ArticleMMWR. Morbidity and mortality weekly report2013
Thrombotic thrombocytopenic purpura (TTP)-like illness associated with intravenous Opana ER abuse--Tennessee, 2012.
Article in MMWR. Morbidity and mortality weekly report, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Health harms of non-medical prescription opioid use: A systematic review.Drug and alcohol review · 2022Pooled it
- Systematic review of nephrotoxicity of drugs of abuse, 2005-2016.BMC nephrology · 2017Pooled it
- Functional properties of thermally tampered poly(ethylene oxide).BioImpacts : BI · 2022Article
- Trends in the medical supply of fentanyl and fentanyl analogues: United States, 2006 to 2017.Preventive medicine · 2019Article
- Mitigation of IV Abuse Through the Use of Abuse-Deterrent Opioid Formulations: An Overview of Current Technologies.Pain practice : the official journal of World Institute of Pain · 2019Review
- Sepsis and septic shock: endothelial molecular pathogenesis associated with vascular microthrombotic disease.Thrombosis journal · 2019Review
- Thrombotic microangiopathy associated with intravenous injection of extended-release oxycodone.BMJ case reports · 2017Article
- Opana-induced thrombotic microangiopathy masquerading as thrombotic thrombocytopenic purpura.Oxford medical case reports · 2017Article
- A mechanistic investigation of thrombotic microangiopathy associated with IV abuse of Opana ER.Blood · 2017Article
- Thrombotic Microangiopathy Secondary to Intravenous Abuse of Opana® ER.Case reports in hematology · 2017Article
- Opiate Injection-associated Infective Endocarditis in the Southeastern United States.The American journal of the medical sciences · 2016Article
- Relapsing thrombotic microangiopathy and intravenous sustained-release oxycodone.Clinical kidney journal · 2016Article
- Drug Formulation Advances in Extended-Release Medications for Pain Control.Current pain and headache reports · 2016Review
- Protocol: changes in rates of opioid overdose and poisoning events in an integrated health system following the introduction of a formulation of OxyContin® with abuse-deterrent properties.BMC pharmacology & toxicology · 2016Article
- Drug-induced thrombotic microangiopathy: Experience of the Oklahoma Registry and the BloodCenter of Wisconsin.American journal of hematology · 2015Article
- Opana(®) ER induced thrombotic thrombocytopenic purpura.International medical case reports journal · 2015Article
- Risk factors for HCV infection among young adults in rural New York who inject prescription opioid analgesics.American journal of public health · 2014Article
- Nephrotoxic effects of designer drugs: synthetic is not better!Nature reviews. Nephrology · 2014Review
- Opana ER abuse and thrombotic thrombocytopenic purpura (TTP)-like illness: a rising risk factor in illicit drug users.BMJ case reports · 2014Article
- Photoletter to the editor: Diffuse cocaine-related purpura.Journal of dermatological case reports · 2013Article
Corrections and comments
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Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
On August 13, 2012, a nephrologist reported to the Tennessee Department of Health (TDH) three cases of unexplained thrombotic thrombocytopenic purpura (TTP), a rare but serious blood disorder characterized by microangiopathic hemolytic anemia and thrombocytopenia. The annual incidence is approximately 1 per 100,000 population. Known risk factors for TTP include infection with Shiga toxin-producing Escherichia coli (STEC) and the use of drugs, including platelet aggregation inhibitors, quinine, and cocaine. The three patients were intravenous (IV) drug users who resided in a rural county in northeast Tennessee. To identify other cases of TTP-like illness that might be associated with injection-drug use, TDH conducted a statewide investigation. By the end of October, a total of 15 such cases had been reported; none were fatal. A case-control study was conducted, and investigators determined that the cases of TTP-like illness were associated with dissolving and injecting tablets of Opana ER (Endo Pharmaceuticals), a recently reformulated extended-release form of oxymorphone (an opioid pain reliever) intended for oral administration. Fourteen of the 15 patients reported injecting reformulated Opana ER. Seven of the 15 were treated for sepsis in addition to TTP-like illness. Twelve patients reported chronic hepatitis C or had positive test results for anti-HCV antibody. Health-care providers who prescribe Opana ER and pharmacists who dispense it should inform patients of the risks from the drug when used other than as prescribed. Health-care providers should ask patients with TTP-like illness of unknown etiology about any IV drug abuse. Suspected cases can be reported to public health officials.
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