Methadone as an Additional Opioid for a Cancer Patient With Severe Neuropathic and Bone Pain Not Responsive to Other Opioids and Adjuvant Analgesics.
Methadone as an additional opioid for a cancer patient with severe neuropathic and bone pain not responsive to other opioids and adjuvant analgesics.
J Palliat Care. 2013; 29(2): 119-21
Leppert W, Kowalski G
Methadone-induced Torsades de pointes.
R I Med J (2013). 2013; 96(8): 20-1
Russell L, Levine D
Torsades de pointes is a polymorphic ventricular tachycardia that can quickly evolve into ventricular fibrillation and sudden death. This arrhythmia often occurs secondary to medication- induced cardiac repolarization dysfunction with resultant prolonged QTc interval on ECG. Numerous medications can predispose patients to this deadly tachycardia. We report a case of methadone-induced Torsades de pointes complicated by ventricular fibrillation and cardiac arrest. Through rapid taper of methadone, the patient’s ECG normalized, allowing for safe discharge. This clinical vignette highlights the importance of close monitoring of patient medications. Performing periodic ECGs with prompt removal of offending agent when repolarization abnormalities are appreciated is ideal. Most importantly, as the vast array of medications continues to grow, it is imperative that clinicians are cognizant of side effects and tailor treatment accordingly.
HubMed – Methadone
Methadone maintenance treatment participant retention and behavioural effectiveness in china: a systematic review and meta-analysis.
PLoS One. 2013; 8(7): e68906
Zhang L, Chow EP, Zhuang X, Liang Y, Wang Y, Tang C, Ling L, Tucker JD, Wilson DP
Methadone maintenance treatment (MMT) has been scaled up by the Chinese government alongside persistent compulsory drug user detention, but the extent to which detention interferes with MMT is unknown. The study systematically reviews Chinese MMT retention rates, reasons for drop out, and behavioural changes.Chinese and English databases of literature are searched for studies reporting retention rates, drug use and sexual behaviours among MMT participants in China between 2004 and 2013. The estimates are summarized through a systematic review and meta-analysis.A total of 74 studies representing 43,263 individuals are included in this analysis. About a third of MMT participants drop out during the first three months of treatment (retention rate 69.0% (95% CI 57.7-78.4%)). Police arrest and detention in compulsory rehabilitation was the most common cause of drop out, accounting for 22.2% of all those not retained. Among retained participants, changing unsafe drug use behaviours was more effective than changing unsafe sexual behaviours. At 12 months following MMT initiation, 24.6% (15.7-33.5%) of MMT participants had a positive urine test, 9.3% (4.7-17.8%) injected drugs and only 1.1% (0.4-3.0%) sold sex for drugs. These correspond to 0.002 (<0.001-0.011), 0.045 (0.004-0.114) and 0.209 (0.076-0.580) times lower odds than baseline. However, MMT participants did not have substantial changes in condom use rates.MMT is effective in drug users in China but participant retention is poor, substantially related to compulsory detention. Reforming the compulsory drug user detention system may improve MMT retention and effectiveness. HubMed – Methadone
Boyle Leads Fight Against Methadone Clinic – Pa. state Rep. Kevin Boyle speaks to a crowd of citizens who came out to stand up for the community and protest the placement of a methadone clinic. Boyle ha…
Find More Methadone Treatment Information…