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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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Corresponding Responsibilities for Patient Well-Being
Many of the chain pharmacies have implemented policies relating to the know-your-customer policy of the Drug Enforcement Administration and many of the pharmacists are required now to document and corroborate information relating to the...
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Corresponding Responsibilities for Patient Well-Being
In the big picture it may have been a good idea, but the way it was implemented became a problem. Prescribers and pharmacists have little time as it is, and for them to take away their time to engage in a national policy and doing it on each...
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Dr. Zacharoff sketches the background history of Prescription Drug Monitoring Programs, and offers an assessment of how well they are performing and how they can be improved. Watch the segment for recommendations on what you need to know to successfully engage these tools in your prescribing...
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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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There are several female specific pain conditions, including chronic pelvic pain, which is a particular problem for women, as well as vulvodynia or vaginal pain, and pain after breast cancer treatment which certainly affects exclusively women. It’s important to recognize, though, that pain as a...
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Pain education in the US today unfortunately is warped. Whether coming from industry, whether from the Food and Drug Administration, it ends up being lopsided and very often to opioids, when opioids are just one piece of the management of pain. We need to do more to help it diffuse into the training...
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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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A number of factors have coalesced to make pain and hormones a topical issue in pain management. One is that there are enough scientific studies to show us that pain itself has a dramatic effort on the hormone system. It will deplete hormones, for example. We also have learned that you can’t get...