Methadone Conversion
نویسنده
چکیده
Rotation among opioids to minimize side effects and improve analgesia is a common clinical strategy in pain and palliative care. Methadone is frequently prescribed during opioid rotation, either by mouth or intravenously (IV) with patient-controlled analgesia (PCA) at home. However, there is a lack of consensus on rotation strategies from other opioids to methadone, as well as on conversion ratios. As a result, strategies for achieving rotation vary widely, among not only providers, but also institutions. Clinical decisions surrounding opioid rotation must take into consideration the patient’s overall medical condition, the expertise and comfort level of the prescribing physician, the medical evidence, and institutional guidelines, in addition to goals of care. The following case study and discussion refers to all of these aspects of opioid rotation and depicts an example of conversion and use of parenteral methadone for refractory pain due to cancer.
منابع مشابه
Conversion from prolonged intravenous fentanyl infusion to enteral methadone in critically ill children
AIM To describe our institutional experience with conversion from intravenous (IV) fentanyl infusion directly to enteral methadone and occurrence of withdrawal in critically ill mechanically ventilated children exposed to prolonged sedation and analgesia. METHODS With Institutional Review Board approval, we retrospectively studied consecutively admitted invasively mechanically ventilated chil...
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