0 - THD Internal Medicine Training Program
... PO onset of action 30-60 minutes Duration of action ...
... PO onset of action 30-60 minutes Duration of action ...
Pain management Best practices
... • Purdue recently reformulated to prevent initial high • Conversion ratio of 1.5 for Morphine equivalent • Often used in combination with short acting,sometimes dosed too frequently by MD • Leads to significant opioid tolerance saturating Mu receptor • If used should be lowest dose possible with pla ...
... • Purdue recently reformulated to prevent initial high • Conversion ratio of 1.5 for Morphine equivalent • Often used in combination with short acting,sometimes dosed too frequently by MD • Leads to significant opioid tolerance saturating Mu receptor • If used should be lowest dose possible with pla ...
Diagnosis And Treatment Of Prescription Opioid Dependence
... – 2. Getting off addictive drugs with as little discomfort as possible. – 3. Buprenorphine treatment for narcotic addiction recovery.” ...
... – 2. Getting off addictive drugs with as little discomfort as possible. – 3. Buprenorphine treatment for narcotic addiction recovery.” ...
Opioid Dependence and Buprenorphine: An Update
... Use of opioids for purposes other than analgesia threaten individuals and society Physicians have a responsibility to minimize abuse and diversion *Federation of State Medical Boards, 2003 ...
... Use of opioids for purposes other than analgesia threaten individuals and society Physicians have a responsibility to minimize abuse and diversion *Federation of State Medical Boards, 2003 ...
Medication Assisted Treatment in Adolescents
... Background: MAT for OUDs Receptors are stabilized with MAT medications Patients on MAT experience fewer and less intense cravings and use drugs at much lower rates MAT is the gold standard for OUD treatment: Reduces drug use Protects against overdoses Prevents injection behaviors ...
... Background: MAT for OUDs Receptors are stabilized with MAT medications Patients on MAT experience fewer and less intense cravings and use drugs at much lower rates MAT is the gold standard for OUD treatment: Reduces drug use Protects against overdoses Prevents injection behaviors ...
Slide 1
... Freye, E. (2008). Opioids in Medicine: A comprehensive review on the mode of action and the use of analgesics in different clinical pain states. New York: Springer Publishing Co. Smith, H. (2009). Opioid metabolism. Mayo Clinic Proceedings, 84(7), 613-624 ...
... Freye, E. (2008). Opioids in Medicine: A comprehensive review on the mode of action and the use of analgesics in different clinical pain states. New York: Springer Publishing Co. Smith, H. (2009). Opioid metabolism. Mayo Clinic Proceedings, 84(7), 613-624 ...
Opioid Presentation pt2(updated) [Read
... inadequate dosing with opioids. Resp. depression can usually be avoided with careful titration and individualisation of dose against effect. Opioid naive patient is at greater risk. Resp. depression may occur due to incorrect dose by any route, accumulation during inadequately monitored continuous i ...
... inadequate dosing with opioids. Resp. depression can usually be avoided with careful titration and individualisation of dose against effect. Opioid naive patient is at greater risk. Resp. depression may occur due to incorrect dose by any route, accumulation during inadequately monitored continuous i ...
Slide 1
... Metabolize to M6G (agonist), M3G High addictive potential (rush (neurotoxicity), may and stimulant effect) accumulate in renal failure More CNS toxicity (i.e. seizures, delirium due to norpethidine metabolite Should not be used any more ...
... Metabolize to M6G (agonist), M3G High addictive potential (rush (neurotoxicity), may and stimulant effect) accumulate in renal failure More CNS toxicity (i.e. seizures, delirium due to norpethidine metabolite Should not be used any more ...
CM 21- Stimulants, Benzo, Barbs, Opiates, Heroin Psychostimulants
... Better regulated = decreased manufacture Short term effects = releases dopamine o Increases wakefulness; decreases appetite o Oral or snorting long-lasting high o Injecting gm every 2-3 hours (“run”) o Long lasting high Long-term effects o Anxiety, confusion, paranoia, hallucinations, aggression o 5 ...
... Better regulated = decreased manufacture Short term effects = releases dopamine o Increases wakefulness; decreases appetite o Oral or snorting long-lasting high o Injecting gm every 2-3 hours (“run”) o Long lasting high Long-term effects o Anxiety, confusion, paranoia, hallucinations, aggression o 5 ...
Neonatal Abstinence Syndrome
... Rosenthal, et al, 1964: “reports of cases from the beginning of the century … point to the fact that infants born to opiate or opiate-like drug-addicted (at time of delivery) mothers may be addicted.” ...
... Rosenthal, et al, 1964: “reports of cases from the beginning of the century … point to the fact that infants born to opiate or opiate-like drug-addicted (at time of delivery) mothers may be addicted.” ...
Drugs and their Effects by Class
... volunteers, single doses of methadone will impair driving ability. Studies of long-term methadone maintenance patients have shown appropriately administered methadone doses do not cause significant psychomotor or cognitive impairment when administered regularly and when the subject abstains from all ...
... volunteers, single doses of methadone will impair driving ability. Studies of long-term methadone maintenance patients have shown appropriately administered methadone doses do not cause significant psychomotor or cognitive impairment when administered regularly and when the subject abstains from all ...
Drugs For The Treatment Of Heroin Addiction
... coldness with contraction of muscles attached to hair, so hair will erect (Goose bumps-cold turkey) or sweating ...
... coldness with contraction of muscles attached to hair, so hair will erect (Goose bumps-cold turkey) or sweating ...
Prescription Drug Abuse
... It is generally believed that the broad availability of prescription drugs (e.g., via the medicine cabinet, the Internet, and physicians) and misperceptions about their safety make prescription medications particularly prone to abuse. Among those who abuse prescription drugs, high rates of other ris ...
... It is generally believed that the broad availability of prescription drugs (e.g., via the medicine cabinet, the Internet, and physicians) and misperceptions about their safety make prescription medications particularly prone to abuse. Among those who abuse prescription drugs, high rates of other ris ...
Clincial Pharmacology of Analgesic Medications
... Emesis, diarrhea, cramping Anxiety, agitation, hostility Insomnia Tachycardia and hypertension ...
... Emesis, diarrhea, cramping Anxiety, agitation, hostility Insomnia Tachycardia and hypertension ...
What is the Block Grant? - Florida Alcohol and Drug Abuse Association
... • Determination will be made for the appropriate treatment modality and an individualized treatment plan will be created with the ...
... • Determination will be made for the appropriate treatment modality and an individualized treatment plan will be created with the ...
Chemical Dependency - Health Care Association of New Jersey
... • Excreted in the urine as free or conjugated morphine • Euphoria, sedation, and analgesia are the desired effects ...
... • Excreted in the urine as free or conjugated morphine • Euphoria, sedation, and analgesia are the desired effects ...
Opioids
... Processing of pain information is inhibited by a direct spinal effect at the dorsal horn, which involves presynaptic inhibition of the release of tachykinins like substance P. Emotional response to pain altered by opioid actions on the limbic cortex Act presynaptically to block Ca2+ uptake and conse ...
... Processing of pain information is inhibited by a direct spinal effect at the dorsal horn, which involves presynaptic inhibition of the release of tachykinins like substance P. Emotional response to pain altered by opioid actions on the limbic cortex Act presynaptically to block Ca2+ uptake and conse ...
The Slippery Slope of Relieving Pain: Be Wary of Opioid Drugs
... Who Is Most at Risk for Overdose? The two main populations in the United States at risk for prescription drug overdose are the approximately 9 million people who report long-term medical use of opioids and the roughly 5 million who report nonmedical use (use without a prescription or medical need) ...
... Who Is Most at Risk for Overdose? The two main populations in the United States at risk for prescription drug overdose are the approximately 9 million people who report long-term medical use of opioids and the roughly 5 million who report nonmedical use (use without a prescription or medical need) ...
Document
... Can use it to taper people down Build a “chemical staircase” for them to walk down Can use it to maintain people as well Put on same dose of methadone as heroin Stops withdrawal Ratchet up dose to way past how much heroin they used Price it out of reach Stops positive and negative re ...
... Can use it to taper people down Build a “chemical staircase” for them to walk down Can use it to maintain people as well Put on same dose of methadone as heroin Stops withdrawal Ratchet up dose to way past how much heroin they used Price it out of reach Stops positive and negative re ...
Presentation Part II
... Pain…2002 OK’d for OMT…Suboxone=added Naloxone (4:1)…Butrans for pain only Partial Mu agonist…>Doses
Poor GI absorption…SL-Buccal-Nasal-Anal-Vaginal-Tinctures are Best
Butrans dose=100-500mcg daily…Bupe pain dose=1-32mg daily
OMT Dosing=8-32mg daily ...
... Pain…2002 OK’d for OMT…Suboxone=added Naloxone (4:1)…Butrans for pain only Partial Mu agonist…
Exploratory Outcome Study of Ibogaine Therapy in Subjects
... How well does it work and under what conditions does it work best? Does it work best in some subset of subjects more so than in others? Ideally lead to placebo-controlled double-blind studies, or not ...
... How well does it work and under what conditions does it work best? Does it work best in some subset of subjects more so than in others? Ideally lead to placebo-controlled double-blind studies, or not ...
Exploratory Outcome Study of Ibogaine Therapy in Subjects
... How well does it work and under what conditions does it work best? Does it work best in some subset of subjects more so than in others? Ideally lead to placebo-controlled double-blind studies, or not ...
... How well does it work and under what conditions does it work best? Does it work best in some subset of subjects more so than in others? Ideally lead to placebo-controlled double-blind studies, or not ...
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.