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Paul man charged in Lowertown apartment break- in. A St. Paul woman woke up to the sound of someone . She was about to call the police when she heard a can open in her kitchen. George Lowe, 4. 5, of St. Paul was charged with kidnapping, robbery and burglary in Ramsey County on Oct. He had been trying to break the lock on her door, and that of a female neighbor, for hours. And it wasn. Paul was charged Wednesday with kidnapping, first- degree aggravated robbery and two counts of first- degree burglary. When the victim, identified in charging documents as KCL, tried to escape, Lowe grabbed her by the neck, dragged her back inside, took her phone and said he wanted her . The first instance occurred on the top floor, where he . She called after she woke up. Paul police have had several encounters with Lowe this month, including one in which he profanely threatened. He also tackled a woman to the pavement and pinned her to the ground. Lowe told police he has legally changed his name to “Carlos Vagus Gotcha” in an attempt to leave behind his criminal past. He has prior convictions for robbery, armed robbery, theft, auto theft, criminal sexual conduct in the fifth degree and forgery, the charges said. POPSUGAR, the #1 independent media and technology company for women. Where more than 75 million women go for original, inspirational content that feeds. The top 10 percent of American drinkers consume more than 10 drinks per day. As Billy Carter’s odd, beer-swilling star was rising, the venerable Falls City Brewing Company’s fortunes were fading. Louisville-based Falls City had.
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Do not cut, chew, or swallow SUBOXONE sublingual film. Sublingual Administration. Place one film under the tongue, close to the base on the left or right side. If an additional film is necessary to achieve the prescribed dose, place an additional film sublingually on the opposite side from the first film. Place the film in a manner to minimize overlapping as much as possible. The film must be kept under the tongue until the film is completely dissolved. If a third film is necessary to achieve the prescribed dose, place it under the tongue on either side after the first 2 films have dissolved. Buccal Administration. Place one film on the inside of the right or left cheek. If an additional film is necessary to achieve the prescribed dose, place an additional film on the inside of the opposite cheek. The film must be kept on the inside of the cheek until the film is completely dissolved. If a third film is necessary to achieve the prescribed dose, place it on the inside of the right or left cheek after the first two films have dissolved. SUBOXONE sublingual film should NOT be moved after placement. Proper administration technique should be demonstrated to the patient. Clinical Supervision. Treatment should be initiated with supervised administration, progressing to unsupervised administration as the patient's clinical stability permits. Medication should be prescribed in consideration of the frequency of visits. A once- monthly visit schedule may be reasonable for patients on a stable dosage of medication who are making progress toward their treatment objectives. Continuation or modification of pharmacotherapy should be based on the physician's evaluation of treatment outcomes and objectives such as: Absence of medication toxicity. Absence of medical or behavioral adverse effects. Responsible handling of medications by the patient. Patient's compliance with all elements of the treatment plan (including recovery- oriented activities, psychotherapy, and/or other psychosocial modalities). Abstinence from illicit drug use (including problematic alcohol and/or benzodiazepine use). If treatment goals are not being achieved, the physician should re- evaluate the appropriateness of continuing the current treatment. Patients With Hepatic Impairment. Because the doses of this fixed combination product cannot be individually titrated, the combination product should generally be avoided in patients with severe hepatic impairment and may not be appropriate for patients with moderate hepatic impairment . For example, some patients may be abusing or dependent on various drugs, or unresponsive to psychosocial intervention such that the physician does not feel that he/she has the expertise to manage the patient. In such cases, the physician may want to assess whether to refer the patient to a specialist or more intensive behavioral treatment environment. Decisions should be based on a treatment plan established and agreed upon with the patient at the beginning of treatment. Patients who continue to misuse, abuse, or divert buprenorphine products or other opioids should be provided with, or referred to, more intensive and structured treatment. Stopping Treatment. The decision to discontinue therapy with SUBOXONE sublingual film after a period of maintenance should be made as part of a comprehensive treatment plan. Taper patients to avoid opioid withdrawal signs and symptoms. See full prescribing information for SUBOXONE sublingual film. SUBOXONE (buprenorphine and naloxone) sublingual film for sublingual administration CIII. Approval: 2002 SUBOXONE sublingual film. This guideline applies to Tufts Health Together and Tufts Health Direct members who meet specific coverage criteria. Suboxone Sublingual Film, Suboxone Sublingual Tablets, Subutex AMCP Dossier (2010). Reckitt Benckiser Pharmaceuticals. Learning to cut Suboxone strips for use in Rehab and Opiate Withdrawals. Buprenorphine comes as a sublingual tablet. The combination of buprenorphine and naloxone comes as a sublingual tablet (Zubsolv) and as a sublingual film (Suboxone) to take under the tongue and as a buccal film (Bunavail) to apply between the gum and cheek. Switching Between Buprenorphine or Buprenorphine and Naloxone Sublingual Tablets and SUBOXONE Sublingual Film. Patients being switched between buprenorphine and naloxone or buprenorphine only sublingual tablets and SUBOXONE sublingual film should be started on the corresponding dosage of the previously administered product. However, dosage adjustments may be necessary when switching between buprenorphine products. Not all strengths and combinations of the SUBOXONE sublingual films are bioequivalent to the SUBOXONE (buprenorphine and naloxone) sublingual tablets as observed in pharmacokinetic studies . Therefore, systemic exposures of buprenorphine and naloxone may be different when patients are switched from tablets to film or vice- versa. Patients should be monitored for symptoms related to over- dosing or under- dosing. Switching Between SUBOXONE Sublingual Film Strengths. As indicated in Table 1, the sizes and the compositions of the four units of SUBOXONE sublingual films, i. If patients switch between various combinations of lower and higher strength units of SUBOXONE sublingual films to obtain the same total dose, (e. For this reason, pharmacist should not substitute one or more film strengths for another without approval of the prescriber. Table 1. Comparison of Available SUBOXONE Sublingual Film Strengths by Dimensions and Drug Concentrations. SUBOXONE sublingual film unit strength (buprenorphine/naloxone)SUBOXONE sublingual film unit dimensions. Buprenorphine Concentration% (w/w)Naloxone Concentration% (w/w)2 mg/0. X 1. 9. 2 mm. 17. Switching Between Sublingual and Buccal Sites of Administration. The systemic exposure of buprenorphine between buccal and sublingual administration of SUBOXONE sublingual film is similar. Therefore, once induction is complete, patients can switch between buccal and sublingual administration without significant risk of under or overdosing. Dosage Forms and Strengths. SUBOXONE sublingual film is supplied as an orange rectangular film with a white printed logo in four dosage strengths: buprenorphine/naloxone 2 mg/0. Contraindications. SUBOXONE sublingual film should not be administered to patients who have been shown to be hypersensitive to buprenorphine or naloxone as serious adverse reactions, including anaphylactic shock, have been reported . Prescribe and dispense buprenorphine with appropriate precautions to minimize risk of misuse, abuse, or diversion, and ensure appropriate protection from theft, including in the home. Clinical monitoring appropriate to the patient's level of stability is essential. Multiple refills should not be prescribed early in treatment or without appropriate patient follow- up visits . Many, but not all, post- marketing reports regarding coma and death associated with the concomitant use of buprenorphine and benzodiazepines involved misuse by self- injection. Deaths have also been reported in association with concomitant administration of buprenorphine with other depressants such as alcohol or other CNS depressant drugs. Patients should be warned of the potential danger of self- administration of benzodiazepines or other depressants while under treatment with SUBOXONE sublingual film . Naloxone may be of value for the management of buprenorphine overdose. Higher than normal doses and repeated administration may be necessary. SUBOXONE sublingual film should be used with caution in patients with compromised respiratory function (e. CNS Depression. Patients receiving buprenorphine in the presence of opioid analgesics, general anesthetics, benzodiazepines, phenothiazines, other tranquilizers, sedative/hypnotics, or other CNS depressants (including alcohol) may exhibit increased CNS depression. Consider dose reduction of CNS depressants, SUBOXONE sublingual film, or both in situations of concomitant prescription . Store buprenorphine- containing medications safely out of the sight and reach of children. Buprenorphine/naloxone - Wikipedia. Buprenorphine/naloxone (trade name Suboxone) is a combination drugformulation of buprenorphine, a . The Suboxone formulation still has potential to produce an opioid agonist . Published data show that the . In addition, opioids and especially benzodiazepines increase the risk for potentially lethal respiratory depression. Aschenbrenner; Samantha J. Drug Therapy in Nursing. Lippincott Williams & Wilkins. ISBN 9. 78- 0- 7. Roget (1. 1 November 2. Encyclopedia of Substance Abuse Prevention, Treatment, and Recovery. ISBN 9. 78- 1- 4. Iqbal Choudhary (1 January 2. Frontiers in CNS Drug Discovery. Bentham Science Publishers. ISBN 9. 78- 1- 6. Mc. Cuistion; Joyce Le. Fever Kee; Evelyn R. Hayes (2. 5 March 2. Pharmacology: A Patient- Centered Nursing Process Approach. Elsevier Health Sciences. ISBN 9. 78- 0- 3. Austria- Codex (in German). Clinical Pharmacology & Therapeutics. Drug and Alcohol Dependence. The Journal of Pharmacology and Experimental Therapeutics. Drug and Alcohol Dependence. Treatment Improvement Protocol (TIP) 4. US Department of Health and Human Services.^Volpe DA, Mc. Mahon Tobin GA, Mellon RD, Katki AG, Parker RJ, Colatsky T, Kropp TJ, Verbois SL (2. 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