MTD and myelography

Started by Mister Mxyzptlk
This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Get help with your application

Use all the free resources available to you from SDN: articles, guides, expert advising, forums discussions, and school research.

Browse articles Compare schools My application plan Read Interview Feedback
Practice for interviews Ask an Advisor
Mister Mxyzptlk

Mister Mxyzptlk

Full Member
20+ Year Member
Advertisement - Members don't see this ad
Just had a patient turned down for CT-myelo because of methadone intake. They want her weaned off before they will do the procedure. I am unaware of problems with contrast and methadone, and couldn't find anything online.
 
gorback said:
Just had a patient turned down for CT-myelo because of methadone intake. They want her weaned off before they will do the procedure. I am unaware of problems with contrast and methadone, and couldn't find anything online.
Click to expand...



never heard of it either....what reason did they give?
 
Advertisement - Members don't see this ad
Most radiologists are creatures of habit without much thought going into the process. The expansive lists of things that people must discontinue because of theoretical risk due to a drug interaction demonstrates the technician rather than physician component of the performance of myelography. Neurontin is also on the list along with a hundred other commonly taken drugs, whose withdrawal may cause significant side effects. Sometimes calling them and discussing these issues reveal the reasons for the lack of weighing the risk/benefits of drug withdrawal, and usually it is because these were published by some academic institution as a cautionary document, but ultimately became codified as law in the small city hospital's radiology department.
 
I spoke with the radiologist and she said since MTD can lower seizure threshold it's on the list of drugs to discontinue. You'd think the patient was on picrotoxin.

I told her I couldn't find a single report of methadone causing seizures after a myelogram.

She said all we need to do is have the pt off MTD for a day before and a day after the procedure. I mentioned that MTD hangs around a bit and that I doubt she will have no MTD in her system after one day. That flustered her a bit.

She reluctantly agreed to do the test "if I really need it" (I routinely order tests that I don't need - doesn't everybody?).
 
DUDE

this is your opening... you tell the patient they need a CT-myelo... that you need to wean them off methadone...

you get two birds with one stone: 1) CT-Myelo results 2) OFF narcotics...

i think the radiologist is doing you a favor!
 
You must log in or register to reply here.