A guide for effective dosing mcpherson, mary lynn isbn. This book is a concise, practical guide to the mathematical equations necessary to do opioid drug calculation conversions conversions are explained using a variety of teaching methods. Demystifying opioid conversion calculations a guide for effective dosing is a thorough synopsis of opioid pharmacotherapy. A guide for effective dosing mcpherson, demystifying opioid conversion calculations. Demystifying opioid conversion calculations vii preface writing a book such as this one is like purposely walking around with a bulls eye painted on your forehead.
Request pdf on may 1, 2011, lauren shaiova and others published demystifying opioid conversion calculations, a guide for effective dosing by mary lynn mcpherson find, read and cite all the. Assess patientspecific factors that warrant adjustment to an opioid regimen. Demystifying opioid conversion calculations a guide to effective dosing this title has been archived. Demystifying opioid conversion calculations r2 digital. The pharmacists role in pain management during transitions. Demystifying opioid conversion calculations by mary lynn m. If you ask five experts about a specific opioid conversion calculation, youll probably get fifteen different answers. The emr pcc grants permission to reproduce parts of this publication for clinical and educational use only, provided that the eastern metropolitan region palliative care consortium is. An equianalgesic chart is a conversion chart that lists equivalent doses of analgesics drugs used to relieve pain. Ashp ebooks sign in with your ashp username and password to access purchased ebooks in my library. When switching patients to a different opioid agent, equivalence.
The morleymakin model directs the clinician to offer a methadone dose equal to 10% of the daily oral morphine dose but not to exceed 30 mg as needed every 3 hours. Jun 20, 2014 meet mary lynn mcpherson, author of ashps demystifying opioid conversion calculations, who tells us the idea behind her book and how it has helped countless healthcare professionals over the years. Demystifying opioid conversion calculations, a guide for effective. Individualize the dosage based on assessment and ensure adequate access to breakthrough medication 5. A patient is taking sustainedrelease oxycodone, 100 mg every 12 hours, but has developed intolerable sedation. Tables of this general type are also available for nsaids, benzodiazepines, depressants, stimulants, anticholinergics and. Drug equianalgesic oral dose morphine 30 mg hydromorphone 7. Calculate an opioid starting dose for an opioidnaive patient.
Offer pdf demystifying opioid conversion calculations. Aug 18, 2017 the cdc recommends shortacting opioids for breakthrough pain and, when possible, using the same class of opioid analgesics for longacting pain relief. Nd opioid symposium best practice for safe and effective prescribing legal and liability considerations andrew j. Opioid conversion ratios guide to practice 20 updated as version 2 november 2014 20. The free opioid calculator the calculator provided by remedy health media llc the company, and all information contained therein, is solely for use by trained medical professionals who are experienced in the calculation of doses of opioids based on currently published conversion factors and. Introduction to opioid conversion calculations1 chapter 2 converting among routes and formulations of the same opioid. Survey participants were asked to perform conversion calculations for five preselected opioids to oral morphine equivalent doses. The manufacturer of methadone recommends that opioidnaive patients receive methadone 2.
A guide for effective dosing, has long been the goto guide for learning how to calculate opioid conversions. The collection is divided into two sets with some overlap. When switching patients to a different opioid agent, equivalence tables are used to estimate an equipotent dose of the target opioid. Titration should occur every 4 to 8 days, based on the pharmacokinetic profile and time to reach steadystate plasma levels. From there, you can view and download your ashp ebooks to the reader of your choice. In this segment, she speaks to why this is an important skill set for prescribing clinicians, and summarizes.
Determine doses when converting a patient from one opioid to another. A guide for effective dosing by mcpherson, mary lynn created date 8152011 5. Update to demystifying opioid conversion calculations. Gwent guidance on the use of strong opioids in non malignant pain is available at. One invaluable tool is the stepbystep examples for the very challenging methadone, fentanyl, pca, and neuraxial opioid therapy conversions, which help. Metric conversion chart 2 documents tire conversion chart 3 documents dog years chart 2 documents measurements chart 1 documents class attendance sheet 2 documents seating chart template 3 documents sample attendance sheet 7 documents html color code chart 4 documents urine color chart 4 documents color wheel chart 4 documents. Describe how pharmacogenetic differences can effect opioid. It carefully walks clinicians through a fivestep process for performing opioid conversion calculations in the realworld situations they often see. Download for offline reading, highlight, bookmark or take notes while you read demystifying opioid conversion calculations. Research offcampus without worrying about access issues. The conversion of other opioids when on higher doses to methadone should be.
In most patients, morphine is the favored drug, however. Conversion from one extended releaselong acting opioid to another may be necessary. Evaluation and comparison of online equianalgesic opioid dose. Table of contents for 9781585281985 demystifying opioid conversion calculations. Practical guide for using methadone in pain and palliative care. Best practice for safe and effective prescribing legal and liability considerations author. Calculating total daily dose of opioids for safer dosage. Opioid conversions and opioid dosing calculator disclaimer. Mcpherson, 9781585281985, available at book depository with free delivery worldwide. It should not be used to determine doses when converting a patient from one opioid to another. This easytounderstand and often humorous book is the most comprehensive todate on opioid calculations for pain management and palliative care. Since we used the same reference tables to compare all. Steps and methods for the conversions of various opioids are provided.
Meet mary lynn mcpherson, author of ashps demystifying opioid conversion calculations, who tells us the idea behind her book and how it has helped countless healthcare professionals over the years. After 5 days of administration, the total daily methadone doses required on days 4 and 5 are averaged. Praised by practitioners, students and instructors for its engaging approach to teaching a very complex subject, demystifying opioid conversion calculations. To reduce the risk of unintentional overdose, the conversion ratio calculated for a patient undergoing opioid rotation should be adjusted based on clinical. A guide to effective dosing mcpherson,demystifying opioid conversion calculations by. Starting dose will range from 75 mcg once daily or every 12 hours to 300 mcg every 12 hours depending on the patients prior opioid experience and risk for abuse potential. University of maryland school of pharmacy, baltimore publisher. Demystifying opioid conversion calculations, 2nd edition, is designed to help practitioners including pharmacists, physicians, nurses, and others develop a high level of skill in performing the required mathematical calculations associated with opioid conversions, plus the confidence to safely and effectively manage their patients needs for. Use the dosing and conversion chart for opioid analgesics to convert original opioid to an alter. Equianalgesic charts are used for calculation of an equivalent dose a dose which would offer an equal amount of analgesia between different analgesics. Equianalgesic opioid dosing adapted from mcpherson, m. Demystifying opioid conversion calculations new york state. Divide the 24 hour dose of the equianalgesic dose of the new opioid to determine the unit doses and frequency.
Calculate the total daily dose of the original opioid add longacting and rescue doses. After converting from one opioid to another, the derived dose should be used as a starting point. Since provid ers and pharmacists often use question able equianalgesic conversion tables or easyaccess opioid conversion calculators as tools for converting opioids, we present an updated comparison. Ashp ebooks can be read online or downloaded as pdf or epub files. Similar to morphine, oxycodone is available in a sustained acting preparation oxycodone oxycontin that can be dosed every 12 hours. Opioid conversion table hop16091451 croni ain anaeen tooli calculating total daily doses of opioids is important to appropriately and effectively prescribe, manage, and taper opioid. Demystifying opioid conversion calculations, a guide for effective dosing by mary lynn mcpherson. Higher dosages of opioids are associated with higher risk of overdose and deatheven relatively low dosages 2050 morphine milligram equivalents mme per day increase risk.
She would like to try an immediaterelease opioid agent, hydromorphone. Practical pain management is a remedy health media, llc web property. This project aimed to compare and contrast the various online opioid con. Correlation between 24hour predischarge opioid use and. We performed manual calculations referencing the opioid analgesic comparison tables sanctioned by the american pain society guidelines and pereira et al. Intrathecal infusional therapies for intractable pain. Higher dosages havent been shown to reduce pain over the long term.
This calculator is intended for calculating the morphine equivalent dose med dose for a patient taking one or more opioid medications. Calculating total daily dose of opioids for safer dosage higher dosage, higher risk. Mcpherson has published extensively on the topic of opioid conversion calculations. A guide for effective dosing ebook written by mary lynn mcpherson. Best practice for safe and effective prescribing legal and liability considerations andrew j. Another proposed model for converting morphine to methadone was presented in 1990 in the form of an algorithm fig. Despite the lack of evidence, opioid conversion calculations skills while mostly science, still have. Demystifying opioid conversion calculations r2 digital library. Variability in opioid equivalence calculations pain medicine. Aug 24, 2009 demystifying opioid conversion calculations. Further careful titration of the drug will often be required to achieve.
Identify important drug interactions that can affect opioid serum levels. A guide to effective dosing mcpherson, demystifying opioid conversion calculations by. Calculate opioid dose adjustments and opioid starting doses. Opioid rotation basic consideration reasons for rotation. However, it is common for patients in a community hospital setting who are candidates for methadone therapy to be rotating from another opioid and not opioidnaive. Demystifying opioid conversion calculations, a guide for. Use the dosing and conversion chart for opioid analgesics to convert from an oral to iv dose. American society of healthsystem pharmacists publication date. Evaluation and comparison of online equianalgesic opioid.
Opioid switching using equivalence tables page 1 of 5. Best practice for safe and effective prescribing legal and. A guide to effective dosing am j hosp palliat care june 2011 vol. Now in its second edition, this reference is a musthave for clinicians involved in pain management at all levels. Demystifying opioid conversion calculations youtube. Explain opioid conversion and calculation strategies when developing a care plan for patients with chronic pain. Pain control is a complex process that requires multiple titrations of drug doses over time. Opioid conversion calculator for morphine equivalents. However, variation among patients in bioavailability of. Explain opioid conversion and calculation strategies when. Opioid switching using equivalence tables home saskatchewan. Establish frequent patient follow up and reassessment 11 mcpherson, mary lynn demystifying opioid conversion calculation. How to bring out the best in people at their worst by rick kirschner, rick brinkman. A guide for effective dosing, 2nd edition mary lynn mcpherson.
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