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Podcast: Emergency Medical Minute
Episode:

Podcast 618: Treating Opiate Side Effects
Category: Science & Medicine
Duration: 00:04:18
Publish Date: 2020-12-01 11:00:00
Description:

Contributor: Don Stader, MD

Educational Pearls:

  • Majority of patients experience side effects while taking opioids
  • Most common include nausea/vomiting, puriitis, constipation; more severe and less common include respiratory depression, addiction and overdose
  • Opiates can cause nausea, but ondansetron (Zofran) is the wrong treatment because it’s not antidopaminergic. Instead consider using metoclopramide (Reglan), olanzapine (Zyprexa), or haloperidol (Haldol)
  • Itching from opiates isn’t histamine mediated so hydroxyzine (Atarax) and diphenhydramine (Benadryl) aren’t effective - oddly ondansetron may help with itching.
  • Constipation is best treated with promotility agents like Senna, rather than stool softeners

References

Rogers E, Mehta S, Shengelia R, Reid MC. Four Strategies for Managing Opioid-Induced Side Effects in Older Adults. Clin Geriatr. 2013 Apr;21(4):  PMID: 25949094; PMCID: PMC4418642.

Farmer AD, Holt CB, Downes TJ, Ruggeri E, Del Vecchio S, De Giorgio R. Pathophysiology, diagnosis, and management of opioid-induced constipation. Lancet Gastroenterol Hepatol. 2018 Mar;3(3):203-212. doi: 10.1016/S2468-1253(18)30008-6. PMID: 29870734.

Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD

The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at www.emergencymedicalminute.com/cme-courses/ and create an account. 
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