Podcast 668: Opioid-Induced Hyperalgesia

<p><strong>Contributor: Donald Stader, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Opioids target kappa and NMDA receptors that can lead to central nervous system sensitization and therefore increased pain</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">For patients with opioid-induced hyperalgesia (OIH), oral ketamine (25-50 mg) can be used to treat their pain as it targets the NMDA receptor</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Other treatments is IV magnesium, NSAIDs, tylenol, and clonidine</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Buprenorphine and methadone are options for chronic pain management in the setting of OIH</span></li> </ul> <p><strong>References</strong></p> <p><span style="font-weight: 400;">Lee M, Silverman SM, Hansen H, Patel VB, Manchikanti L. A comprehensive review of opioid-induced hyperalgesia. Pain Physician. 2011;14(2):145-161.</span></p> <p><em><span style="font-weight: 400;">Summarized by John Spartz, MS3 | Edited by Erik Verzemnieks, MD</span></em></p> <p> </p> <p><span style="font-weight: 400;">The Emergency Medical Minute is excited to announce that we are now offering</span> <em><span style="font-weight: 400;">AMA PRA Category 1 credits™</span></em> <span style="font-weight: 400;">via online course modules. To access these and for more information, visit our website at</span> <a href= "http://www.emergencymedicalminute.com/cme-courses"><span style= "font-weight: 400;">www.emergencymedicalminute.com/cme-courses/</span></a> <span style="font-weight: 400;">and create an account. </span></p> <p><a href= "https://www.paypal.com/donate?token=6bIZ91UwjZALMiRLAEcQYYPHyLILwbivQwgtGl3JzaB6oGAQK1B2nrGSGvrS-g7zJApXzVlWIO-lmLfB"> <span style="font-weight: 400;">Donate to EMM today!</span></a></p> <p><br /> <br /></p>