Dopesick
Not really my realm, but you all watching this? What are your impressions?
I very much remember the pervasiveness of drug reps in children's hospitals in the early 2000s (I still have my green Ceftriaxone pen) and very much remember MS Contin, but again, I don't do adult so my experience and recall is limited... (Source: Student Doctor Network)
Source: Student Doctor Network - October 24, 2021 Category: Universities & Medical Training Authors: SurfingDoctor Tags: Pain Medicine Source Type: forums
Is the whole concept of MME's pharmacologically unsound? Implications for pain...
Should pain MD's be commanding "Show me the data" on MME conversion?
Comments to the FDA: Opioid Dosing Based on Milligram Morphine Equivalents Is Unscientific
The following comments will be submitted to the FDA. I will demonstrate why the Morphine Milligram Equivalent (MME) conversion chart, the main pillar of the CDC 2016 Prescribing Guidelines, is deeply flawed. Hence, all opioid policies are based on MMEs are likewise invalid, yet they continue to...
www.acsh.org
&q...
Source: Student Doctor Network - May 25, 2021 Category: Universities & Medical Training Authors: drusso Tags: Pain Medicine Source Type: forums
Low spinals in c-sections
We are getting fairly frequent low spinals at my shop. Probably several a month in L&D. I thought it may have been a bad batch of bupi but now it’s been going on for several years. How frequently do you see this in OB? What do you think is the cause? I noticed our CRNAs tend to under dose spinals 1.2-1.4 bupi with fent/morphine vs 1.6 is what I trained on. Also noticing a real lack of urgency to get the patient supine (excess time cleaning back/pulling down drape ect ). Not sure the...
Read more (Source: Student Doctor Network)
Source: Student Doctor Network - March 4, 2021 Category: Universities & Medical Training Authors: castafari Tags: Anesthesiology Source Type: forums
IV fentanyl conversion
Do any of you have a conversion factor for IV fentanyl to oral morphine equivalents?
I was able to find a couple but they are not consistent so I figured I'd ask the board. (Source: Student Doctor Network)
Source: Student Doctor Network - March 3, 2021 Category: Universities & Medical Training Authors: GottaHaveIt Tags: Pain Medicine Source Type: forums
Morphine question.
For a 80kg previously healthy service member. Who during theater was just shot in the mandible and shot on the right side of his chest.
What is considered a hefty dosage of morphine to give him. In order to relieve his pain and anxiety. Without going overboard? (Source: Student Doctor Network)
Source: Student Doctor Network - February 5, 2021 Category: Universities & Medical Training Authors: mjl1717 Tags: Pharmacy Source Type: forums
Abdominal pain in women
Alright, 6 months out and this one keeps getting me extended LOS and honestly when I get 2 or 3 at a time it seems like my cognitive load capacity is just depleted. Had two tonight. Young women, present in agonizing pain. Maybe a little tacky, maybe not. Tender belly. Improve with morphine. CT neg. Labs pretty much normal, maybe a mildly bumped WBC or some other nonspecific finding. Normal UA, preg neg. US comes back neg. Still tearful in bed saying they are dying. Seems like I just can't...
Read more (Source: Student Doctor Network)
Source: Student Doctor Network - December 24, 2020 Category: Universities & Medical Training Authors: wareagle726 Tags: Emergency Medicine Source Type: forums
Silly questions
Hey
I do some locums in some smaller places when all ive worked at is ivory towers til now...
They dont have all the equipment and meds etc freely available that other places have
Just simple things
So...
They dont easily have 1 ml syringes. Is it ok to use 2 or 3ml syringes to draw up narcotic for intrathecal use like it morphine? I usually use 15 mcg fent and 150 mcg epimorph for spinals
The also don't have glass vials for fent/epimorp so to draw up IT meds you have to push thru a...
Read more (Source: Student Doctor Network)
Source: Student Doctor Network - November 19, 2020 Category: Universities & Medical Training Authors: Newtwo Tags: Anesthesiology Source Type: forums
Pain Management Advice?
Current 4th year med student on an audition rotation in EM. Seems like it should be simple but for some reason I'm having issues when it comes to deciding which pain medications to order for my patients. Tylenol/NSAIDs seem like a safe bet and simple choice most of the time, but choosing when to jump to Norco/Morphine/Fentanyl/etc. and which one to choose at the time seems to be tripping me up. For some reason I feel hesitant to as I'm nervous about overmedicating the patient. Does anyone...
Pain Management Advice? (Source: Student Doctor Network)
Source: Student Doctor Network - November 1, 2020 Category: Universities & Medical Training Authors: Pokedoc Tags: Emergency Medicine Source Type: forums
intrathecal morphine induced hypothermia
Y'all ever seen this? Interesting case this last month. Healthy g1p0 undergoing elective cesarean. Standard spinal dose of 12mg but, 200mcg duramorph, 10mcg feet, and 100mcg epi. Not acute issues during the procedure. In the pacu, pt's temperature drops to 94-95 degrees F and remains there despite forced air warming gown/blanket thingy, warmed fluids etc. Pt's temp eventually returned to normal after several hours. The pt stated she felt fine throughout the ordeal and was not shivering at all. (Source: Student Doctor Network)
Source: Student Doctor Network - September 2, 2020 Category: Universities & Medical Training Authors: MirrorTodd Tags: Anesthesiology Source Type: forums
avoiding opioid use in cancer surgery
Some of my colleagues have been avoiding opioids altogether (and using ketamine) for cancer surgery, based on some animal and in-vitro studies showing that opioids may lead to immunosuppression of protective mechanisms and may increase risk of cancer recurrence. From what I've read it is mostly with morphine and there has not been any RCTs performed for this.
I haven't jumped on the bandwagon on this. Most of the attendings here like to use remi for head and neck, other surgeries where...
avoiding opioid use in cancer surgery (Source: Student Doctor Network)
Source: Student Doctor Network - January 17, 2020 Category: Universities & Medical Training Authors: eikenhein Tags: Anesthesiology Source Type: forums
Holy trinity-would you put your name on this?
Not a pharmacist, but I’ve been a tech for the past five years while completing my undergrad, and I’m starting med school this July.
While home for the summer, I was filling at my local (chain) store. At work today, I received a script for Vicodin 10. After looking at their recent fills, I noticed they were also getting morphine IR 30, klonopin 0.5, and soma 350 for the past several months. I pointed it out to my pic, and she said to just continue to fill as is.
Forces notes stated...
Holy trinity-would you put your name on this? (Source: Student Doctor Network)
Source: Student Doctor Network - June 28, 2019 Category: Universities & Medical Training Authors: pharmchica15 Tags: Pharmacy Source Type: forums
DEA Raids Arizona Naturopathic Pain Clinic
DEA raids Tempe pain management clinic, 2 arrested
Authorities say two employees at a pain management clinic were arrested Thursday in a raid involving federal agents.
www.abc15.com
"The DEA identified the two suspects Friday as Naturopathic Medical Doctor Jelina Ip and her mother, Alane Ip. The two are accused of over-prescribing controlled substances, including oxycodone and morphine. The Ips face dozens of criminal charges including fraud schemes, illegally conducting an enterprise, illegal administration of a narcotic...
DEA Raids Arizona...
Source: Student Doctor Network - April 21, 2019 Category: Universities & Medical Training Authors: drusso Tags: Pain Medicine Source Type: forums
Opioid Shortages
Opioid shortages leave US hospitals scrambling - CNN
Does anyone else's hospital have this problem? We've been out of dilaudid for over a month now and are critically low on fentanyl, morphine, and ketamine. Many of us are moving onto IV methadone, demerol, alfentanil... (Source: Student Doctor Network)
Source: Student Doctor Network - April 1, 2018 Category: Universities & Medical Training Authors: banister Source Type: forums
Intrathecal AND epidural morphine for C/S
A colleague of mine inserted CSE with Bupi + 0.2mg Morphine intrathecal. Then this same colleague gave 3mg morphine through epidural right at the end of case. Attending flipped out when he found out. Wanted MICU consult, etc. Patient fine but experienced vomiting in PACU despite zofran, dex etc. thoughts? (Source: Student Doctor Network)
Source: Student Doctor Network - November 15, 2017 Category: Universities & Medical Training Authors: User21218 Source Type: forums
Fentanyl
fentanyl deaths rising, but "experts say no one is paying close enough attention." fentanyl is 50-100x more potent than morphine, and u add oxycodone to the mix. its amazing how ppl on here are defending these deadly combo.
Fentanyl deaths rising in Central Texas, going untracked (Source: Student Doctor Network)
Source: Student Doctor Network - September 18, 2017 Category: Universities & Medical Training Authors: sosoo Source Type: forums
