methadone

aimeee, BSN, RN · Nov 8, 2005

Sounds like you have a story to tell. How about giving us the scenario?

Methadone has a long half life and attention to proper dosing is important. But, as with many other drugs, the side effects can be difficult to separate from the normal dying process. Its not always clear what is causing what.

doodlemom · Nov 9, 2005

i would like to know other hospice nurses experience w/methadone in lung ca. resp depression?? confusion?:angryfire

we use a lot of methadone, but our medical director is extremely well trained in it's use. it can cause confusion and respiratory depression just as other narcotics can. as aimee said, because of it's 1/2 life, it is very important to dose correctly. the doses build up and after a few days, if you're using too much, you will get too much sedation. we start out low and titrate very slowly - like every 4th day. if the patient is already on a long acting, then we start out higher to take them off of the other one - but we have had remarkable results. pt's that have come to us in pain and on all kinds of other meds get relief. i've been amazed at the difference in pain control. i thought that it was just going to save us a bunch of money - which it does, but it actually works better than other narcotics. when titrated slowly, i've seen less side effects than with other narcotics. i've been attending hospice inservices for years and have been hearing how wonderful methadone works, but nobody would instruct on how to dose it. now that we have this medical director that walks us through it, i have seen the difference it makes.

CANRN, MSN, RN · Nov 11, 2005

I just attended a conference today in Columbus Ohio and two sessions I attended were devoted to Methadone. We use it in our Hospice and have for two years now. Our pharmacist and MD are great when it comes to using Methadone and also, found out today, it can be crushed and put directly on painful wounds and it can be mixed with creams (ie Stoma paste) and applied. Don't have all the particulars on this, but I'm excited as I have a patient with a nasty nasty leg wound and I can't wait to get to work tomorrow to discuss the possibility of using it on her. She is in a great deal of pain.

Also, we admitted a patient who was not controlled by his pain meds and he was on huge doses. We changed him to Methadone and he has been staying up and playing cards with his son and grandson! Three weeks ago, he was so snowed he did not know his name!

Also, the pharmiscist that spoke on Methadone stated the increasing the dose of other narcotic drugs does not mean better pain control, actually they can have INCREASED pain. Very informative stuff today!

Methadone is awesome and the more I learn about it, the more I like it!

rosemadder · Jan 18, 2006

LOVE LOVE LOVE Methodone...am so pleased that our Medical Director uses this drug...

mlynn · Jan 19, 2006

Our hospice also uses alot of methadone. Our medical director is great at dosing and we have very good results. Was this patient on ativan? The few bad reactions we have seen were in patients who were also taking ativan.