Methadone restlessness

[litbitblack, ASN, RN]

I have noticed an increase in restlessness and jerking in my hospice pt who is end stage lung ca. He was previously on OxyContin 20 q 12 and oxy ir 30 qid prn.before admitting to hospice his OxyContin had been increased to 40 bid and he was severely nauseated with poor pain control. So methadone 5 me q8 hrs was started with oxy ir qid,Xanax 1mg q2hrs and atropine q2 hrs. He seems to be very restless after the methadone is given so much so that his resp increase. Anyone else have problems with methadone?

[Nashvillejeanne]

Methadone is tricky due to the long half life. Work closely with your Medical Director or a Pharmacist trained in palliative care. Try to stay in the same drug family when possible to decrease side effects.