Your medical briefing
Research, guidelines, and safety alerts for your specialty.
Browse recent updates across specialties.
Dr. Christopher P. Holstege of UVA Health's Blue Ridge Poison Center describes synthetic opioids informally called 'orphines,' which have appeared in the US since 2019 and have no approved medical use. He states they produce sedation, pinpoint pupils and respiratory depression similar to fentanyl and morphine, and that fentanyl test strips do not detect them.
The American College of Physicians published a new clinical guideline in Annals of Internal Medicine recommending estrogen-progestogen combination therapy (for those with a uterus) or estrogen monotherapy (for those without) as first-line treatment for menopausal vasomotor symptoms. For patients with contraindications to or intolerance of estrogen, ACP suggests SNRIs as second-line therapy, and SSRIs, gabapentin, or NK3 receptor antagonists as third-line options, while advising clinicians to use shared decision-making accounting for benefits, harms, comorbidities, and patient preferences.
