Not available / text

Thesis (M.S.)--Virginia Polytechnic Institute and State University, 1994. / Vita. Abstract. Includes bibliographical references (leaves 93-104). Also available via the Internet.

Thesis (M.S.)--Virginia Polytechnic Institute and State University, 1990. / Vita. Abstract. Includes bibliographies. Also available via the Internet.

The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from PDF of title page (University of Missouri--Columbia, viewed on July 13, 2010). Thesis advisor: Amy DeClue. "May 2010" Includes bibliographical references.

The number of opioid-related overdose deaths in the United States has quadrupled since 1999. For this reason, in October 2017 President Donald Trump declared the opioid epidemic a public health emergency. Massachusetts is particularly affected by the opioid epidemic as evident in an opioid-related death rate that is double the national rate. Naloxone is a prescription medication that works antagonistically to bind opioid receptors and rapidly reverses and blocks the effects of opioids. This drug is widely used to revive patients who are experiencing an opioid overdose. Prior research on the topic of attitudes toward naloxone prescriptions and dispensing has focused primarily on three groups of people: patients, prescribers, and pharmacists. However, in recent years there has been an expansion of the role of the pharmacy technician in healthcare administration, such as in the administration of vaccines. Thus, there is a lack of research centered on the role of pharmacy technicians in the dispensing of naloxone. The aim of this study was to investigate the attitudes and perceptions of pharmacy technicians in the dispensing of naloxone across Massachusetts. This goal was accomplished by purposively sampling CVS pharmacies in 13 municipalities across the state, with 7 municipalities having an opioid-related death rate per 100,000 people greater than the state average and 6 municipalities having an opioid-related death rate per 100,000 people less than the state average. These municipalities were termed High-Risk Municipalities and Low-Risk Municipalities, respectively. Three CVS pharmacies were sampled within each municipality, yielding a total sample size of 39 CVS pharmacies with 21 from High-Risk Municipalities and 18 from Low-Risk Municipalities. Pharmacy technicians working in each pharmacy were administered a survey pertaining to their attitudes and perceptions on naloxone dispensing. The results of this study demonstrated that there was a significant difference between technicians working in High-Risk Municipalities and Low-Risk Municipalities regarding the percentage of patients who they believed could benefit from naloxone. Specifically, 67% of participants in Low-Risk Municipalities indicated that less than 25% of patients could benefit from having a naloxone kit available whereas 67% of participants in High-Risk Municipalities indicated that greater than 50% of patients could benefit (Mann-Whitney U significance level = 0.001). This result is critical, especially considering the fact that there was no significant difference between both groups of technicians on their perceptions of patients who used illicit opioids or prescription opioids. In addition, unsolicited feedback from participants revealed several common themes among technicians working in both groups, including the belief that patients could benefit from a reduced cost of naloxone and that both technicians and patients may be unaware that naloxone can benefit individuals taking prescription opioids rather than just people who inject drugs. Future studies could investigate whether participant characteristics, such as years of experience working in the pharmacy may have influenced the results. Also, future research could be directed toward determining if there might be a relationship between syringe sales and naloxone sales in High-Risk Municipalities.

Class of 2015 Abstract / Objectives: Evaluate prescriber knowledge on naloxone use for opioid overdose reversals in intravenous drug users. Interview prescribers on their perceptions about intravenous drug users, syringe access programs, and other related topics. Subjects: Prescribers and medical professionals in the State of Arizona. Methods: Medical facilities were contacted by email, fax, or telephone requesting for prescribers to complete the survey and return by email or fax, or call to schedule a face-to-face appointment. The respondents of the survey were kept anonymous and were permitted to answer the survey in free text. Surveys were sent to the 68 selected medical facilities at least twice during the study period. Results: All of the six respondents were male, of the respondents had at least 11 years experience, with two having >30 years. A majority practiced in rehab centers or worked with drug abuse patients, however the number of patients treated per week by respondent varies from 10-320. Also of note five of the six respondents had a family member or relative with an addiction to opioids. The respondents seem to be in support of a naloxone distribution program however it is difficult to draw any conclusions since the number of responses was low. Conclusions: It appears that prescribers have a favorable perception of naloxone use and support harm reduction strategies, however response rate was too low to make any definitive conclusions.

Summary: The possible involvement of an adrenergic-endorphin system in the mediation of the pressor response to isometric muscular contraction was studied in cats. Fatiguing contractions of the gastrocnemius and plantaris muscles caused an increase in the mean arterial blood pressure by 35 to 70 mmHg. Intravenous infusion (30 μg·kg-1) as well as intracisternal injection (2.5 μg) of clonidine-HCl eliminated the pressor response to muscular contraction. In both sets of experiments, the mean blood pressure remained at the resting level throughout the duration of the isometric contraction. Injection of naloxone (0.5 μmol·litre-1) into the cisterna magna did not alter the resting blood pressure and did not affect the rise in mean arterial pressure during muscle contractions. Intracisternal injection of naloxone (0.5 μmol·litre-1) prior to an intracisternal injection of clonidine (2.5 μg) did not alter the resting blood pressure but effectively antagonised the anti-pressor effects of clonidine during fatiguing isometric contractions. These data may indicate that activation of muscle "ergoreceptor" afferents (group III and IV fibres) during muscular contraction may cause an increase in the arterial blood pressure by interfering with an inhibitory adrenergic-endorphinergic pathway in the brainstem.

No description available.

Naloxone (NX) potentiated epinephrine (EPI) induced submaximal vasoconstriction in canine renal and skeletal muscle arterial segments, yet had no vasoconstrictor action alone. Developed tension generated in-vitro by 4 x 1mm. O.D. rings from 1st degree branches of canine femoral arteries was expressed as % of KCI induced maximum response. NX (10^-5 M) potentiated EPI induced submaximal contractions (34.2%) significantly more than contractions induced by norepinephrine, phenylephrine, lofexidine, ADH, KCI and serotonin (13.8,13.4,4.7,13.5,14.4 and 11.4% respectively). The NX response was unaffected by beta-adrenergic blockade and NX did not reverse an isoproterenol mediated vasodilation. Alphaadrenergic blockade with phentolamine completely eliminated EPI plus NX induced vasoconstriction. After washout, vessels exposed to EPI plus NX relaxed by 50% significantly faster than vessels exposed to EPI alone (18.5 and 27.9 min respectively). EPI induced vasoconstrictions were potentiated by 10^-5 M corticosterone (49.0%) which inhibits extraneuronal catecholamine uptake, but not by 10^-7 M desipramine (1.1%) which inhibits neuronal uptake. EPI induced vasoconstrictions were also potentiated by 10^-4 M pyrogallol (33.0%) which inhibits catechol-o-methyl transferase activity, but not by 10^-5 M pargyline (-1.1%) which inhibits monoamine oxidase activity. The NX effect was endothelium independent. The dose-response of various opioid receptor agonists and antagonists were compared to the NX response. A specific opioid receptor subclass could not be identified as the mediator of the NX effect. The ED_50s for NX (3.7x^-6 M) and (+)NX (8.1x^-7M) indicated a significant stereoselectivity for the (+)enantiomer. A variety of sigma receptor ligands, steroids and steroid metabolites were tested for the ability to augment EPI vasoconstrictions. Several of the opioid, sigma and steroid ligands, all with polycyclic structures, induced responses similarto those of NX. NX exerted its effect independent of traditional opiate receptors and may have influenced the cellular uptake or degradation of EPI. Endogenous compounds with sigma or steroid activity may modulate these processes in-vivo.

Opioid abuse and addiction affects more than 2.4 million people in the United States. Medication assisted treatment (MAT), in combination with counseling, is recognized as the most effective treatment for patients with opioid dependence and abuse. Although MAT is considered the most effective treatment, previous research has found clinically significant weight gain with methadone. The purpose of this study was to determine if hedonic eating behaviors, sugar cravings, and addictive like eating was related to weight gain in opioid addicted patients receiving methadone and buprenorphine/naloxone (Suboxone™). Hedonic eating behaviors were measured using three validated surveys. Following survey collection, a chart review was completed to determine weight changes over time. One hundred twenty surveys were completed and 113 were analyzed. No differences were found between the medication groups in terms of mean age, weight at entry, BMI at entry, race, sex, and Hepatitis C status. A subset of 39 participants was analyzed for weight changes during treatment. There were no differences in food addiction scores, hedonic eating behaviors, and food cravings between the medication groups. We found significant weight gain in patients receiving methadone and no weight changes for those receiving Suboxone™. Weight gain in methadone maintenance does not appear to be related to addictive like eating, food craving, or hedonic eating. This research suggests that weight gain seen in methadone maintenance for opioid addiction treatment is related to something other than hedonic eating behaviors. Clinically significant weight gain should be considered when prescribing methadone for opioid addiction.