China
Africa
Explore chapters and articles related to this topic
The administration of medicines to children
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
Several drugs are administered intranasally for local effect, such as corticosteroids for allergic rhinitis, but absorption across the mucous membrane may be useful for systemic effect for drugs such as desmopressin for diabetes insipidus or nocturnal enuresis and sumatriptan for migraine. Bioavailability may be low and local irritation may limit usefulness. Midazolam hydrochloride injection has been administered intranasally for sedation and to control convulsions, but may be painful, although onset of action is rapid [64]. Diamorphine may be useful for rapid analgesia [65].
Street drugs
Published in Anne Lee, Sally Inch, David Finnigan, Therapeutics in Pregnancy and Lactation, 2019
All opioids pass into breast milk in measurable quantities but for individual opioids the published data are limited. There are no recent data on diamorphine (heroin) although many reviews cite references from 1915–1940 as evidence of diamorphine passage into human breast milk; these papers are of no scientific value.84,85 Collectively they contend that diamorphine use by the mother can ameliorate symptoms of neonatal opioid withdrawal, or can cause symptoms of intoxication in the neonate. They cannot be relied upon.
Future Directions and Partnerships: The Way Forward for Nursing
Published in Rosie Winyard, Andrew McBride, Substance Misuse in Primary Care, 2018
Nurses are currently practising in a time of change, controversy and professional staff shortages. Within the coming decade, considerable changes in prescribing policy in the UK will occur as statutory and voluntary agencies, government departments and professional bodies work through many issues linked to nurse prescribing and the issue of patient group directions — see for example www.npc.co.uk/pdf/pgd.pdf. Currently diamorphine can be prescribed by specialist trained nurses in Accident and Emergency Departments and Coronary Care Units for the treatment of cardiac pain under a patient group direction, but as yet no substitute opiates can be prescribed for addiction treatments. The debate around substitute prescribing for opiates is one key aspect as many drug related deaths involve methadone. The fear of litigation around this issue has made many GPs reluctant to participate in prescribing for substance misuse patients. It is unlikely that nurses will willingly go down this path without generous pay enhancements that will enable them to purchase expanded professional indemnity.
An update on current and emerging drug treatments for idiopathic pulmonary fibrosis
Published in Expert Opinion on Pharmacotherapy, 2023
Athina Trachalaki, Nadiya Sultana, Athol Umfrey Wells
The cornerstone of the pharmacological management of breathlessness is opioids, based on clinical experience and data from palliative care studies in a number of diseases. There are few trials, with small patient numbers, investigating the use of opioids in ILDs and IPF. One RCT showed that diamorphine reduces breathlessness in end-stage IPF [68], but nebulized morphine did not clearly show any benefit in exercise induced breathlessness [69]. Despite this, guidelines do recommend oral morphine for the management of breathlessness in IPF, mainly backed by significant evidence in other chronic lung diseases.