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A clinical professor of pharmacy offers some insights for primary care on best practice in opioid prescribing. Dr. Atayee discusses the importance of risk assessment, competence in dosing and titration, and alternate routes of administration, especially in the palliative care setting.
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A panel of legal and compliance experts discuss some of the issues confronting prescribers of controlled substances in the management of patients who may be abusing and/or diverting their medications. How should clinicians negotiate the terrain between confronting suspicious patient behavior and...
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It turns out that psychological factors strongly correlate with prescription for opioids and also for opioid dose. Some of those factors are depression, anxiety, post-traumatic stress disorder, and history of substance use disorder. So a person’s history and also their current psychological make-up...
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Avoiding Risks while Preserving Benefits
The current approach to managing pain in a postoperative environment has continued to progress even over the last decade in terms of multimodal analgesia. So after a patient leaves the hospital, after they finish their surgery and had this intensive...
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Constipation happens universally in patients who are prescribed opioids. I’ve met a handful of patients over the years that don’t develop constipation from opioids and I always think the same thing. You’re not taking your drug. That’s how universal constipation is associated with opioids. Just as we...
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Primary care clinicians need to be very careful about dosing methadone for all sorts of reasons. Most importantly they need to worry about drug interactions and dosing, converting a patient from morphine or an equivalent dose of another opioid to methadone. Even if we could determine what an exact...
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With acetaminophen, the most important thing to think about is liver toxicity, and remembering to take age into account when you’re thinking about the maximum dosing. And it’s important to be sure that patients are aware that there are a lot of agents out there that have acetaminophen as an...
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An epidemiologist looks at opioid therapy from the perspective of dose vs risk relationships, and comments on how communities can better harness local initiative and interest to combat overdose events.
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Drs. Carter and Schatman consider the consequences that would accrue from the removal of opioids from the therapeutic options for chronic pain. The segment also discusses the characteristics of a “better” opioid, and the research understanding needed to get there.
| Video
Drs. Carter and Schatman consider the consequences that would accrue from the removal of opioids from the therapeutic options for chronic pain. The segment also discusses the characteristics of a “better” opioid, and the research understanding needed to get there.