Related Experiment Video
Updated: Sep 6, 2025
07:29
Intravascular Delivery of Biologics to the Rat Kidney
Published on: September 1, 2016
7.7K
Development of an intravenous low-dose buprenorphine initiation protocol
Lindsay A Jablonski1, Alia R Bodnar2, Rosalyn W Stewart2
1Johns Hopkins Hospital, Department of Pharmacy, USA.
Drug and Alcohol Dependence
|June 26, 2022
Summary
Low-dose initiation (LDI) with intravenous buprenorphine effectively treats opioid use disorder (OUD) in hospitalized patients. This strategy shows high tolerability and completion rates, offering a viable alternative to standard buprenorphine initiation.
Area of Science:
- Addiction Medicine
- Pharmacology
- Clinical Research
Background:
- Buprenorphine is a critical medication for treating opioid use disorder (OUD).
- Low-dose initiation (LDI) offers a strategy to overcome traditional barriers to buprenorphine treatment.
- Intravenous (IV) buprenorphine LDI is an emerging approach in inpatient settings.
Purpose of the Study:
- To evaluate the tolerability and completion rates of IV buprenorphine LDI.
- To define and assess various dosing protocols for IV buprenorphine LDI.
- To explore indications for IV buprenorphine LDI in hospitalized patients.
Main Methods:
- Retrospective chart review of 59 patients undergoing IV buprenorphine LDI between September 2020 and February 2021.
- Exclusion criteria included lack of OUD diagnosis, missing COWS scores, or prior sublingual buprenorphine within 24 hours.
- Assessment of LDI completion, adherence to dosing strategies, and Clinical Opiate Withdrawal Scale (COWS) data.
Main Results:
- 72.9% of patients tolerated IV buprenorphine LDI, and 91.5% completed treatment initiation.
- 75% of cases were adherent to established dosing strategies.
- Median LDI durations varied by strategy: 23.7 hours (rapid), 37.1 hours (moderate), and 48.8 hours (slow).
Conclusions:
- Intravenous buprenorphine LDI is a well-tolerated and effective method for initiating treatment in hospitalized patients.
- Established dosing protocols facilitate a swift transition to sublingual buprenorphine.
- Factors such as acute pain, recent methadone, or fentanyl exposure can guide the selection of IV LDI dosing strategies.
Related Concept Videos
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
417
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
417
00:59Nonlinear Pharmacokinetics: Drug Elimination for IV Bolus Injection
144
In pharmacokinetics, the elimination rate of a drug following a capacity-limited model is primarily controlled by two parameters: Vmax and KM. These parameters are crucial in how the drug behaves inside the body after administration.
Following the administration of a single intravenous (IV) bolus injection, we can determine the concentration of the drug in the plasma at any given time. This calculation is achieved using a specific equation that integrates the values of Vmax and KM.
We can also...
Following the administration of a single intravenous (IV) bolus injection, we can determine the concentration of the drug in the plasma at any given time. This calculation is achieved using a specific equation that integrates the values of Vmax and KM.
We can also...
144
01:19One-Compartment Open Model for IV Bolus Administration: General Considerations
315
The one-compartment model is a pharmacokinetic tool that models the body as a single, uniform compartment, facilitating the understanding of drug distribution and elimination. This model is particularly beneficial for intravenous (IV) bolus administration, where the drug rapidly circulates throughout the body.
The drug's presence in the body is defined by an equation representing the difference between the rates of drug entry and exit. Key parameters—elimination rate constant,...
The drug's presence in the body is defined by an equation representing the difference between the rates of drug entry and exit. Key parameters—elimination rate constant,...
315
01:15Drug Dosage Regimen: Overview
3.8K
A drug dosage regimen describes the specific instructions and schedule for administering a drug to a patient. It considers factors such as drug dosage, frequency, route of administration, and duration of treatment. Designing an appropriate dosage regimen for a patient aims to achieve a target drug concentration at the site of action.
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
3.8K
01:24Rational Dosage Regimen: Maintenance Dose and Loading Dose
4.4K
A rational dosage regimen considers a drug's pharmacokinetics, including its absorption, distribution, metabolism, and elimination from the body. By understanding these factors, the appropriate dosage can be determined, and the dosing schedule can be designed to achieve and maintain the desired therapeutic effect while minimizing adverse effects.
In most cases, drugs are administered repetitively or infused continuously to maintain a steady-state concentration in the body. At a steady...
In most cases, drugs are administered repetitively or infused continuously to maintain a steady-state concentration in the body. At a steady...
4.4K
01:18Two-Compartment Open Model: IV Bolus Administration
690
The two-compartment model for intravenous (IV) bolus administration illustrates drug distribution in the body, subdividing it into central and peripheral compartments. This model operates on the concept of two-compartment kinetics. The drug's plasma concentration shows a bi-exponential decline following IV bolus administration, signaling the presence of two disposition processes: distribution and elimination.
The disparity between drug input and the sum of drug transfer rates between...
The disparity between drug input and the sum of drug transfer rates between...
690