Emergency Medical Minute1 Des 2020

Podcast 618: Treating Opiate Side Effects

Contributor: Don Stader, MD

Educational Pearls:

Majority of patients experience side effects while taking opioids
Most common include nausea/vomiting, puriitis, constipation; more severe and less common include respiratory depression, addiction and overdose
Opiates can cause nausea, but ondansetron (Zofran) is the wrong treatment because it's not antidopaminergic. Instead consider using metoclopramide (Reglan), olanzapine (Zyprexa), or haloperidol (Haldol)
Itching from opiates isn't histamine mediated so hydroxyzine (Atarax) and diphenhydramine (Benadryl) aren't effective - oddly ondansetron may help with itching.
Constipation is best treated with promotility agents like Senna, rather than stool softeners

References

Rogers E, Mehta S, Shengelia R, Reid MC. Four Strategies for Managing Opioid-Induced Side Effects in Older Adults. Clin Geriatr. 2013 Apr;21(4): PMID: 25949094; PMCID: PMC4418642.

Farmer AD, Holt CB, Downes TJ, Ruggeri E, Del Vecchio S, De Giorgio R. Pathophysiology, diagnosis, and management of opioid-induced constipation. Lancet Gastroenterol Hepatol. 2018 Mar;3(3):203-212. doi: 10.1016/S2468-1253(18)30008-6. PMID: 29870734.

Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD

The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at www.emergencymedicalminute.com/cme-courses/ and create an account.

Denne episoden er hentet fra en åpen RSS-feed og er ikke publisert av Podme. Den kan derfor inneholde annonser.

Episoder(1177)

Podcast 1022: Emergent Dialysis

Contributor: Taylor Lynch, MD Educational Pearls: When a patient who missed dialysis presents to the emergency department, our clinical concern is who needs to be admitted to the hospital for emerge...

21 Sep 4min

Podcast 1021: Pulmonary Edema From Naloxone Administration

Contributor: Travis Barlock, MD Educational Pearls: What is pulmonary edema? Pulmonary edema is the accumulation of fluid initially in the interstitium of the lungs, that when severe enough can als...

14 Sep 4min

Podcast 1020: Benign Paroxysmal Positional Vertigo (BPPV)

Contributor: Alec Coston, MD Educational Pearls: Benign Paroxysmal Positional Vertigo (BPPV) Common inner ear condition that can cause dizziness Diagnosis of BPPV can help to avoid admissions and ...

7 Sep 6min

Podcast 1019: Trauma Blunt Cardiovascular Injuries (BCVI)

Contributor: Aaron Lessen, MD Educational Pearls: Blunt cerebrovascular injury (BCVI) BCVI is a traumatic injury to the carotid or vertebral arteries Patients may initially have no neurologic sy...

31 Aug 3min

Podcast 1018: Occult Ventricular Fibrillation on Echocardiography

Contributor: Aaron Lessen, MD Educational Pearls: Big question in cardiac arrest: is the rhythm shockable? Shockable: ventricular fibrillation (VF) and pulseless ventricular tachycardia Non-sho...

24 Aug 2min

Podcast 1017: CPR Hand Placement

Contributor: Taylor Lynch, MD Educational Pearls: CPR is an important life-saving measure designed for anyone to perform. Chest compressions works by two mechanisms: Cardiac pump: Direct squ...

17 Aug 2min

Podcast 1016: Hypokalemia

Contributor: Meghan Hurley, MD Educational Pearls: What is hypokalemia? Hypokalemia is when the measured blood level of potassium falls below 3.5 mEq/L (normal 3.5 - 5.2 mEq/L). Can generally be ...

10 Aug 6min

Podcast 1015: Calcium in Hyperkalemia

Contributor: Meghan Hurley, MD Educational Pearls: What is hyperkalemia? Hyperkalemia is when the measured blood level of potassium reaches above 5.2 - 5.5 mEq/L (normal 3.5 - 5.2 mEq/L). What ar...

3 Aug 7min