Pharmacology and Clinical Use of Opiates
... • in humans (actively debated) It’s not that tolerance does not occur in humans, but that the design of studies does not take into account the complexity of the system ...
... • in humans (actively debated) It’s not that tolerance does not occur in humans, but that the design of studies does not take into account the complexity of the system ...
Slide 1
... high as 43%. Aberrant medication-taking behaviors ranged from 5% to 24%. Limitations: Retrieval and publication biases and poor study quality. No trial evaluating the efficacy of opioids was longer than 16 ...
... high as 43%. Aberrant medication-taking behaviors ranged from 5% to 24%. Limitations: Retrieval and publication biases and poor study quality. No trial evaluating the efficacy of opioids was longer than 16 ...
Welcome to the Turning Point Red Envelope!
... Missed Doses After a patient has gone THREE days without their regular opioid dose, they may have lost their tolerance to the prescribed drug and so are at risk of overdose if the usual dose is then taken/given. It is therefore important NOT to dispense the medication after this amount of time has ...
... Missed Doses After a patient has gone THREE days without their regular opioid dose, they may have lost their tolerance to the prescribed drug and so are at risk of overdose if the usual dose is then taken/given. It is therefore important NOT to dispense the medication after this amount of time has ...
OPIATE ANALGESICS AND ANTAGONISTS
... • G. Methadone • 1. Pharmacology and analgesic potency similar to morphine; μ- receptor agonist. • 2. Very effective following oral administration. • 3. Longer duration of action than morphine due to plasma protein binding (t1/2 approximately 25 hrs). • 4. Used in methadone maintenance programs for ...
... • G. Methadone • 1. Pharmacology and analgesic potency similar to morphine; μ- receptor agonist. • 2. Very effective following oral administration. • 3. Longer duration of action than morphine due to plasma protein binding (t1/2 approximately 25 hrs). • 4. Used in methadone maintenance programs for ...
Treatment options for the Opioid Dependent Patient
... ≥ 3 of the following occurring in the same 12- month period 1. Desire or unsuccessful efforts to cut down on opiate use 2. Large amount of time spent obtaining opiates, using opiates, or recovering from opiate effects 3. Social, occupational, or recreational activities reduced because of opiate use ...
... ≥ 3 of the following occurring in the same 12- month period 1. Desire or unsuccessful efforts to cut down on opiate use 2. Large amount of time spent obtaining opiates, using opiates, or recovering from opiate effects 3. Social, occupational, or recreational activities reduced because of opiate use ...
Chapter 18 Opioid Analgesics
... • Opioid agonists produce analgesia by binding to specific receptors, located primarily in brain and spinal cord regions involved in the transmission and modulation of pain. • Receptor types: The major classes of receptors are µ (mu for morphine) delta(δ), and kappa(κ). All are members of the G-prot ...
... • Opioid agonists produce analgesia by binding to specific receptors, located primarily in brain and spinal cord regions involved in the transmission and modulation of pain. • Receptor types: The major classes of receptors are µ (mu for morphine) delta(δ), and kappa(κ). All are members of the G-prot ...
Novel Psychoactive Substances and Other Drugs May 2014
... • Stories from the UK started 3-4 years ago and over the last year or two in Canada and the United States. • Sometimes toxicology reports show that “bath salts” were actually not ingested. • The extreme cases are the ones reported; many people have used the substances with no problems at all. ...
... • Stories from the UK started 3-4 years ago and over the last year or two in Canada and the United States. • Sometimes toxicology reports show that “bath salts” were actually not ingested. • The extreme cases are the ones reported; many people have used the substances with no problems at all. ...
April 2017
... Addiction is also defined many ways. The American Society of Addiction Medicine (ASAM) defines addiction as a primary, chronic, neurobiologic disease of brain motivation, reward, and memory with genetic, psychosocial, and environmental factors influencing its development and manifestations. The Amer ...
... Addiction is also defined many ways. The American Society of Addiction Medicine (ASAM) defines addiction as a primary, chronic, neurobiologic disease of brain motivation, reward, and memory with genetic, psychosocial, and environmental factors influencing its development and manifestations. The Amer ...
Safe Opioid Prescribing
... In anything other than acute emergencies, the healthcare practitioner concerned or their clinical supervisor should: Confirm any recent opioid dose, formulation, frequency of administration and any other analgesic medicines prescribed for the patient This can be done through discussion with the pati ...
... In anything other than acute emergencies, the healthcare practitioner concerned or their clinical supervisor should: Confirm any recent opioid dose, formulation, frequency of administration and any other analgesic medicines prescribed for the patient This can be done through discussion with the pati ...
Switching opioids using equivalence tables
... Calculate dose needed for PRN immediate release rescue opioid o If patient is started on Hydromorph Contin 9 mg BID, rescue dose is 10 to 15 % x 18 mg = 0.1 to 0.15 x 18mg hydromorphone = 1.8 to 2.7 mg hydromorphone. The patient can be provided with hydromorphone immediate release 2 mg with instruct ...
... Calculate dose needed for PRN immediate release rescue opioid o If patient is started on Hydromorph Contin 9 mg BID, rescue dose is 10 to 15 % x 18 mg = 0.1 to 0.15 x 18mg hydromorphone = 1.8 to 2.7 mg hydromorphone. The patient can be provided with hydromorphone immediate release 2 mg with instruct ...
analgesics
... morphine 12–24 hours, e.g. hot plate test – in mice, after 3 days dose of morphine required for analgesia increases 5-fold). Important in drug addiction – may need to increase dose 50-fold. ...
... morphine 12–24 hours, e.g. hot plate test – in mice, after 3 days dose of morphine required for analgesia increases 5-fold). Important in drug addiction – may need to increase dose 50-fold. ...
10A NCAC 27G .3604(d)
... (g) Withdrawal From Medications For Use In Opioid Treatment. The risks and benefits of withdrawal from methadone or other medications approved for use in opioid treatment shall be discussed with each client at the initiation of treatment and annually thereafter. (h) Random Testing. Random testing fo ...
... (g) Withdrawal From Medications For Use In Opioid Treatment. The risks and benefits of withdrawal from methadone or other medications approved for use in opioid treatment shall be discussed with each client at the initiation of treatment and annually thereafter. (h) Random Testing. Random testing fo ...
OPIATE ANALGESICS AND ANTAGONISTS
... G. Methadone – Pharmacology and analgesic potency similar to morphine; μ- receptor agonist. – Very effective following oral administration. – Longer duration of action than morphine due to plasma protein binding (t1/2 approximately 25 hrs). – Used in methadone maintenance programs for treatment of ...
... G. Methadone – Pharmacology and analgesic potency similar to morphine; μ- receptor agonist. – Very effective following oral administration. – Longer duration of action than morphine due to plasma protein binding (t1/2 approximately 25 hrs). – Used in methadone maintenance programs for treatment of ...
investing in drug and alcohol treatment
... · Alpha-adrenergic agents such as clonidine, guanfacine and lofexidine have been compared with methadone and, although effective, they have been found to have more side-effects and lesser effects on withdrawal symptoms. · The opioid agonists naloxone and naltrexone (unassisted or with clonidine) may ...
... · Alpha-adrenergic agents such as clonidine, guanfacine and lofexidine have been compared with methadone and, although effective, they have been found to have more side-effects and lesser effects on withdrawal symptoms. · The opioid agonists naloxone and naltrexone (unassisted or with clonidine) may ...
Pain Management Guide Card
... Eliminate nonessential CNS-acting drugs ↑ dosing frequency with a lower opioid dose to decrease peak serum concentration ↓ opioid dose (by 10-25%) & Add or increase the nonopioid analgesic for additional pain relief If excessive sedation persists, switch opioid Respiratory depression* Monitor sedati ...
... Eliminate nonessential CNS-acting drugs ↑ dosing frequency with a lower opioid dose to decrease peak serum concentration ↓ opioid dose (by 10-25%) & Add or increase the nonopioid analgesic for additional pain relief If excessive sedation persists, switch opioid Respiratory depression* Monitor sedati ...
View the Module - PCSS-MAT
... More rural, impoverished counties tend to have higher prescription opioid overdose death rates. • Medicaid populations are at greater risk for overdose than other insured groups. ...
... More rural, impoverished counties tend to have higher prescription opioid overdose death rates. • Medicaid populations are at greater risk for overdose than other insured groups. ...
I. Morphine
... G. Methadone – Pharmacology and analgesic potency similar to morphine; μ- receptor agonist. – Very effective following oral administration. – Longer duration of action than morphine due to plasma protein binding (t1/2 approximately 25 hrs). – Used in methadone maintenance programs for treatment of ...
... G. Methadone – Pharmacology and analgesic potency similar to morphine; μ- receptor agonist. – Very effective following oral administration. – Longer duration of action than morphine due to plasma protein binding (t1/2 approximately 25 hrs). – Used in methadone maintenance programs for treatment of ...
pain management guidelines - About PRC
... Peak effect of immediate-release opioid is ≈ one hour; may repeat dose every one hour if patient is not overly sedated. IV/SQ breakthrough dose is ≈ 50 to 100% of the hourly IV/SQ rate. Peak effect of IV opioids is ≈ 10-15 minutes; may repeat dose every 15 minutes if patient not overly sedated. Peak ...
... Peak effect of immediate-release opioid is ≈ one hour; may repeat dose every one hour if patient is not overly sedated. IV/SQ breakthrough dose is ≈ 50 to 100% of the hourly IV/SQ rate. Peak effect of IV opioids is ≈ 10-15 minutes; may repeat dose every 15 minutes if patient not overly sedated. Peak ...
Effective October 1, 2012 - Harm Reduction Coalition
... A licensed health care professional who is permitted by law to prescribe an opioid antagonist may, if acting with reasonable care, prescribe, dispense or administer an opioid antagonist [to a drug user in need of such intervention] to treat or prevent a drug overdose without being liable for damages ...
... A licensed health care professional who is permitted by law to prescribe an opioid antagonist may, if acting with reasonable care, prescribe, dispense or administer an opioid antagonist [to a drug user in need of such intervention] to treat or prevent a drug overdose without being liable for damages ...
Opioids and Chronic Benign Pain: A Different Perspective
... • Oxycodone sales increased 383% between 1997 and 2002 • Methadone sales increased 392% between 1997 and 2002 -Paulozzi & Ryan, Am. J. Prev. Med., 2006 • More than 80% of patients who use trans-mucosal fentanyl do not have cancer, its only FDA-approved indication -ImpactRx 2005-2006 survey data ...
... • Oxycodone sales increased 383% between 1997 and 2002 • Methadone sales increased 392% between 1997 and 2002 -Paulozzi & Ryan, Am. J. Prev. Med., 2006 • More than 80% of patients who use trans-mucosal fentanyl do not have cancer, its only FDA-approved indication -ImpactRx 2005-2006 survey data ...
Overdose Prevention with Community Based Naloxone: An …
... Collaborative Drug Therapy Agreement for Naloxone Medication in Opioid Overdose Reversal I, __________________, MD, a licensed health care provider authorized to prescribe medication in the State of Washington, delegate prescriptive authority to _______________________ Pharmacy and the pharmacists l ...
... Collaborative Drug Therapy Agreement for Naloxone Medication in Opioid Overdose Reversal I, __________________, MD, a licensed health care provider authorized to prescribe medication in the State of Washington, delegate prescriptive authority to _______________________ Pharmacy and the pharmacists l ...
Opioid Induced Hyperalgesia
... • Roller coaster effect – Leads to opioid withdrawal – Increased pain during withdrawal – Higher tolerance develops with ever increasing doses of opioids to cover pain (usually initiated in the ER) ...
... • Roller coaster effect – Leads to opioid withdrawal – Increased pain during withdrawal – Higher tolerance develops with ever increasing doses of opioids to cover pain (usually initiated in the ER) ...
Methadone
Methadone, also known as Dolophine among other brand names, is a synthetic opioid. It is used medically as a pain medication and a maintenance therapy in people with opioid dependence. Methadone is also used in managing severe chronic pain owing to its long duration of action and strong analgesic effect.Side effects are similar to that of other opioids. The number of drug-poisoning deaths in the United States involving methadone increased from 784 in 1999 to 5,518 in 2007 but declined to 4,418 in 2011.Methadone is an acyclic analog of morphine and heroin and acts on the same opioid receptors.Methadone was developed in Germany in 1937 by Gustav Ehrhart and Max Bockmühl, mainly because Germany required a reliable internal source of opioids. Methadone was introduced into the United States in 1947 by Eli Lilly and Company. It is regulated similarly to morphine in most countries. In the United States, it is a Schedule II controlled substance. Globally in 2013 41,400 kilograms were manufactured. Methadone is on the World Health Organization's List of Essential Medicines, a list of the most important medication needed in a basic health system.