Podcast # 491: Buprenorphine for Withdrawal

Podcast # 491: Buprenorphine for Withdrawal

Educational Pearls:

  • Buprenorphine is a semi-synthetic derivative of the opium poppy
  • FDA approved for the treatment of opiate use disorder and chronic pain
  • Benefit in emergency department use is the ceiling effect - producing less euphoria as well as respiratory depression with higher doses
  • It has an onset of 30-60 minutes, peak effect at 1-4 hours
  • Duration of action depends is dose dependent, typically 6-12 hours, but can be as long as 24-72 hours in doses over 16 mg
  • Use buprenorphine in those in moderate to severe opiate withdrawal
  • Clinical Opioid Withdrawal Scale (COWS) can be used to assess and score severity of withdrawal
  • A reasonable starting dose is 8mg. A second dose can be given after an hour, ranging from 8-24 mg depending on symptoms still present
  • Buprenorphine can induce withdrawals so someone needs to be in true withdrawals for it to provide benefit

References

https://www.mdcalc.com/cows-score-opiate-withdrawal

https://ed-bridge.org

Herring AA, Perrone J, Nelson LS. Managing Opioid Withdrawal in the Emergency Department With Buprenorphine. Ann Emerg Med. 2019 May;73(5):481-487. doi: 10.1016/j.annemergmed.2018.11.032. Epub 2019 Jan 5. Review. PubMed PMID: 30616926.

Summarized by Will Dewispelaere, MS4 | Edited by Erik Verzemnieks, MD



Jaksot(1145)

Podcast 883: Migraine Treatment in Cardiovascular Disease

Podcast 883: Migraine Treatment in Cardiovascular Disease

Contributor: Jorge Chalit, OMS II Educational Pearls: Migraine pathophysiology Primarily mediated through the trigeminovascular system Serotonin, dopamine, and calcitonin gene-related peptide (...

25 Joulu 20233min

Podcast 882: Thrombolytics for Minor Strokes

Podcast 882: Thrombolytics for Minor Strokes

Contributor: Aaron Lessen MD Educational Pearls: How is the severity of a stroke assessed? Strokes are assessed by the NIH Stroke Scale (NIHSS), this scale has different tasks, such as asking the pe...

20 Joulu 20232min

Podcast 881: Pediatric Readmissions

Podcast 881: Pediatric Readmissions

Contributor: Nick Tsipis MD Educational Pearls: The review article assessed 16.3 million patients across six states to identify those at high-risk for critical revisit Criteria for critical revis...

12 Joulu 20233min

Podcast 880: OB Delivery in the ED

Podcast 880: OB Delivery in the ED

Contributor: Meghan Hurley MD Educational Pearls: Pearls about labor: Labor is split into 3 stages. Stage 1 starts when the first persistent contractions are felt and goes up until the cervix is ...

4 Joulu 20238min

Podcast 879: A Case of Pediatric Anaphylactic Shock

Podcast 879: A Case of Pediatric Anaphylactic Shock

Contributor: Dr. Taylor Lynch Educational Pearls: Time of arrival until intubation was 26 minutes but nobody tried anterior neck access like a cricothyrotomy until his dad arrived Traditional ACLS...

27 Marras 20235min

Podcast 878: Opioids for Low Back and Neck Pain

Podcast 878: Opioids for Low Back and Neck Pain

Contributor: Jared Scott MD Educational Pearls: Should we use opioids to treat low back and neck pain? The OPAL Trial, published in The Lancet, in June 2023, attempted to answer this very question. ...

20 Marras 20233min

Podcast 877: Viral Respiratory Infections in Children

Podcast 877: Viral Respiratory Infections in Children

Contributor: Jared Scott MD Educational Pearls A recently published study assessed the burden of respiratory viruses in a longitudinal cohort of children from 0 to 2 years of age The children in t...

13 Marras 20233min

Podcast 876: Sedation Pearls

Podcast 876: Sedation Pearls

Contributor: Travis Barlock MD Educational Pearls: Common sedatives used in the Emergency Department and a few pearls for each. Propofol Type: Non-barbiturate sedative hypnotic agonizing GABA rec...

6 Marras 20235min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
rss-duodecim-lehti
docemilia
filocast-filosofian-perusteet
rss-ammamafia
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
rss-sosiopodi
utelias-mieli
radio-antro
rss-astetta-parempi-elama-podcast
rss-tiedetta-vai-tarinaa