Essay on Opiate Conversion Calculators

Opiate conversion calculator is used to facilitate the equianalgesic conversions during pain management. Several factors must be considered during the conversion process to manage pain effectively. The conversions in this calculator majorly base on the American Pain Society guidelines. Most equianalgesic conversions lack data. Therefore opiate regimens are of great importance. It is noticeable that the equianalgesic tables and conversions have significant limitations that should be emphasized to come up with the best solution. These differences are not captured within the traditional equianalgesic tables hence there is a limitation.

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Dose-dependent conversions: In some cases, the conversion ratio of certain opioids can be dependent on the dose of the first opioid. This issue brings differences in the relative potency of the patients converting from very high doses. A cross-tolerance of 25-50% is the most recommended in the conversion that involves, unlike opioids. This difference of between 25% and 50% is very significant (Opioids, 2011). The reason is that it makes the dose inherently inaccurate which may result in incomplete cross-tolerance due to variability in the opioid required. The bi-directional conversion is another disadvantage. It is where the direction of conversion produces a different conversion ratio when converting between certain opioids (McPherson, 2009).

Another disadvantage is Equianalgesic Discrepancies. The differences in equianalgesic dosing tables are very significant to the extent that even the FDA drugs that are approved do not demonstrate agreement. It influences the patients receiving long-acting opioid formulations negatively breaking through opioid dosing. Furthermore, there is a requirement for a rescue dose for patients receiving long-acting formulation. The recommended size of the breakthrough dose is 5-15%. A rescue treatment can be provided in every 15-30 minutes to manage pain effectively (Marosszeky, 2008). Therefore, these factors must be considered to manage pain effectively.

There are various advantages of using the opiate conversion calculators. Some of these merits include; it enables the calculation of the daily doses given to the patients. This importance is key as it contributes to the efficient management of pain (McPherson, 2009). It also gives a reasonable clinical judgment on the opioid regimes. The alternative to using the calculator is with Narcotic Equivalence Converter. There are different types of calculators used in the conversion of opiates. These include the general, fluid, and cardiology, obstetric and pediatric calculators.

References

Indelicato, R. A., & Portenoy, R. K. (2002). Opioid Rotation in the management of refractory cancer pain. Journal of Clinical Oncology, 20(1), 348-352.

Meares, S., Shores, E. A., Taylor, A. J., Batchelor, J., Bryant, R. A., Baguley, I. J., ... & Marosszeky, J. E. (2008). Mild traumatic brain injury does not predict acute postconcussion syndrome. Journal of Neurology, Neurosurgery & Psychiatry, 79(3), 300-306.

McPherson, M. L. (2009). Demystifying Opioid Conversion Calculations: a guide for effective dosing. ASHP.

Opioids, A. (2011). Pain Management. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 12th Ed. New York, NY: McGraw-Hill, 481-525.