Lofexidine for acute opioid withdrawal: A clinical case series
| Autor: | Lucas G. Hill, Mandy L Renfro, Lindsey J. Loera, Carlos F Tirado |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
safety
medicine.medical_specialty media_common.quotation_subject Vital signs 03 medical and health sciences 0302 clinical medicine lofexidine Heart rate medicine Pharmacology (medical) 030212 general & internal medicine General Pharmacology Toxicology and Pharmaceutics Adverse effect Original Research media_common business.industry Opioid use disorder Abstinence medicine.disease opioid withdrawal Clinical trial Neuropsychology and Physiological Psychology Blood pressure Emergency medicine Lofexidine Neurology (clinical) business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | The Mental Health Clinician |
| ISSN: | 2168-9709 |
| DOI: | 10.9740/mhc.2020.09.259 |
| Popis: | Introduction Maintaining abstinence through the opioid withdrawal period is a substantial barrier to treatment for patients with opioid use disorder. The alpha-2 agonist lofexidine has demonstrated efficacy and safety in clinical trials, but pragmatic studies describing its use in clinical practice are lacking. This case series describes the use of lofexidine for opioid withdrawal symptoms in an inpatient addiction treatment facility. Methods Seventeen patients receiving at least 1 dose of lofexidine during inpatient treatment for opioid withdrawal were included in this study. A retrospective chart review was conducted for clinical, subjective, and objective data. Adverse events, total daily dose, clinical opioid withdrawal scale (COWS) scores, vital signs, and reasons for early discontinuation of lofexidine are reported. Results Patients treated with lofexidine experienced mild withdrawal symptoms throughout treatment. Most patients (65%) experienced a decrease in their average daily COWS scores from intake to discharge. Two patients (12%) left treatment against medical advice, and 5 patients (29%) discontinued treatment prior to day 7 due to resolution of symptoms. Average daily blood pressure readings remained stable, and daily average heart rate decreased over time. Discussion Lofexidine can be successfully incorporated into a conventional withdrawal management protocol. The cost of lofexidine and its recent introduction to the market remain barriers to accessibility in the United States. Studies evaluating patient-reported outcomes as well as direct comparisons with other alpha-2 agonists are needed to inform optimal clinical use of lofexidine. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|