Applying legal risk management to the clinical use of methadone.

نویسندگان

  • James O'Donnell
  • F Randy Vogenberg
چکیده

tion was removed in 1976; physicians with appropriate Drug Enforcement Agency registration may now prescribe methadone for analgesia.3 The unique pharmaco kinetic and pharmacodynamic characteristics of methadone make it a valuable option for the management of chronic pain both as a first-line agent and as a replacement opioid.1,4 Even though methadone may be administered by several routes––oral, rectal, intravenous, intramuscular, subcutaneous, epidural, and intrathecal–– it is most commonly given orally in either tablets or solution.1,5 Numerous evaluations of methadone, including placebo-controlled clinical trials, have shown that it is an effective analgesic in cancer pain and in chronic non-cancer pain.1 Its pharmacological properties, however, demand greater precautions than are necessary with other opioids.6 Methadone has a long-elimination halflife (8–59 hours),7–9 which might not correlate with its duration of analgesic efficacy (typically 8–12 hours with repeated dosing).4 This pharmacokinetic property necessitates careful management and titration of effective dosing schedules, because the mismatch of half-life and duration of analgesia is potentially lifethreatening.10 Day-to-day monitoring is essential when chronic methadone therapy is initiated or when patients are switching from another opioid to methadone for pain relief.1

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Concomitant Drug Use in Patients on Methadone Maintenance Therapy

Background: Methadone maintenance therapy (MMT) is considered as an efficient and effective treatment in management of high risk opioids addiction; although, concomitant use of other drugs may interfere with treatment course and outcome in MMT cases. This study aimed at evaluating patterns of drug use along with methadone based on self reported and urine analysis data in two MMT clinics. Method...

متن کامل

Methadone Related Poisoning on the Rise in Tehran, Iran

Background: In Iran, methadone has been used for methadone maintenance treatment (MMT) as well as analgesic treatment in pain clinics. Recently, there are some reports regarding accidental and intentional methadone poisonings and deaths. The aim of this study was to evaluate the trend of methadone poisonings and deaths during a 10-year period in Tehran, Iran. Methods: This was a retrospective c...

متن کامل

The Comparison of Applying a Designed Model to Measure Credit Risk Between Melli and Mellat Banks

The main purpose of this paper is providing a model to calculate the credit risk of Melli bank clients and implement it at Mellat Bank. Therefore, the present study uses a multi-layered neural network method. The statistical population of this research is all real and legal clients of Melli and Mellat banks. Sampling method used in this research is a simple random sampling method. Friedman test...

متن کامل

Methadone Maintenance Treatment Program in Prisons from the Perspective of Medical and non-Medical Prison Staff: A Qualitative Study in Iran

Background As one of the most important components of harm reduction strategy for high-risk groups, following the HIV epidemics, Methadone Maintenance Treatment (MMT) has been initiated in prisoners since 2003. In this paper, we aimed to assess the advantages and shortcomings of the MMT program from the perspective of people who were involved with the delivery of prison healthcare in Iran.   Me...

متن کامل

Mortality Rates Due to Substance and Stimulants Abuse in Corpses Submitted to the Forensic Medicine Organization of Kohgiluyeh and Boyer-Ahmad Province during 2013-2018

Aims: Addiction as a social problem is a phenomenon that destroyed the ability of society to organize and maintain the order of actual affairs, and it is one of the major causes of early death. The aim of the present research was to determine the mortality rates due to substance and stimulant abuse in the deceased submitted to the forensic medicine department of Kohgiluyeh and Boyer Ahmad who d...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • P & T : a peer-reviewed journal for formulary management

دوره 36 12  شماره 

صفحات  -

تاریخ انتشار 2011