AI Snips
Chapters
Transcript
Episode notes
Choose Opioids By Metabolite Clearance
- Check whether the pain syndrome will respond to opioids and whether the opioid's metabolites are renally cleared.
- Avoid morphine and codeine in CKD because active metabolites accumulate and cause toxicity.
Benefits Versus Hidden Harms
- Treating pain is an experiment weighing benefits versus harms for each patient.
- Chronic opioid harm (dependence) can masquerade as ongoing benefit and mislead clinicians.
Avoid Certain Opioids In Advanced CKD
- Avoid morphine, meperidine, codeine and propoxyphene in advanced CKD and dialysis patients.
- Prefer agents without active renally cleared metabolites and be cautious with oral hydromorphone.