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

Avsnitt(1145)

Podcast 716: Resuscitation Fluids

Podcast 716: Resuscitation Fluids

Contributor: Nick Tsipis, MD Educational Pearls: Fluid choice may have an impact on outcomes in resuscitation, and a meta-analysis has relevant insight into their use in sepsis and trauma patients La...

29 Sep 20214min

Podcast 715: Heated High Flow O2

Podcast 715: Heated High Flow O2

Contributor: Nick Hatch, MD Educational Pearls: High flow nasal cannula (HFNC) or "heated high flow" can deliver higher oxygen levels than nasal cannula It typically is used as an "intermediate" betw...

27 Sep 20214min

Podcast 714: Intradermal Sterile Water for Back Pain

Podcast 714: Intradermal Sterile Water for Back Pain

Contributor: Aaron Lessen, MD Educational Pearls: Randomized controlled-trial evaluated intradermal injections of sterile water to manage low back pain versus an IV NSAID Four intradermal injections ...

21 Sep 20213min

Podcast 713: Oral Ketamine

Podcast 713: Oral Ketamine

Contributor: Don Stader, MD Educational Pearls: Those on chronic opioid therapy may have high tolerance to opioids and/or opioid hyperalgesia Ketamine is a good adjunct for pain control in patients o...

20 Sep 20213min

Podcast 712: Cephalosporin with a Penicillin Allergy

Podcast 712: Cephalosporin with a Penicillin Allergy

Contributor: Aaron Lessen, MD Educational Pearls: Retrospective cohort study in the Kaiser system looked at over 4 million patients receiving antibiotics to determine the effect of penicillin allergy...

13 Sep 20213min

On the Streets #10: IO Administration Gone Awry

On the Streets #10: IO Administration Gone Awry

Dr. Glenda Quan, trauma surgeon from Swedish Medical Center joins our host Jordan Ourada to review a case of an incorrectly placed IO and how to avoid it. The Emergency Medical Minute is excited to an...

8 Sep 202115min

Podcast 711: Insulin Pumps

Podcast 711: Insulin Pumps

Contributor: Aaron Lessen, MD Educational Pearls: Insulin pumps provide a continuous infusion of fast-acting insulin using a basal rate and bolus prior to meals Some connect to a continuous glucomete...

7 Sep 20214min

Podcast 710: Droperidol vs. Zyprexa

Podcast 710: Droperidol vs. Zyprexa

Contributor: Nick Tsipis, MD Educational Pearls: Prospective trial studied 5 mg IM droperidol to 10 mg IM olanzapine (Zyprexa) in the reducing levels of agitation Time to adequate sedation was about ...

31 Aug 20215min

Populärt inom Vetenskap

p3-dystopia
dumma-manniskor
svd-nyhetsartiklar
allt-du-velat-veta
kapitalet-en-podd-om-ekonomi
det-morka-psyket
pojkmottagningen
dumforklarat
rss-vetenskapsradion-2
halsorevolutionen
rss-vetenskapsradion
rss-ufo-bortom-rimligt-tvivel
sexet
rss-spraket
rss-experimentet
rss-broccolipodden-en-podcast-som-inte-handlar-om-broccoli
medicinvetarna
vetenskapsradion
rss-arkeologi-historia-podden-som-graver-i-vart-kulturlandskap
bildningspodden