Podcast 760: Why Fentanyl is the Worst

Podcast 760: Why Fentanyl is the Worst

Contributor: Don Stader, MD

Educational Pearls:

  • Fentanyl's common administration route through pills has lowered the psychological barrier of using opioid compared to injecting and smoking heroin
  • Fentanyl is showing up in all illicit drugs with documented cases even in marijuana
  • Testing for fentanyl is difficult and requires a send out test because UA does not show up not common in ED but can better inform our care
  • Fentanyl doesn't show up on UA drug screen and requires a send out test, thus we should ask patients if they're using fentanyl specifically
  • Send any patient using an illicit drug home with Narcan to protect them from potential opioid overdoses
  • Start patients on buprenorphine for opioid withdrawal in the ED
  • Fentanyl is very lipophilic, thus patients require longer washout times (sometimes over 24 hours) before buprenorphine induction to avoid precipitated withdrawal

References:

Adams, K.K., Machnicz, M. & Sobieraj, D.M. Initiating buprenorphine to treat opioid use disorder without prerequisite withdrawal: a systematic review. Addict Sci Clin Pract 16, 36 (2021). https://doi.org/10.1186/s13722-021-00244-8

Moustaqim-Barrette, A., Dhillon, D., Ng, J. et al. Take-home naloxone programs for suspected opioid overdose in community settings: a scoping umbrella review. BMC Public Health 21, 597 (2021). https://doi.org/10.1186/s12889-021-10497-2

*Image from NIDA

Summarized by Mason Tuttle

Jaksot(1145)

Episode 897: Adrenal Crisis

Episode 897: Adrenal Crisis

Contributor: Ricky Dhaliwal MD Educational Pearls: Primary adrenal insufficiency (most common risk factor for adrenal crises) An autoimmune condition commonly known as Addison's Disease Defects...

1 Huhti 20244min

Podcast 896: Cancer-Related Emergencies

Podcast 896: Cancer-Related Emergencies

Contributor: Travis Barlock, MD Educational Pearls: Cancer-related emergencies can be sorted into a few buckets: Infection Cancer itself and the treatments (chemotherapy/radiation) can be immunos...

25 Maalis 20242min

Episode 895: Indications for Exogenous Albumin

Episode 895: Indications for Exogenous Albumin

Contributor: Travis Barlock MD Educational Pearls: There are three indications for IV albumin in the ED Spontaneous bacterial peritonitis (SBP) Patients with SBP develop renal failure from volu...

18 Maalis 20242min

Episode 894: DKA and HHS

Episode 894: DKA and HHS

Contributor: Ricky Dhaliwal, MD Educational Pearls: What are DKA and HHS? DKA (Diabetic Ketoacidosis) and HHS (Hyperosmolar Hyperglycemic State) are both acute hyperglycemic states. DKA More com...

11 Maalis 20247min

Episode 893: Home Treatments for Button Battery Ingestion

Episode 893: Home Treatments for Button Battery Ingestion

Contributor: Aaron Lessen MD Educational Pearls: Button batteries cause alkaline corrosion and erosion of the esophagus when swallowed Children swallow button batteries, which create a medical eme...

4 Maalis 20242min

Episode 892: Tourniquets

Episode 892: Tourniquets

Contributor: Ricky Dhaliwal, MD Educational Pearls: What can you do to control bleeding in a penetrating wound? Apply direct pinpoint pressure on the wound as well as proximal to the wound. Build ...

27 Helmi 20245min

Pharmacy Phriday #11: Riddles, Medical Jargon, NNT, and Time Travel

Pharmacy Phriday #11: Riddles, Medical Jargon, NNT, and Time Travel

Contributors: Kali Olson PharmD, Travis Barlock MD, Jeffrey Olson MS2 Summary: In this episode of Pharmacy Phriday, Dr. Kali Olson joins Dr. Travis Barlock and Jeffrey Olson in studio to discuss a var...

23 Helmi 202443min

Episode 891: Hypothermia

Episode 891: Hypothermia

Contributor: Taylor Lynch MD Educational Pearls Hypothermia is defined as a core body temperature less than 35 degrees Celsius or less than 95 degrees Fahrenheit  Mild Hypothermia: 32-35 degrees C...

19 Helmi 20244min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
docemilia
rss-duodecim-lehti
utelias-mieli
radio-antro
filocast-filosofian-perusteet
rss-laakaripodi
rss-sosiopodi
ihanat-ipanat
sotataidon-ytimessa
mielipaivakirja
rss-bios-podcast
rss-radplus
rss-opeklubi
rss-lihavuudesta-podcast