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Methadone pain medications is an effective opioid analgesic for severe ongoing pain. Because of low cost and apparent efficacy in complex pain syndromes, it is increasing used as a first line opioid. Retrospective analyses of consecutive patients initiated on methadone 10mg in an outpatient palliative care clinic confirm safety and effectiveness.
It is, in effect, combination drug part opioid and part NMDA receptor antagonist, although there is yet to be any evidence from controlled trials that it is a superior first-line analgesic to other opioids.
The Methods of dose conversion to methadone 10mg medications from other opioid analgesics that account for its dual action were discussed. The Fast Fact will described strategies for beginning methadone pills when the patient has not been taking a strong opioid pills.
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Pharmacology: Methadone 10mg is lipophilic, thus it takes time to developed tissue stores that maintain serum levels. After a single dosage there is a short distribution phase (associated with acute pain relief) with a half life of 3 hours and a slow elimination phase (60 hours). Dosage must account for the accumulation of drugs over days. It is this accumulation that account for most therapeutic misadventures.
Liver metabolites are inactive; therefore no dosage reduction is require with renal failure. After steady states is reached, about two-thirds of patient will get adequate pain relief with twice a day dose. Note: A number of drugs will alter methadone 10mg metabolism, so there needs to be close follow-up to drugs interactions.
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There are several approaches to starting methadone medicines for the treatment of body pain. All take into account the long-half life of the drugs that leads to drug accumulation over days. Physicians are feeling the heat over the highly publicized (national public health) crisis stemming from overprescribed oxycodone for non-cancer chronic pain.
One result has been a huge shift to using methadone 10mg for that indication. Methadone medications is a widely perceived as an attractive alternative to oxycodone because it’s less euphoria-inducing and thus, somewhat less prone to abuse, as well as less expensive.
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