There have been several recent topics to get us thinking more about this. Without trying to be morbid in the wake of yesterday’s post about Physician Assisted Dying on our sister site, the high number of recent deaths from fentanyl makes us think about whole different kind of PAD.
iMedicalApps just posted a note about an app called ‘Safe Opioids‘, (scan the QR code to find the app) along with comments and review, along with commentary about some other apps and calculators that are out there. I do agree with their comments that there is a quite a bit of variability with the narcotic equivalent calculators – worth doing a comparison run to see what equivalent doses you get.
It also reminded me of something that I came across on Bandolier a few years ago. The Oxford League of analgesics in acute pain – a nicely done table. It does rank quite a few -coxibs that we don’t have here but is useful nonetheless, especially for educating your learners.
You’ll note that the narcotics don’t fare particularly well. Doctors from other countries remark upon our high use of codeine in Canada. Maybe we are training our patients’ nociceptors to expect a certain hit. CaMH and the College of Physicians and Surgeons of Alberta do a very practical course on Opioid Dependence Treatment, facilitated by our CME office here at the University of Calgary. Lots of case discussions, based on our OpenLabyrinth virtual patient platform.