ASHP Midyear 2017 Day 4

I will be heading on my way back to Minnesota tomorrow, so this will be the last ASHP Midyear post. Hope you all enjoyed it, and maybe I will head back next year…we’ll see!  Day 4 of ASHP Midyear took on a medication safety theme.

I took part in a pain management in opioid use disorder lecture.  It was interesting.  What really stuck out to me is how to handle acute pain management in patients who are on agents that are being used for management of addiction.  The example that really made me think was a patient on long acting Vivitrol.  I’m certainly paraphrasing, but the speaker basically said you’re screwed in trying to figure out how much opioid to give a patient on Vivitrol.  I haven’t been in that situation, but I can imagine it being very stressful with extremely close monitoring of our patient being necessary.

I went to an insulin talk today.  Insulin is always considered a classic high risk medication.  A good error example was a patient with poor vision was switched to Tresiba U200 from Lantus and went by the number of clicks when dialing up the dose.  The Tresiba pen goes by 2’s so the patient essentially doubled the dose without knowing it at the time.

Fentanyl patches were on the hit list for ISMP.  Don’t use fentanyl patches in patients who are opioid naive.  Also don’t use fentanyl for acute pain.  Here’s some more fentanyl mistakes!

I want to thank everyone for the great presentations as well as the great interaction.  Lots of good people are doing a lot of work to advance the profession!

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Written By Eric Christianson

December 6, 2017

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