Repeated administration of many addictive drugs leads to a progressive increase in their locomotor effects. This increase in locomotor activity often develops concomitantly with increases in their positive-reinforcing effects, which are believed to contribute to the etiology of substance use disorders. The purpose of this study was to examine changes in sensitivity to the locomotor effects of opioids after their repeated administration and to determine the role of and receptors in mediating these effects. Separate groups of rats were treated with opioid receptor agonists and antagonists every other day for 10 days, and changes in locomotor activity were measured. Repeated administration of the agonists, morphine and buprenorphine, produced a progressive increase in locomotor activity during the treatment period, and this effect was blocked by coadministration of the opioid antagonist naltrexone. The agonist spiradoline decreased locomotor activity when administered alone and blocked the progressive increase in locomotor activity produced by morphine. The ability of spiradoline to block morphine-induced increases in locomotor activity was itself blocked by pretreatment with the antagonist nor-binaltorphimine. Repeated administration of high doses, but not low or moderate doses, of the mixed / agonists butorphanol, nalbuphine, and nalorphine produced a progressive increase in locomotor activity during the treatment period. Doses of butorphanol, nalbuphine, and nalorphine that failed to produce a progressive increase in locomotor activity when administered alone did so when subjects were pretreated with nor-binaltorphimine. These findings suggest that and receptors have functionally opposing effects on opioid-mediated locomotor activity and sensitization-related processes.Locomotor activity after psychotropic drug administration has long been of interest to behavioral pharmacologists in general and substance abuse researchers in particular. The reasons for this interest can be traced to the fact that the anatomical structures and neurotransmitter systems mediating locomotor activity overlap those that mediate positive reinforcement and reward (for review, see Wise, 1987;Tzschentke, 2001). Because of this overlap, a careful examination of locomotor activity after drug administration can shed light on the neuropharmacological basis of substance abuse and other addictive behaviors.Opioid analgesics produce a stereotypical pattern of locomotor activity that has been well characterized. After systemic administration, -opioid agonists initially produce a transient decrease in locomotor activity that gradually dissipates over the course of 60 to 120 min, which is then followed by an increase in locomotor activity lasting several hours (Babbini and Davis, 1972;Buxbaum et al., 1973). Sensitivity to both the initial decrease and the subsequent increase in locomotor activity changes after the repeated administration of opioids, such that the initial decrease becomes gradually smaller, and the subsequent increase becom...

Purpose Although the characteristics of pharmacy postgraduate year 1 (PGY1) residency programs have been examined among large academic medical centers, there are no identified studies comparing the attributes of individual programs in the Veterans Affairs (VA) Health Administration System. The primary objective of this study was to describe and contrast characteristics of VA PGY1 residency programs. Methods This was a cross-sectional survey of VA pharmacy residency programs. An online survey was distributed electronically to residency program directors of VA PGY1 residencies. Results Responses from 33 (33%) PGY1 programs were available for the analysis. Programs reported growth over the previous 2 years and expected continued expansion. There was a wide variety of learning opportunities, although experiences were customizable based on residents’ interests. Notably, many programs allowed residents to seek rotations at other locations if specific experiences were not available on-site. Additionally, most programs had a mandatory staffing component and required residents to present the results of residency research projects. Conclusion There is a high degree of variability among individual VA facilities with regard to the requirements and opportunities available to PGY1 pharmacy residents. This assessment is able to characterize the currently established residency programs and allows for an active comparison of programs in a nationally integrated health care system.

Sensitization refers to an increase in sensitivity to the effects of a drug and is believed to play a role in the etiology of substance use disorders. Cross-sensitization has been observed between drugs from different pharmacological classes and may play a role in the escalation of drug use in polydrug-abusing populations. The purpose of this study was to examine cross-sensitization between opioids and cocaine and to determine the extent to which cross-sensitization is mediated by an opioid's selectivity for , , and ␦ receptors. Separate groups of rats were treated with opioid receptor agonists and antagonists every other day for 10 days, and the locomotor effects of cocaine were tested 8 days later. The agonists, morphine and buprenorphine, and the, produced cross-sensitization to cocaine, such that repeated administration of these drugs over a 10-day period significantly enhanced cocaine's locomotor effects when tested later. Coadministration of the opioid antagonist naltrexone prevented morphine and buprenorphine from producing cross-sensitization. Coadministration of naltrexone, but not the ␦ antagonist naltrindole, also prevented BW373U86 from producing crosssensitization. The agonist spiradoline failed to produce crosssensitization, but coadministration of spiradoline prevented morphine and buprenorphine from producing cross-sensitization. The ability of spiradoline to block cross-sensitization was itself blocked by the antagonist nor-binaltorphimine. The mixed / opioids butorphanol, nalbuphine, and nalorphine did not produce cross-sensitization under any condition examined. These data indicate that agonist activity at receptors positively modulates cross-sensitization between opioids and cocaine, whereas agonist activity at receptors negatively modulates this effect.

Objectives To determine the potential impact of a brief human immunodeficiency virus (HIV) educational intervention delivered by a pharmacist during a provider visit on patient knowledge and retention in HIV care. Methods This study was performed in an HIV clinic at a large medical centre in Philadelphia. Patients had been attending the clinic for at least 1 year and were receiving antiretroviral therapy (ART). Participants were randomized to standard care (SC) or SC plus a 10‐min educational presentation (EP). Participants were followed over their next two scheduled visits. All participants received a baseline and end of study knowledge assessment. EP patients also received a knowledge assessment immediately following the presentation. A participant answering all assessment questions correctly was considered to have perfect knowledge. Participant retention in care was measured by attendance at provider visits, completion of laboratory work and adherence to ART. Key findings Forty‐five patients were enrolled; 24 received the EP. At baseline, two‐thirds of participants (31/45) had nonperfect knowledge and most had nonperfect retention (31/45). Among those with nonperfect baseline knowledge, most had nonperfect retention (23/31, P = 0.042). Following education, perfect knowledge improved in the intervention group (5/24 at baseline versus 16/24 post‐EP, P = 0.002) and maintained through study completion. EP patients were more likely to have perfect retention compared with SC patients at study visit two (17/24 versus 5/21, P = 0.002) and study completion (16/24 versus 5/21, P = 0.026). Conclusion Brief education delivered by a pharmacist may improve patient knowledge and retention in HIV care.