Then change to the other opioid using the conversion guide below. Clinicians generally calculate doses for opioid rotation using equianalgesic dose tables, but published data for conversion frequently are inconsistent. The free opioid calculator the calculator provided by remedy health media llc the company, and all information contained therein, is solely for use by trained medical professionals who are experienced in the calculation of doses of opioids based on currently published conversion factors and. Caution is required if opioid dose equivalence tables are used to guide opioid switching, as the administration of a calculated equivalent dose of the replacement opioid may lead to. Gwent guidance on the use of strong opioids in non malignant pain is available at.
Describe how pharmacogenetic differences can effect opioid. Equianalgesic opioid dosing adapted from mcpherson, m. Opioid conversion calculator for morphine equivalents. A guide for effective dosing, second edition, 2018. Metric conversion chart 2 documents tire conversion chart 3 documents dog years chart 2 documents measurements chart 1 documents class attendance sheet 2 documents seating chart template 3 documents sample attendance sheet 7 documents html color code chart 4 documents urine color chart 4 documents color wheel chart 4 documents.
Opioid conversions and opioid dosing calculator disclaimer. Variability in opioid equivalence calculations pain medicine. Transdermal and parenteral fentanyl dosage calculations. Demystifying opioid conversion calculations a guide to effective dosing this title has been archived.
Evaluation and comparison of online equianalgesic opioid. This project aimed to compare and contrast the various online opioid con. A userfriendly guide on opioid conversion calculations. Download free printable opioid conversion chart samples in pdf, word and excel formats. Demystifying opioid conversion calculations, a guide for. Vadod clinical practice guideline for opioid therapy for chronic. Calculate the rescue dose 1020% of tdd based on new daily opioid dose case 1 mj is a 47yearold hispanic female with chronic back pain. The book concentrates on the important mathematical, pharmacokinetic, pharmacodynamic, and patient parameters that a pain medicine clinician needs to safely administer opioids. Therefore the opioid conversion guidelines have been developed to assist when changing opioid drug therapy. Explain opioid conversion and calculation strategies when developing a care plan for patients with chronic pain. Buy the paperback book demystifying opioid conversion calculations. Diagnostic and statistical manual of mental disorders for opioid. Opioid conversion chart 4 free templates in pdf, word.
Divide the 24 hour dose of the equianalgesic dose of the new opioid to determine the unit doses and frequency. This calculator is intended for calculating the morphine equivalent dose med dose for a patient taking one or more opioid medications. Demystifying opioid conversion calculations a guide for effective dosing is a thorough synopsis of opioid pharmacotherapy. In this segment, she speaks to why this is an important skill set for prescribing clinicians, and summarizes. Written in a conversational tone with a splash of humor, the book covers key areas of opioid conversions unlike any other book. American society of healthsystem pharmacists publication date. The mechanisms of analgesia for intrathecal opioids result from a. Differences between transdermal fentanyl and buprenorphine in. Identify important drug interactions that can affect opioid serum levels. Calculate opioid dose adjustments and opioid starting doses. Equianalgesic charts are used for calculation of an equivalent dose a dose which would offer an equal amount of analgesia between different analgesics.
Determine doses when converting a patient from one opioid to another. Against a backdrop of the growing scrutiny of appropriate dosages, this textbook takes a fresh, new approach to helping. Patients may vary in their response to different opioids. Assess patientspecific factors that warrant adjustment to an opioid regimen. A guide for effective dosing by mcpherson, mary lynn created date 8152011 5. The usual method of converting one opioid to another is to. Free shipping and pickup in store on eligible orders. Mary lynn mcpherson, pharmd, ma, mde, bcps, a professor of pharmacy practice and science at the university of maryland school of pharmacy in baltimore, md, has released the second edition of her book, demystifying opioid conversion calculations. There is no universally accepted opioid conversion method, however. An equianalgesic chart is a conversion chart that lists equivalent doses of analgesics drugs used to relieve pain. There are many opioids and many formulations available e. Another proposed model for converting morphine to methadone was presented in 1990 in the form of an algorithm fig. Demystifying opioid conversion calculations 87 n in patients who are not opioidtolerant note. Praised by practitioners, students and instructors for its engaging approach to teaching a very complex subject, demystifying opioid conversion calculations.
The information outlined below is intended as a guide only. Tables of this general type are also available for nsaids, benzodiazepines, depressants, stimulants, anticholinergics and. The morleymakin model directs the clinician to offer a methadone dose equal to 10% of the daily oral morphine dose but not to exceed 30 mg as needed every 3 hours. Calculate the total shortacting opioid ir used in 24 hours convert this total to a longacting opioid 2. Increase the newlyconverted longacting opioid by 50% 3. University of maryland school of pharmacy, baltimore publisher. After 5 days of administration, the total daily methadone doses required on days 4 and 5 are averaged.
Demystifying opioid conversion calculations 87 n in patients who are not opioid tolerant note. Calculating total daily dose of opioids for safer dosage higher dosage, higher risk. Mcpherson, 9781585281985, available at book depository with free delivery worldwide. E4306, 2018, 288 pages praised by practitioners, students and instructors for its engaging approach to teaching a very complex subject, demystifying opioid conversion calculations. Item detail demystifying opioid conversion calculations. Policy gaining expertise with the use of morphine, and other related opioids, for pain management should be the primary goal of those managing pain in the patient with advanced illness. Calculate an opioid starting dose for an opioid naive patient. A guide to effective dosing mcpherson, demystifying opioid conversion calculations by. The equianalgesic conversion ratio for iv to epidural to intrathecal opioids varies depending upon the meningeal permeability of the opioid in question.
Evaluation and comparison of online equianalgesic opioid dose conversion calculators. Prescribing information does not exclude the 12 mcgh tdf patch from this contraindication n in the management of acute pain or in patients who require opioid analgesia for a short period of time n in the management of postoperative pain, including use after outpatient or day. Higher dosages havent been shown to reduce pain over the long term. Table of contents for 9781585281985 demystifying opioid conversion calculations. Ashp ebooks sign in with your ashp username and password to access purchased ebooks in my library. The textbook includes easytofollow case studies, charts, tables and realworld practice examples to give clinicians the principles they need. The conversion of other opioids when on higher doses to methadone should be performed. Use the dosing and conversion chart for opioid analgesics to convert original opioid to an alter. Rennick a, atkinson tj, cimino nm, strassels sa, mcpherson ml, fudin j. Meet mary lynn mcpherson, author of ashps demystifying opioid conversion calculations, who tells us the idea behind her book and how it has helped countless healthcare professionals over the years.
From there, you can view and download your ashp ebooks to the reader of your choice. Use the dosing and conversion chart for opioid analgesics to convert from an oral to iv dose. Request pdf on may 1, 2011, lauren shaiova and others published demystifying opioid conversion calculations, a guide for effective dosing by mary lynn mcpherson find, read and cite all the. It carefully walks clinicians through a fivestep process for performing opioid conversion calculations in the realworld situations they often see. Practical pain management is a remedy health media, llc web property. Opioid conversion table hop16091451 croni ain anaeen tooli calculating total daily doses of opioids is important to appropriately and effectively prescribe, manage, and taper opioid. Despite the lack of evidence, opioid conversion calculations skills while mostly science, still have. Opioid conversion guide these conversions are a guide only.
How lipophilic the drug is, as well as in part by its molecular weight, and possibly structure, affect meningeal permeability. Engage in risky behaviors such as driving while intoxicated or combining opioids with alcohol or. Calculating total daily dose of opioids for safer dosage. This easytounderstand and often humorous book is the most comprehensive todate on opioid calculations for pain management and palliative care. Demystifying opioid conversion calculations by mary lynn m. Convert current opioid to oral morphine equivalents, i. After changing opioid, close assessment should follow and the dose altered as necessary. Similar to morphine, oxycodone is available in a sustained acting preparation oxycodone oxycontin that can be dosed every 12 hours. About europe pmc funders joining europe pmc governance roadmap outreach.
Now in its second edition, this reference is a musthave for clinicians involved in pain management at all levels. Calculate the total daily dose of the original opioid add longacting and rescue doses. After converting from one opioid to another, the derived dose should be used as a starting point. This opioid dose equivalence table is intended for comparison of different opioid and opioid formulations in individual patients or in patient cohorts. Set up conversion ratio between old opioid and route of. Explain opioid conversion and calculation strategies when.
Amer soc of healthsystems pharm, bethesda, md, 2010. It should not be used to determine doses when converting a patient from one opioid to another. Mcpherson has published extensively on the topic of opioid conversion calculations. There is no universally accepted opioid conversion method, however, and there is often significant variability between conversion. Equianalgesic conversion methods are commonly used to switch patients from one opioid to another due to suboptimal pain relief or adverse events. Pain control is a complex process that requires multiple titrations of drug doses over time. Demystifying opioid conversion calculations youtube. Offer pdf demystifying opioid conversion calculations. Further careful titration of the drug will often be required to achieve.
Demystifying opioid conversion calculations new york state. Have you ever wondered if you calculated your patients dosage correctly. Since provid ers and pharmacists often use question able equianalgesic conversion tables or easyaccess opioid conversion calculators as tools for converting opioids, we present an updated comparison. We recommend against opioid doses over 90 mg morphine equivalent. A guide for effective dosing by mary lynn mcpherson at indigo. A guide for effective dosing, has long been the goto guide for learning how to calculate opioid conversions. Higher dosages of opioids are associated with higher risk of overdose and deatheven relatively low dosages 2050 morphine milligram equivalents mme per day increase risk. Demystifying opioid conversion calculations r2 digital. Practical guide for using methadone in pain and palliative care. There are differences in the literature regarding opioid conversion ratios.