Flashcards in Opioid epidemic Deck (19):
What therapies are preferred for chronic pain now?
What type of opioids are preferred now?
Immediate release instead of extended-release/long acting
What is the preferred prescribed dose of opioids? How are you monitoring this?
Lowest effective dose
Reassess risks and benefits when doses increase to ≥ 50 morphine milligram equivalents (MME) per day and avoid increasing to ≥ 90 MME without careful justification
What is the dosing of opioids for acute pain?
Lowest effective dose of IR opioids for 3-7 days
How often do you evaluate the benefit and harm of opioids?
Evaluate first w/in 1-4 weeks of starting
Then again every 3 months or so
What is a strategy to mitigate risk of opioid use?
What should you monitor with pts if thinking of giving them an opioid?
Their controlled substance use
What should you test before starting opioid therapy? How often should you do this?
Urine drug testing
At least annually
What should you not prescribe w/ opioids?
What should you do for pts w/ opioid-use disorder?
Offer/arrange evidence based tx (medication assisted therapy)
What kind of drug is buprenorphine?
Partial opioid agonist
How does buprenorphine assist w/ MAT?
Helps relieve withdrawal sx
When can you start buprenorphine?
W/ opioids in the pts system
What is naltrexone?
What is the role of naltrexone w/ MAT?
May precipitate withdrawal sx
How do you administer naltrexone and when can you start it?
PO daily or IM monthly
Must be opioid free
What kind of drug is methadone?
Long acting opioid agonist
What is the role of methadone w/ MAT?
Transfers opioid addiction to longer half life agonist allowing a taper