Episode 903: Treating Precipitated Opioid Withdrawal

Episode 903: Treating Precipitated Opioid Withdrawal

Contributor: Aaron Lessen MD

Educational Pearls:

  • Opioid overdoses that are reversed with naloxone (Narcan), a mu-opioid antagonist, can precipitate acute withdrawal in some patients

  • Treatment of opioid use disorder with buprenorphine can also precipitate withdrawal

  • Opioid withdrawal symptoms include nausea, vomiting, diarrhea, and agitation

  • Buprenorphine works as a partial agonist at mu-opioid receptors, which may alleviate withdrawal symptoms

    • The preferred dose of buprenorphine is 16 mg

  • Treatment of buprenorphine-induced opioid withdrawal is additional buprenorphine

  • Adjunctive treatments may be used for other opioid withdrawal symptoms

    • Nausea with ondansetron

    • Diarrhea with loperamide

    • Agitation with hydroxyzine

References

1. Quattlebaum THN, Kiyokawa M, Murata KA. A case of buprenorphine-precipitated withdrawal managed with high-dose buprenorphine. Fam Pract. 2022;39(2):292-294. doi:10.1093/fampra/cmab073

2. Spadaro A, Long B, Koyfman A, Perrone J. Buprenorphine precipitated opioid withdrawal: Prevention and management in the ED setting. Am J Emerg Med. 2022;58:22-26. doi:10.1016/j.ajem.2022.05.013

Summarized by Jorge Chalit, OMSII | Edited by Meg Joyce & Jorge Chalit

Episoder(1150)

Episode 964: Ketamine & Midazolam for Prehospital Seizure Management

Episode 964: Ketamine & Midazolam for Prehospital Seizure Management

Contributor: Aaron Lessen, MD Educational Pearls: Prehospital seizures are typically managed with intramuscular midazolam (Versed) Seizures theoretically involve the NMDA pathway, and ketamine is a p...

7 Jul 20254min

Episode 963: Antihypertensives and Emergency Room Considerations

Episode 963: Antihypertensives and Emergency Room Considerations

Contributor: Alec Coston, MD Educational Pearls: For patients presenting to the emergency room with hypertension, clinicians should determine if it is isolated and uncomplicated, or involves comorbidi...

30 Jun 20254min

Episode 962: HEART Score

Episode 962: HEART Score

Contributor: Taylor Lynch, MD Educational Pearls: How do we risk-stratify chest-pain patients? One option is the HEART score This score predicts a patient's 6-week risk of a major adverse cardiac ev...

23 Jun 20254min

Episode 961: Cell Phone Sign

Episode 961: Cell Phone Sign

Contributor: Aaron Lessen, MD Educational Pearls: A prospective study at the Mayo Clinic Rochester was conducted to examine whether patients actively using their phones on initial assessment in the E...

16 Jun 20251min

Episode 960: Frank's Sign - A Marker for Coronary Artery Disease

Episode 960: Frank's Sign - A Marker for Coronary Artery Disease

Contributor: Travis Barlock MD Educational Pearls Frank's sign is a curious physical exam finding first described in the literature in 1973 Bilateral earlobe creases are recognized as a marker of co...

9 Jun 20251min

Episode 959: The KLM Flight Disaster and Lessons in Healthcare Communication

Episode 959: The KLM Flight Disaster and Lessons in Healthcare Communication

Contributor: Taylor Lynch, MD Educational Pearls: The KLM Flight Disaster, also known as the Tenerife Airport Disaster, occurred on 27 March 1977. It involved the collision of two Boeing 747 passenger...

2 Jun 20256min

Episode 958: Intranasal Fentanyl

Episode 958: Intranasal Fentanyl

Contributor: Aaron Lessen, MD Educational Pearls: How do we take care of kids in severe pain? There are many non-pharmacologic options for pain (i.e. ice, elevation) as well as more conventional medi...

26 Mai 20251min

Episode 957: Cardiac Asthma

Episode 957: Cardiac Asthma

Contributor: Travis Barlock, MD Educational Pearls: Wheezing is classically heard in asthma and COPD, but it can be the result of a wide range of processes that cause airflow limitation Narrowed bro...

19 Mai 20253min

Populært innen Vitenskap

fastlegen
rekommandert
jss
tingenes-tilstand
rss-rekommandert
liberal-halvtime
sinnsyn
forskningno
tomprat-med-gunnar-tjomlid
villmarksliv
rss-nysgjerrige-norge
fjellsportpodden
dekodet-2
kvinnehelsepodden
smart-forklart
rss-paradigmepodden
vett-og-vitenskap-med-gaute-einevoll
nevropodden
tidlose-historier
utenrikshospitalet