Mary Lynn McPherson

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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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GeriPal - A Geriatrics and Palliative Medicine Podcast · All the Questions You Had About Opioids But Were Afraid To Ask: A Podcast with Mary Lynn McPherson · 5 Oct 2018 podcast

My table looked very similar to the tables that are still out there today, where you would say, for example, that one and a half milligrams of IV hydromorphonus, seven and a half milligrams oral, which is thirty milligrams of oral morphine.

So if you went from IV dilotid to oromorphine, you would multiply by twenty.

That was based on single dose, acute pain, crossover trials, mostly in healthy normal people.

So there's most of the tables that are out there do not account for

Patients young, the patient's old.

The patient's in the pink of health, the patient is sick.

They're skinny, they're fluffy.

It takes no account um patient specific variables, I would say.

But now we do have some data that's starting to emerge.

So uh Dr.

Akilah Reddy from MD Anderson has done several studies looking at IV hydromorphone to oral opioids.

She's looked at hydrocodone to morphine more carefully, transnermal fentanyl.

So this data is finally starting to come out.

But

It still requires caution in using these charts.

If you read the book, you remember the line where I said, Using one of these charts is like giving you a ticket to the ballpark, but you still don't know exactly which of the forty thousand seats is your seat.

You still have to use your brain and your clinical acumen to decide how to go with this.

And I am a board certified card carrying weenie.

when it comes to this scheduled around the clock dose of the opioid that I've just calculated, but I'm insanely generous with the breakthrough because I don't want anyone to suffer because I'm a big weenie.

No, because if you look at data that's actually quite old, the bioavailability is about fifty percent.

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