Discover and read the best of Twitter Threads about #pallcare
Most recents (2)
(1/n) Pain management is far from easy, and having chronic kidney disease only complicates things. Let’s take a quick look at the effects pain has on the kidney population, and what we can do about it!
#tweetorial #NephTwitter #pallcare
#tweetorial #NephTwitter #pallcare
(2/n) Pain has a prevalence of 60% in the CKD population, 2-3x that of the general population!
It leads to:
⬆️ Depression and Insomnia
⬆️ Withdrawal From Dialysis
⬆️ Hospital Visits
⬇️ Health Related QOL
⬇️ Social Support
⬇️ Life Satisfaction
It leads to:
⬆️ Depression and Insomnia
⬆️ Withdrawal From Dialysis
⬆️ Hospital Visits
⬇️ Health Related QOL
⬇️ Social Support
⬇️ Life Satisfaction
(3/n) A H&P qualifies pain and chronicity, but every pain discussion should discuss expectations. To set expectations you need to
🔴 Determine a pain level that would be tolerable
🔴 Come up with a tentative duration of treatment
🔴 Discuss risk and benefits of treatment
🔴 Determine a pain level that would be tolerable
🔴 Come up with a tentative duration of treatment
🔴 Discuss risk and benefits of treatment
OLWLT🗣 MICU edition @HeavnerPharmD
Always have to keep an👁on💩movements in MICU patients esp w/↗️doses of opioids used for sedation😴➕pain🩹
Methylnaltrexone➡️mu-receptor antagonist🛑➡️used for refractory OIC
Very💰agent&dosing based on BW in obese can lead to↗️↗️drug cost‼️
Always have to keep an👁on💩movements in MICU patients esp w/↗️doses of opioids used for sedation😴➕pain🩹
Methylnaltrexone➡️mu-receptor antagonist🛑➡️used for refractory OIC
Very💰agent&dosing based on BW in obese can lead to↗️↗️drug cost‼️
On rounds, our pt would’ve required 1 + 1/2 12 mg vials BUT we 🤔 💭 to look up if fixed doses in obesity (>130kg)= similar efficacy
ncbi.nlm.nih.gov/pmc/articles/P…
This study found ICU pts >62 kg responded to 12mg FIXED dose (1 vial)>62kg & efficacy maintained when BW >114 kg! 👏👍
ncbi.nlm.nih.gov/pmc/articles/P…
This study found ICU pts >62 kg responded to 12mg FIXED dose (1 vial)>62kg & efficacy maintained when BW >114 kg! 👏👍
Responses (I.e 💩) were observed within4️⃣hours! And ADEs including abdominal pain were LOWER compared to placebo 🤩
Bottom line➡️ constipation REFRACTORY to senna, miralax, & suppository/enema➡️try methynaltrexone!
In pts >62 kg fixed dose 12mg is a💰saving initiative!
Bottom line➡️ constipation REFRACTORY to senna, miralax, & suppository/enema➡️try methynaltrexone!
In pts >62 kg fixed dose 12mg is a💰saving initiative!
