Opioids Part 4 – Methadone and Buprenorphine

In this episode of Real Life Pharmacology, we’re taking a closer look at two unique opioids: methadone and buprenorphine. Both medications have important roles in pain management and opioid use disorder, but their pharmacology, dosing, drug interactions, and safety considerations are quite different. We’ll review the key clinical pearls you need to know when using these medications in real-world practice.

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Opioids Part 3 – Test Prep and Practice Pearls – Codeine and Fentanyl

On this podcast episode, we will explore the most important practice pearls of codeine and fentanyl. Both medications are opioids, but codeine is frequently found in combination with acetaminophen. Fentanyl has numerous unique dosage forms, including the transdermal formulation which is a source of frequent test questions. I break these two medications down in this podcast episode.

Opioids Part 2 – Test Prep and Practice Pearls

In Part 2 of my series on opioids, I cover hydromorphone, oxycodone, and oxymorphone. Hydromorphone and oxycodone are two opioids that are used frequently in clinical practice, and I will discuss what makes them unique, in addition to numerous other practice pearls and test prep nuggets. Enjoy the podcast and be sure to share it with friends, colleagues, and students!

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Opioids Part 1 – Test Prep and Practice Pearls

On part 1 of opioids, I’ll discuss morphine, morphine equivalents, conversion, and hydrocodone. The pharmacokinetic differences will be important between opioids, as well as the dosage forms. I hope you enjoy this podcast episode and share it with your friends!

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Top 200 Drugs – Medications 181-185

On this Real Life Pharmacology Podcast episode, we cover medications 181-185.

Proscar is the brand name for finasteride. This medication can be helpful in shrinking the size of the prostate but it does typically take a while to work (months).

Sinemet is a combination of carbidopa and levodopa. Levodopa is converted in the central nervous system to dopamine to help alleviate a shortage of dopamine in the brain.

Risedronate is a bisphosphonate medication that can be used in the treatment of osteoporosis.

Albuterol (Ventolin) is a short-acting beta-agonist that is used to relieve symptoms of acute respiratory distress most often associated with an asthma exacerbation.

Tramadol is classified as an opioid analgesic. It also has activity similar to SNRIs as it has the ability to increase serotonin and norepinephrine in the brain.

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Methadone Pharmacology Podcast

In this podcast episode, I discuss methadone pharmacology, adverse effects, drug interactions, and pharmacokinetics.

Methadone is a full opioid agonist that may be used for pain management and opioid use disorder.

Transitioning from methadone to another opioid is complicated. I discuss conversion in this podcast episode.

Methadone can increase the risk of QTc prolongation and also has a lot of drug interactions. I discuss them in detail in this podcast episode.

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Meperidine Pharmacology Podcast

On this podcast episode, I discuss meperidine pharmacology, adverse effects, pharmacokinetics, drug interactions, and much more!

Meperidine is an opioid that is seldom used due to neurotoxicity. I describe how this can happen in this podcast episode.

Meperidine has numerous drug interactions and using a CYP3A4 inhibitor may increase the risk for toxicity.

Seizures are a risk with meperidine due to its neurotoxic metabolite normeperidine. I discuss this further in this podcast episode.

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Oxymorphone Pharmacology Podcast

In this episode, I discuss oxymorphone pharmacology, adverse effects, drug interactions, and more!

Oxymorphone is approximately 3 times more potent than morphine. I break down some common opioid comparisons in this episode.

Oxymorphone avoids many of the CYP interactions. I discuss some of the common interactions in this episode.

I discuss histamine release in relation to opioids and oxymorphone and specifically how this may impact our patients.

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Hydromorphone Pharmacology

On this episode, I discuss hydromorphone pharmacology, adverse effect, and drug interactions.

I discuss the pharmacokinetics of hydromorphone and also discuss the relative potency compared to other opioids.

Hydromorphone drug interactions are mostly additive effects. Drugs that cause sedation or constipation can have additive effects on hydromorphone.

Be extremely careful with hydromorphone dosage forms. There are numerous different concentrations and strengths. I discuss this in this episode.

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Naloxone Pharmacology

Naloxone is a life saving drug that can help manage an opioid overdose situation.

Naloxone blocks opioids receptors so opioid agonists cannot bind there.

One of the biggest risks with opioid overdose includes respiratory depression. Naloxone can help reduce the risk of this if administered in a timely manner.

IV naloxone will have the quickest physiological onset of action, but nasal naloxone may be the best opportunity in the community to get this drug on board quickly.

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