Related Experiment Video
Updated: May 3, 2026
10:17
High-throughput and Comprehensive Drug Surveillance Using Multisegment Injection-Capillary Electrophoresis-Mass Spectrometry
Published on: April 23, 2019
11.3K
Evaluation of a pharmacist-managed methadone taper*.
Katherine J Steineck1, Angela K Skoglund, Melissa K Carlson
11Department of Pharmacy, University of Minnesota Amplatz Children's Hospital, Minneapolis, MN. 2Department of Pharmacy, University of Minnesota Medical Center, Minneapolis, MN. 3Division of Pediatric Critical Care Medicine, University of Minnesota Amplatz Children's Hospital, Minneapolis, MN.
Summary
A pharmacist-managed methadone taper protocol significantly reduced the time to discontinue opioids in pediatric patients. This optimized approach also decreased opioid infusion duration and potentially hospital length of stay.
Area of Science:
- Pediatric critical care
- Pharmacology
- Clinical pharmacy
Background:
- Opioid use in pediatric patients, particularly in intensive care settings, necessitates effective and safe discontinuation strategies.
- Methadone is a commonly used opioid for prolonged analgesia and withdrawal management.
- Optimizing methadone tapering protocols is crucial for improving patient outcomes and resource utilization.
Purpose of the Study:
- To evaluate the efficacy of a pharmacist-managed methadone tapering protocol compared to historical prescribing practices.
- To assess the impact of the protocol on the duration of methadone taper, opioid discontinuation, and hospital length of stay.
Main Methods:
- Retrospective chart review comparing patients before and after the implementation of a pharmacist-managed methadone taper protocol.
- Study included pediatric patients aged 1 month to 16 years undergoing opioid weaning.
- Data collected included taper length, additional opioid requirements, withdrawal scores, and hospital length of stay.
Main Results:
- The pharmacist-managed protocol significantly reduced the average methadone taper length from 24.7 to 15 days (p = 0.0026).
- Opioid infusions were discontinued sooner by an average of 1.54 days in the intervention group (p = 0.0039).
- A statistically significant decrease in hospital length of stay was observed in the group managed by the protocol (p = 0.023).
Conclusions:
- A pharmacist-managed, protocolized methadone taper is an effective strategy for expediting the discontinuation of opioids in pediatric patients.
- Implementation of this protocol can lead to earlier cessation of opioid infusions and potentially reduce overall hospital length of stay.
- This protocol represents an effective method for weaning pediatric patients from opioids in a quaternary care setting.
Related Concept Videos
01:29Therapeutic Drug Monitoring: Affecting Factors
429
Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
429
01:26Therapeutic Drug Monitoring: Drug Analysis Methods
342
Therapeutic Drug Monitoring (TDM) is a clinical practice that measures specific drug levels in a patient's blood or body tissues to tailor drug therapy effectively. This monitoring is critical for managing drugs with narrow therapeutic indices like digoxin and phenytoin, ensuring they are both safe and effective. For instance, monitoring theophylline levels in asthma patients involves precision and sensitivity to adjust doses according to individual responses to therapy, ensuring efficacy and...
342
01:16Therapeutic Drug Monitoring: Overview and Classification
642
Therapeutic Drug Monitoring (TDM) is a clinical practice that measures specific drug levels in a patient's blood at designated intervals to ensure the drug concentration stays within a therapeutic range. This monitoring is crucial for optimizing individual dosage regimens, enhancing therapeutic efficacy, and minimizing drug-related toxicity. TDM is vital for drugs with narrow therapeutic windows, significant variability in pharmacokinetics, and a clear correlation between plasma levels and...
642
01:25Determination of Multiple Dosing Parameters: Loading and Maintenance Doses
394
A loading dose is an essential pharmacological strategy to rapidly achieve the target plasma drug concentration necessary for an immediate therapeutic effect. This approach is especially critical for drugs characterized by slow absorption or extended half-lives, where delaying therapeutic plasma levels could compromise treatment outcomes. By administering a loading dose, clinicians ensure a prompt onset of drug action, even for agents with complex pharmacokinetic profiles.Achieving steady-state...
394
01:28IV Infusion to Oral Dosing: Conversion Methods
212
The development of extended-release formulations has facilitated the transition from intravenous to oral medication, offering a more convenient and patient-friendly approach to drug administration. This transition, however, requires careful management to ensure that therapeutic drug levels are maintained, preserving efficacy and avoiding adverse effects. Understanding pharmacokinetic principles and dosage calculations is critical during this process.Pharmacokinetics of the...
212
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
271
In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
271