puneetcheema1+log

Log Title of Article: "The effect of FDA approval of a generic competitor to OxyContin® (oxycodone HCl controlled-release) tablets on the abuse of oxycodone." Article: [|doi]

Introduction:
• Of 31.2 million lifetime nonmedical users of prescription painkillers, 2.8 million are users of OxyContin. • Absorption of oxycodone is done through inhalation, injection, or indigestion of crushed tablets. This instigates rapid absorption. • On March 24, 2004, the FDA approved of two generic CR oxycodone products. Some groups did not agree with this decision. They believed it would increase abuse with the decreased of price in the generic products. • In comparison, the opioid, tramadol did not have an increase in abuse when generic products were introduced in the market. • It is hypothesized that a cheaper and generic oxycodone product will not lead to an increase in oxycodone abuse. hypothesized that the introduction

Methods:
Source of Data • The 47 standard Toxic Exposure Surveillance System fields offer patient history, first aid measurements, patient and treatment that are recommended for each specific case. • Comparing the classification of misuse, poison control center are measured as exposures and withdrawal that shows good agreement with the clinician evaluation of the cases. Case selection • Cases were assigned intentional exposure reason codes in order to be used as surrogates for abuses of opioids. • Intentional exposure for all oxycodone products are involved in the analysis including OxyContin as well as generic oxycodone products. Statistical Analysis • Intentional exposure rates were measured per 100000 population for the 12 states that included the eight poison control centers using the 2003 for estimations. This is done through four quarters of the year. Measured in the before and after periods. • If the before period and the after period regression slopes are equal this means this can determine whether a significant change in the intentional exposure rates for the generic product were approved by the FDA. • The oxycodone of a before-after regression slops were compared to others with Poisson regressions. • A Poisson regression model can be used to compare changes in comparison opioids intentional exposure rates across a two year span. IE rates calculated from prescription data • IE rates per 10,000 patients were calculated quarterly. • An analysis of the intentional exposures were measured per 10,000 patients. Include a Poisson regression model that compare a change in the opioids' rates during the 2 year span in accordance to the changes that occur in the intentional exposure rates of oxycodone.

Results:
• The mean intentional exposures per 100,000 were substantially different. • None of the regions shows an increase in intentional exposures rates per 100,000 population from the quarter that is prior to the FDA approval as well as the quarter that follows the approval. Results from opioid-specific analysis of IE rates per 100,000 population • The opioid-specific intentional exposure rates per 100,000 for 1 year prior and 1 year after the FDA approval was finalized. • The change in intentional exposure rates after FDA approval was substantial for hydrocodone but not for oxycodone and other opioids. • Oxycodone showed a decrease in intentional exposure rates per 100,000 while other opioids did not show significant change. • The changes in intentional exposure rates were compared between oxycodone and other opioids, no time-opioid interaction was established. Results from opioid-specific analysis of IE rates per 10,000 patients • The results of the rates calculated per 10,000 patients were similar to the results of the rate calculated per 100,000 population.

Discussions:
• The changes in the opioids' comparison of intentional exposure rates that are not different from oxycodone's changes over a 2 year span that showed no time-opioid interaction. • The limitations of using population in the denominator does not measure variances for the levels of medicine that is related to the types of studied prescription opioids. • Abuse of legal and illegal drugs and its relationship with prices. It is expected to increase the abuse of oxycodone with the generic product in the market. • 12,636 intentional exposures were listed for oxycodone in the United States. But the other eight opioids in the study account for 20.2%, 2550 intentional exposures. • The availability of an opioid obtained by prescription could make a difference across an analysis on prescription trends. • Inclusion of suicidal cases may be an issue in opioid abuse cases. • Of 57 intentional exposures that were analyzed, none of the patient gender, age, caller zip code, and caller phone number were duplicate for the oxycodone intentional exposure cases. • Eight poison control centers were analyzed in this study. These poison control centers provide help for 68 million citizens at least. They range from the rural, urban, and suburban environments. • The poison control centers were chosen because of high rates of opioid abuses in an area that is prominent in them. • Only four of the intentional exposure cases were identified to have involved the generic oxycodone product that was approved by the FDA. • Poison control centers are collected through a passive data collection system. • Short follow up after the study is done. • It does not affect the variables that can involve before studies and after studies. • The length of the analysis can be extended to measure the long-term patterns in abuse of the opioids following the generic oxycodone FDA approval.

Final Paper Title: PHARMACOLOGY OF OXYCODONE COMPARED TO OTHER DRUGS Final Paper Outline. 1) Abstract 2) Background 3) Compounds used in the paper 4) Introduction 5) Human impact of OxyContin (a) Mechanism of OxyContin inside the body 6) Human impact of OxyContin compared to clonazepam (a) Mechanism of action of OxyContin compared to the mechanism of action of clonazepam 6) Human impact of oxycodone (a) Mechanism of action of CR oxycodone doses (b) Controlled-released oxycodone used for specifically cancer pain treatment 7)Human impact of oxycodone compared to bupivacaine and morphine (a) Controlled-release oxycodone used for pain treatment in comparison to morphine (b) Comparison of oxyocdone and buipacaine in infiltration during shoulder surgery 7) Rodents impact from oxycodone digestion (a)Antinociceptive effect of oxycodone in diabetic mice and rats 8) Conclusion