Mary Lynn McPherson
speaker
498 appearances
2 recordings
1 series
first heard Oct 2018
last heard Dec 2021
Mary Lynn McPherson’s voice in public audio — every appearance, attributed to the second.
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Appearances
No, that's not what I mean.
I'm talking about the the evidence that we have when those clinical trials were done on patients who were at steady state, that data is more reliable in terms of how much do I really need to dose reduce.
But if if it's not and we're looking at data, for example, conversions where we don't have that kind of data, I would be tend to cut back even more.
Well, I think one thing you have to be concerned about is that they've been on this same opiate regimen for a good while and now they're not not responding as well.
You have to give some thought about tolerance.
So that's why when you switch to a different molecule, you really do need to cut back because they're gonna be more sensitive to the new molecule despite doing the math correctly.
I don't think we can necessarily say that either.
I think any time like we what they
The current thinking is we have 25 different kinds of mu receptors, which is crazy, pants.
But maybe in you, oxycodone binds a little bit differently than morphine or than hydromorphone or than hydrocodone.
So it could be a it could be after one dose, for example, or two doses.
You could be short of steady state and still you could have binding differences when you're switching opioids.
all I'm saying is when you're switching from one opioid to another, it's a muddier picture.
than if you were going from IV hydromorphone to oral hydromorphone because once you get the drug into the systemic circulation, hydromorphone is hydromorphone, whether you put it in rectally or IV or orally.
See what I mean?
do your ratio.
Do our
Right.
So let me tell one more thing about four and then we'll do five.
So let's say you're switching from diluted to morphine, for example.
Showing 201–220 of 498 · page 11 of 25
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