Buprenorphine - Revision history

Helen at 07:34, 5 October 2020

2020-10-05T07:34:51Z

← Older revision		Revision as of 03:34, 5 October 2020
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	[[Category: Drugs]] [[Category: Non-opioid Analgesic]] [[Category: opioid analgesic ]]		[[Category: Drugs]] [[Category: Non-opioid Analgesic]] [[Category: opioid analgesic ]]
			==Introduction==
	'''Buprenorphine''' is an opioid analgesic. It is used for the relief of moderate to severe pain and as an adjunct to anaesthesia. It is also used in the treatment of opioid dependence.		'''Buprenorphine''' is an opioid analgesic. It is used for the relief of moderate to severe pain and as an adjunct to anaesthesia. It is also used in the treatment of opioid dependence.

Helen at 03:45, 5 October 2020

2020-10-05T03:45:27Z

← Older revision		Revision as of 23:45, 4 October 2020
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	Impaired conciouness, Concomitant use of hepatotoxic medication		Impaired conciouness, Concomitant use of hepatotoxic medication
	Tolerance and dependence		Tolerance and dependence

			== FAQ ==
			=== What should I avoid while taking? ===
			Avoid abrupt withdrawal

Helen: /* Precautions */

2020-10-05T03:44:51Z

Precautions

← Older revision		Revision as of 23:44, 4 October 2020
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	mental status, blood pressure, respiratory drive		mental status, blood pressure, respiratory drive
	===Precautions===		===Precautions===
	absorption of buprenorphine from transdermal patches may be increased as the temperature rises. Patients with fever may require monitoring because of increased absorption. It may take up to 30 hours for plasma concentrations of buprenorphine to decrease by 50% after removal of a patch; patients who have had adverse effects should be monitored during this period. ~~===~~It is recommended~~===~~ that transdermal buprenorphine should be avoided in patients with history of QT interval prolongation and used with caution in those with hypokalaemia or unstable cardiac disease such as atrial fibrillation, congestive heart failure, or myocardial ischaemia.		absorption of buprenorphine from transdermal patches may be increased as the temperature rises. Patients with fever may require monitoring because of increased absorption. It may take up to 30 hours for plasma concentrations of buprenorphine to decrease by 50% after removal of a patch; patients who have had adverse effects should be monitored during this period.
			'''It is recommended''' that transdermal buprenorphine should be avoided in patients with history of QT interval prolongation and used with caution in those with hypokalaemia or unstable cardiac disease such as atrial fibrillation, congestive heart failure, or myocardial ischaemia.

	===Caution===		===Caution===
	Impaired conciouness, Concomitant use of hepatotoxic medication		Impaired conciouness, Concomitant use of hepatotoxic medication
	Tolerance and dependence		Tolerance and dependence

Helen: /* Precautions */

2020-10-05T03:44:31Z

Precautions

← Older revision		Revision as of 23:44, 4 October 2020
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	mental status, blood pressure, respiratory drive		mental status, blood pressure, respiratory drive
	===Precautions===		===Precautions===
	absorption of buprenorphine from transdermal patches may be increased as the temperature rises. Patients with fever may require monitoring because of increased absorption. It may take up to 30 hours for plasma concentrations of buprenorphine to decrease by 50% after removal of a patch; patients who have had adverse effects should be monitored during this period.		absorption of buprenorphine from transdermal patches may be increased as the temperature rises. Patients with fever may require monitoring because of increased absorption. It may take up to 30 hours for plasma concentrations of buprenorphine to decrease by 50% after removal of a patch; patients who have had adverse effects should be monitored during this period. ===It is recommended=== that transdermal buprenorphine should be avoided in patients with history of QT interval prolongation and used with caution in those with hypokalaemia or unstable cardiac disease such as atrial fibrillation, congestive heart failure, or myocardial ischaemia.
	===It is recommended=== that transdermal buprenorphine should be avoided in patients with history of QT interval prolongation and used with caution in those with hypokalaemia or unstable cardiac disease such as atrial fibrillation, congestive heart failure, or myocardial ischaemia.
	===Caution===		===Caution===
	Impaired conciouness, Concomitant use of hepatotoxic medication		Impaired conciouness, Concomitant use of hepatotoxic medication
	Tolerance and dependence		Tolerance and dependence

Helen: /* Drug Management */

2020-10-05T03:44:08Z

Drug Management

← Older revision		Revision as of 23:44, 4 October 2020
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	===Safety===		===Safety===
	mental status, blood pressure, respiratory drive		mental status, blood pressure, respiratory drive
	===~~Precautios~~===		===Precautions===
	absorption of buprenorphine from transdermal patches may be increased as the temperature rises. Patients with fever may require monitoring because of increased absorption. It may take up to 30 hours for plasma concentrations of buprenorphine to decrease by 50% after removal of a patch; patients who have had adverse effects should be monitored during this period.		absorption of buprenorphine from transdermal patches may be increased as the temperature rises. Patients with fever may require monitoring because of increased absorption. It may take up to 30 hours for plasma concentrations of buprenorphine to decrease by 50% after removal of a patch; patients who have had adverse effects should be monitored during this period.
	===It is recommended=== that transdermal buprenorphine should be avoided in patients with history of QT interval prolongation and used with caution in those with hypokalaemia or unstable cardiac disease such as atrial fibrillation, congestive heart failure, or myocardial ischaemia.		===It is recommended=== that transdermal buprenorphine should be avoided in patients with history of QT interval prolongation and used with caution in those with hypokalaemia or unstable cardiac disease such as atrial fibrillation, congestive heart failure, or myocardial ischaemia.

Helen at 03:43, 5 October 2020

2020-10-05T03:43:51Z

← Older revision		Revision as of 23:43, 4 October 2020
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	\|Plasma elimination half-lives have ranged from 1.2 to 7.2 hours after intravenous injection; elimination half-lives after sublingual or transdermal use are longer and may range from 20 to 36 hours or more.		\|Plasma elimination half-lives have ranged from 1.2 to 7.2 hours after intravenous injection; elimination half-lives after sublingual or transdermal use are longer and may range from 20 to 36 hours or more.
	\|}		\|}

			==Drug Management==
			===Efficiency===
			Pain control, opioid withdrawal symptom
			===Safety===
			mental status, blood pressure, respiratory drive
			===Precautios===
			absorption of buprenorphine from transdermal patches may be increased as the temperature rises. Patients with fever may require monitoring because of increased absorption. It may take up to 30 hours for plasma concentrations of buprenorphine to decrease by 50% after removal of a patch; patients who have had adverse effects should be monitored during this period.
			===It is recommended=== that transdermal buprenorphine should be avoided in patients with history of QT interval prolongation and used with caution in those with hypokalaemia or unstable cardiac disease such as atrial fibrillation, congestive heart failure, or myocardial ischaemia.
			===Caution===
			Impaired conciouness, Concomitant use of hepatotoxic medication
			Tolerance and dependence

Helen: /* Pharmacokinetics */

2020-10-05T03:41:29Z

Pharmacokinetics

← Older revision		Revision as of 23:41, 4 October 2020
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	!Bioavailability		!Bioavailability
	\|Oral absorption takes place through the buccal mucosa after sublingual doses		\|Oral absorption takes place through the buccal mucosa after sublingual doses
			\|-
			\|
	\|Transdermal application results in absorption through the skin;		\|Transdermal application results in absorption through the skin;
	\|-		\|-
	!Onset of action		!Onset of action
	\|Oral peak plasma concentrations occur after 90 minutes.		\|Oral peak plasma concentrations occur after 90 minutes.
			\|-
			\|
	\|The minimum effective concentration is reached in 12 to 24 hours and peak plasma concentrations occur after about 60 hours.		\|The minimum effective concentration is reached in 12 to 24 hours and peak plasma concentrations occur after about 60 hours.
	\|-		\|-

Helen at 03:41, 5 October 2020

2020-10-05T03:41:01Z

← Older revision		Revision as of 23:41, 4 October 2020
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	Older children may be given the usual adult dose.		Older children may be given the usual adult dose.

			==Side Effects==
			Local reactions such as rash, erythema and itching have been reported with the transdermal patches.

			Anoreia, anxiety, asthenia, diarrhea, dyspnea, mild opioid withdrawal symptom

			==Pharmacokinetics==

			{\|class="wikitable"
			!Bioavailability
			\|Oral absorption takes place through the buccal mucosa after sublingual doses
			\|Transdermal application results in absorption through the skin;
			\|-
			!Onset of action
			\|Oral peak plasma concentrations occur after 90 minutes.
			\|The minimum effective concentration is reached in 12 to 24 hours and peak plasma concentrations occur after about 60 hours.
			\|-
			!Metabolism
			\|Buprenorphine is subject to considerable first-pass metabolism after oral doses.
			\|-
			!Elimination half-life
			\|Plasma elimination half-lives have ranged from 1.2 to 7.2 hours after intravenous injection; elimination half-lives after sublingual or transdermal use are longer and may range from 20 to 36 hours or more.
			\|}

Helen: /* Dosage */

2020-10-05T03:38:46Z

Dosage

← Older revision		Revision as of 23:38, 4 October 2020
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	Sublingual route is licensed in children aged from 6 to 12 years:		Sublingual route is licensed in children aged from 6 to 12 years:
	#16 to 25 kg: 100 micrograms		*16 to 25 kg: 100 micrograms
	#25 to 37.5 kg: 100 to 200 micrograms		*25 to 37.5 kg: 100 to 200 micrograms
	#37.5 to 50 kg: 200 to 300 micrograms		*37.5 to 50 kg: 200 to 300 micrograms

	Older children may be given the usual adult dose.		Older children may be given the usual adult dose.

Helen at 03:38, 5 October 2020

2020-10-05T03:38:27Z

← Older revision		Revision as of 23:38, 4 October 2020
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	Opioid dependence: nitially 0.8-4mg on first day, usual dose 12-24mg QD, max 32mg		Opioid dependence: nitially 0.8-4mg on first day, usual dose 12-24mg QD, max 32mg

			'''Doses in children

			''Intramuscular or slow intravenous'' : 6 months to 12 years: 3 to 6 micrograms/kg every 6 to 8 hours; up to 9 micrograms/kg if required in refractory cases.

			Sublingual route is licensed in children aged from 6 to 12 years:
			#16 to 25 kg: 100 micrograms
			#25 to 37.5 kg: 100 to 200 micrograms
			#37.5 to 50 kg: 200 to 300 micrograms

			Older children may be given the usual adult dose.