? BMC Anesthesiology (Source: Medscape Today Headlines)
Source: Medscape Today Headlines - July 15, 2016 Category: Consumer Health News Tags: Anesthesiology Journal Article Source Type: news

Propofol (Propofol Injectable Emulsion) - new on RxList
(Source: RxList - New and Updated Drug Monographs)
Source: RxList - New and Updated Drug Monographs - July 13, 2016 Category: Drugs & Pharmacology Source Type: news

AstraZeneca enters commercialisation agreement with Aspen for anaesthetic medicines portfolio
AstraZeneca today announced it has entered into a commercialisation agreement with Aspen Global Incorporated (AGI), part of the Aspen Group, for rights to its global anaesthetics portfolio outside the US. The agreement covers seven established medicines - Diprivan (general anaesthesia), EMLA (topical anaesthetic) and five local anaesthetics (Xylocaine/Xylocard/Xyloproct, Marcaine, Naropin, Carbocaine and Citanest). (Source: World Pharma News)
Source: World Pharma News - June 9, 2016 Category: Pharmaceuticals Tags: Featured AstraZeneca Business and Industry Source Type: news

Reduced brain connectivity in frontal cortex linked to propofol-induced loss of consciousness
(Mary Ann Liebert, Inc./Genetic Engineering News) A new study shows that loss of responsiveness induced by propofol, a commonly used anesthetic, is associated with greatly diminished brain connectivity in the frontal cortex and significant changes in resting state brain networks. The study, based on a novel method for constructing total brain connectivity maps and comparing them with results obtained for resting state networks, is published in Brain Connectivity. (Source: EurekAlert! - Social and Behavioral Science)
Source: EurekAlert! - Social and Behavioral Science - April 14, 2016 Category: Global & Universal Source Type: news

Cocaine-associated cardiotoxicity: a systematic review yields no answers
Christopher Siesarchik/shutterstock.com 3 out of 5 stars Treatment of cocaine cardiovascular toxicity: a systematic review. Richards JR et al. Clin Toxicol 2016 Feb 26 [Epub ahead of print] Abstract This paper is the most frustrating thing I’ve read since I force marched my way through the “Oxen of the Sun” chapter of James Joyce’s Ulysses. I must say that, despite its difficulties, the Joyce selection — with its obstetric setting and drunken medical students — was much more fun. There is considerable controversy among toxicologists, emergency physicians, and cardiologists as t...
Source: The Poison Review - April 6, 2016 Category: Toxicology Authors: Leon Gussow Tags: Medical cardiotoxicity cocaine systematic review Source Type: news

Patient experience of sexual hallucinations after propofol-induced painless abortion may lead to violence against medical personnel - Yang Z, Yi B.
Painless abortion is an outpatient surgical procedure performed under general anesthesia, which requires an appropriate anesthetic reagent that must be safe, comfortable for the patient, and highly controllable. At present, fentanyl and propofol are first-... (Source: SafetyLit)
Source: SafetyLit - April 2, 2016 Category: Global & Universal Tags: Alcohol and Other Drugs Source Type: news

Severe bupropion overdose and ECMO: two great saves
ChaNaWiT/shutterstock.com 3.5 out of 5 stars Two Cases of Refractory Cardiogenic Shock Secondary to Bupropion Successfully Treated with Veno-Arterial Extracorporeal Membrance Oxygenation. Heise CW et al. J Med Toxicol 2016 Feb 8 [Epub Ahead of Print] Abstract This awesome, exciting paper from Banner University Medical Center in Phoenix describes two teenagers with severe bupropion overdose who survived refractory cardiac arrest after veno-arterial extracorporeal membrane oxygenation (VA-ECMO): Case 1: A 15-year-old girl was brought to hospital after ingesting up to 90 150-mg bupropion tablets. She had a seiz...
Source: The Poison Review - February 12, 2016 Category: Toxicology Authors: Leon Tags: Medical burpropion ECMO extracorporeal membrane oxygenation Source Type: news

Sevoflurane Versus Propofol During Cardiac SurgerySevoflurane Versus Propofol During Cardiac Surgery
Does sevoflurane or propofol exhibit more favorable cardioprotective effects during cardiac surgery? BMC Anesthesiology (Source: Medscape Pathology Headlines)
Source: Medscape Pathology Headlines - January 20, 2016 Category: Pathology Tags: Anesthesiology Journal Article Source Type: news

Letters to the Editor: Propranolol and Propofol
No abstract available (Source: Emergency Medicine News)
Source: Emergency Medicine News - January 1, 2016 Category: Emergency Medicine Tags: Letters to the Editor Source Type: news

Propofol as a controlled substance: poison or remedy - Jeon YT.
[Abstract unavailable] Language: en... (Source: SafetyLit: All (Unduplicated))
Source: SafetyLit: All (Unduplicated) - December 11, 2015 Category: Global & Universal Tags: Alcohol and Other Drugs Source Type: news

InFocus: No Proven Efficacy for Ketofol over Propofol Alone
No abstract available (Source: Emergency Medicine News)
Source: Emergency Medicine News - October 31, 2015 Category: Emergency Medicine Tags: InFocus Source Type: news

Required Propofol Dose for Anesthesia and Time to Emerge Are Affected by the Use of AntiepilepticsRequired Propofol Dose for Anesthesia and Time to Emerge Are Affected by the Use of Antiepileptics
How do neurological disorders and their medications affect propofol dosing? BMC Anesthesiology (Source: Medscape Today Headlines)
Source: Medscape Today Headlines - June 15, 2015 Category: Consumer Health News Tags: Anesthesiology Journal Article Source Type: news

Computer-Assisted Propofol Hailed by GastroenterologistsComputer-Assisted Propofol Hailed by Gastroenterologists
The sedation system, used instead of an anesthesiologist to deliver propofol during routine endoscopy, led to shorter recovery times and overall physician satisfaction, according to a clinical report. Medscape Medical News (Source: Medscape Medical News Headlines)
Source: Medscape Medical News Headlines - May 21, 2015 Category: Consumer Health News Tags: Anesthesiology News Source Type: news

Computer-Assisted Sedation a Hit With Endoscopists (CME/CE)
(MedPage Today) -- Faster and more predictable recovery seen with propofol. (Source: MedPage Today Gastroenterology)
Source: MedPage Today Gastroenterology - May 20, 2015 Category: Gastroenterology Source Type: news

Computer-assisted sedation reduces patient recovery time by almost 20 percent
(Digestive Disease Week) Use of computer-assisted propofol sedation for routine upper endoscopy and colonoscopy reduced recovery room time by almost 20 percent, according to a study released today at Digestive Disease Week® 2015. The study, conducted by researchers at Virginia Mason Medical Center, Seattle, Wash., showed the process yielded a better recovery experience than the commonly used combination of midazolam and fentanyl. (Source: EurekAlert! - Cancer)
Source: EurekAlert! - Cancer - May 19, 2015 Category: Cancer & Oncology Source Type: news

Dexmedetomidine Versus Remifentanil After Spinal SurgeryDexmedetomidine Versus Remifentanil After Spinal Surgery
Does remifentanil or dexmedetomidine offer better postoperative pain control when used as an adjuvant in propofol-based anesthesia during spinal surgery? BMC Anesthesiology (Source: Medscape Today Headlines)
Source: Medscape Today Headlines - May 5, 2015 Category: Consumer Health News Tags: Anesthesiology Journal Article Source Type: news

Claris confirms patent challenge for generic Propofol in US
The company has filed a an ANDA for Propofol injection in strength of 10 mg/ml with the US Food and Drug Administration (FDA). (Source: The Economic Times)
Source: The Economic Times - December 23, 2014 Category: Consumer Health News Source Type: news

Highmark drops anesthesia ban
Health insurer Highmark Inc. has backed away from restricting the use of certain drugs used in colorectal cancer screening, opting instead to follow Medicare's lead on the issue. At issue is the use of propofol as a sedative in otherwise health patients undergoing colonoscopies and other medical procedures. Propofol, best known for the overdose death of Michael Jackson, requires that an anesthesiologist monitor administration of the drug, which is not needed when other sedatives are used before… (Source: bizjournals.com Health Care:Physician Practices headlines)
Source: bizjournals.com Health Care:Physician Practices headlines - December 22, 2014 Category: American Health Authors: Kris B. Mamula Source Type: news

Crayola toxicology: life-threatening causes of bluish vomiting
This article does serve to remind us of 3 important not-to-miss ingestions on the differential when a patient shows up barfing blue. Unfortunately, the authors misses an obvious mnemonic: Cerulean Blue Puke = Copper sulfate, Boric acid, Paraquat. Related posts: Green urine Propofol causes green urine An elderly woman with purple urine (Source: The Poison Review)
Source: The Poison Review - November 14, 2014 Category: Toxicology Authors: Leon Tags: Medical blue vomit boric acid copper sulfate crayola toxicology emesis paraquat Source Type: news

SEDASYS Computer-Assisted Propofol Sedation System Rolling Out in U.S.
SEDASYS, a division of Ethicon, itself part of J&J, is releasing the SEDASYS Computer-Assisted Personalized Sedation (CAPS) System in the U.S. market. The device is intended for delivery of propofol (1% (10 mg/mL) injectable emulsion) by non-anesthesiologist clinicians when performing colonoscopy and esophagogastroduodenoscopy procedures. The technology allows administration of minimal to moderate amounts of propofol during upper and lower GI endoscopies and for monitoring of patient sedation. According to the company, only adult ASA class I and II patients are eligible to receive propofol via SEDASYS. The SEDASYS...
Source: Medgadget Anesthesiology - October 14, 2014 Category: Anesthesiology Authors: Editors Tags: Anesthesiology GI Source Type: news

ISPE Set To Address Drug Shortages At Annual Meeting
Drug shortages continue to plague the pharmaceutical industry. According to a GAO report on shortages, dated February 2014, the number of shortages continues to increase in the U.S., as well as around the world. In 2007 there were 154 shortages, 114 new shortages and 40 ongoing from a prior year. In 2012, there were 456 shortages, 195 news ones and 261 ongoing. As of June 30, 2013, there were already 73 new shortages and 288 ongoing. The public health importance of these shortages cannot be overemphasized. Shortage situations have included zinc for parenteral nutrition in neonates and premature infants, doxorubicin for ova...
Source: Pharmaceutical Online News - October 6, 2014 Category: Pharmaceuticals Source Type: news

Stimulation of brain region restores consciousness to animals under general anesthesia
Stimulating the ventral tegmental area, one of two dopamine-producing regions in the brain, was able to arouse animals receiving general anesthesia with either isoflurane or propofol. The same effect did not result from stimulation of the substantia nigra. (Source: ScienceDaily Headlines)
Source: ScienceDaily Headlines - July 28, 2014 Category: Science Source Type: news

Stimulation of brain region restores consciousness to animals under general anesthesia
(Massachusetts General Hospital) Stimulating the ventral tegmental area, one of two dopamine-producing regions in the brain, was able to arouse animals receiving general anesthesia with either isoflurane or propofol. The same effect did not result from stimulation of the substantia nigra. (Source: EurekAlert! - Medicine and Health)
Source: EurekAlert! - Medicine and Health - July 28, 2014 Category: Global & Universal Source Type: news

Family's fury over death of teenage girl who was given the sedative which killed Michael Jackson
Amie Miller, 15, from Essex, was given Propofol - a powerful sedative blamed for the death of pop star Michael Jackson - despite it not being recommended for people under 18. (Source: the Mail online | Health)
Source: the Mail online | Health - July 25, 2014 Category: Consumer Health News Source Type: news

Good quick review of bupropion toxicity, but . . . whole bowel irrigation? Seriously??
2.5 out of 5 stars Bupropion Abuse and Overdose. Stall N et al. CMAJ 2014 Apr 28 [Epub ahead of print] No abstract available online This one-page précis is part of CMAJ‘s “Five Things To Know About _______” series. The key points include: Bupropion blocks reuptake of dopamine and norepinephrine, and also blocks the action of acetylcholine at nicotinic receptors. Burpropion is abused recreationally for its mild cocaine-like “high.” Routes of bupropion abuse include snorting, ingestion, and intravenous injection. Brupropion lowers the threshold for seizures, which may be d...
Source: The Poison Review - May 9, 2014 Category: Toxicology Authors: Leon Tags: Medical abuse bupropion overdose seizures Source Type: news

VIDEO: Acupuncture beats propofol for endoscopy analgesia
Read the full story on MD Consult: VIDEO: Acupuncture beats propofol for endoscopy analgesia (Source: MD Consult: News: Top Stories)
Source: MD Consult: News: Top Stories - May 9, 2014 Category: Journals (General) Source Type: news

FDA Announces Recall of Propofol Injectable Emulsion by Hospira:...
On April 18, the FDA announced the nationwide recall of seven lots of Propofol Injectable Emulsion, 1%, 200 mg/20 mL (10 mg/mL) by Hospira due to a glass defect. In light of this news, AttorneyOne, a...(PRWeb April 22, 2014)Read the full story at http://www.prweb.com/releases/2014/04/prweb11782093.htm (Source: PRWeb: Medical Pharmaceuticals)
Source: PRWeb: Medical Pharmaceuticals - April 22, 2014 Category: Pharmaceuticals Source Type: news

Propofol Injectable Emulsion, USP by Hospira: Recall - Visible Particulates
Injected particulate matter may result in local inflammation, phlebitis, and/or low level allergic response through mechanical disruption of tissue or immune response to the particulate. (Source: FDA MedWatch)
Source: FDA MedWatch - April 18, 2014 Category: American Health Source Type: news

Anesthetic technique improves quality of recovery for women having breast cancer surgery
Anesthesiologists using a technique similar to a dental freeze can improve the quality of recovery and decrease recovery time for breast cancer surgery patients, according to a new study. The paravertebral block technique uses ultrasound to precisely guide a needle to intercostal nerves reaching the breast and deliver local anesthetic to freeze these nerves. In total, five blocks are needed to freeze the five nerves involved. The freeze blocks the transmission of pain from the breast where surgeons can perform full or partial mastectomies, or even reconstructive breast surgery. At the same time, patients are given an intra...
Source: ScienceDaily Headlines - March 11, 2014 Category: Science Source Type: news

Drugs and the death penalty - Dresser R.
In October 2013, Missouri officials abandoned a plan to execute a convicted murderer using a novel method-an injection of propofol. The name of this drug became a household word after propofol played a role in singer Michael Jackson's death, but this has b... (Source: SafetyLit: All (Unduplicated))
Source: SafetyLit: All (Unduplicated) - January 23, 2014 Category: Global & Universal Tags: Alcohol and Other Drugs Source Type: news

Global Propofol Market and China Nucleotide Industry Trend Analysis...
“2014 Deep Research Report on Global and China Propofol Industry” and “2014 Deep Research Report on Global And China Nucleotide Industry” are the new research reports added to the online library of...(PRWeb January 21, 2014)Read the full story at http://www.prweb.com/releases/Global-Nucleotide-Market/China-Propofol-Industry/prweb11506809.htm (Source: PRWeb: Medical Pharmaceuticals)
Source: PRWeb: Medical Pharmaceuticals - January 21, 2014 Category: Pharmaceuticals Source Type: news

Case Conference: agitated delirium from snorting “bath salts”
This article is part of the New England Journal of Medicine‘s “Case Records of the Massachusetts General Hospital” series. There is a very good discussion of the initial approach and differential diagnosis for a patient who presents with “agitation, delirium abnormal vital signs, and reports he had taken a toxic substance.” However, I find some of the management decisions puzzling. The patient was initially treated with fomepizole and sodium thiosulfate. Although toxic alcohols and cyanide are certainly in the differential for metabolic acidosis, that seems to me a case of treating the lab val...
Source: The Poison Review - December 27, 2013 Category: Toxicology Authors: Leon Tags: Medical agitated delirium bath salts case records of the massachusetts general hospital methcathinone Source Type: news