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
They're in the middle of the pack.
You know, I do think it's almost as bad as morphine.
I think morphine is still the worst.
Um, and people you'll see on listservs like what's the creatinine clearance cutoff for using morphine or hydromorphone?
And I think that's kind of a subjective question because it's kinda like a three sided um graph because it depends on how much of the opioid they're getting per day and how bad their renal function is.
So for example,
If I had really bad renal function but I only took morphine five milligrams orally once a day, that's not that big of a deal because even if it takes twenty four hours to get the metabolites out of my body, it's okay.
But if it was taking a higher dose and taking it more frequently, then it becomes more of an issue.
And the same cytomorphone.
Of course.
So we do know that um older adults when you look at differences between older adults and younger people, uh there is a pharmacodynamic difference.
So older adults are more sensitive overall to the effects of the opioid.
Just last week
I recommend a physician asked me for a starting dose of methadone in an opioid naive patient, which we actually do in hospice and it makes a lot of people uncomfortable.
And this doctor started the patient on methadone at zero point five milligrams Q twelve.
And I wrote back and I said, I think we can be a little more aggressive and do one Q twelve.
They emailed me back day two and said, Oh my gosh, it's a miracle.
She's completely pain free.
Wow.
That that's not a good look either though.
Showing 261–280 of 498 · page 14 of 25
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