Opioids currently NOT approved for epidural or intrathecal use include what?
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LoveBeingHuman:)
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What kind of homework would this be in? I am not in Medical School nor' taking any medical classes, as if my high school even offered that. I am legitimately curious on what opioids are still / aren't allowed to be used due to the growing opioid epidemic. I know that rules have changed drastically.
I'm not exactly sure what you mean by "no longer allowed". The commonly used intrathecal opioid is fentanyl and the ones that can be used for epidurals are fentanyl, hydromorphone and duramorph. Clonidine, though not an opioid can also be used as an adjunct. I wouldn't want to use methadone or any of the crushed pill forms in there. There are papers out there comparing sufentanil and alfentanil as adjuvants in neuraxial anesthesia as well.
There's a difference between over-prescribing pain medications for outpatient use vs using opioids to control pain in the acute setting. OB patients come in screaming from labor pain, we're not not going to prescribe opioids due to concern for it's potential abuse. You treat the pain, if it's legitimate. Same as if you just had surgery, I'm going to write for dilaudid because you just got cut and that's painful and I will treat that pain. Even if the patient has a history of drug abuse, immediately after the operation I will write for opioids to address surgical pain. Now 5 days after, I would be more judicious. Furthermore, the opioids used in neuraxial anesthesia does not contribute to the "high" associated with addiction. Their effects only stay in the area that's covered by the spinal or epidural which is different from injecting it intravascular where the effect is systemic and does contributes to the high and addiction potential.
That clears up my confusion.
Where did you get the idea that the rules have changed to ban the use of certain opioids? Did you hear this from someone or read it somewhere?
Why are you asking this if you are in high school?
mmmcdowe
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I think technically they only fda approved intrathecal opiod for pumps at least is morphine but others are used off label
