Methadone in Hospice & Palliative Care Appropriate Candidates: - Moderate to severe pain - Pain refractory to opioids - True phenanthrene allergy - Significant renal impairment - Needs a long acting opioid - High opioid tolerance - Neuropathic pain - Hx of dysphagia. inability to swallow etc Inappropriate Candidates: - Patient lives alone. or poor cognitive functioning - Lack of primary care outpatient - History of opioid nonadherence - History of substance misuse - Multiple risk factors for methadone toxicty (ie clinical instability. transplant, TOC) - Hx of QTc prolongation or at high risk - Prognosis is less than projected time to methadone steady state cindybobindy, PharmD, MPH @cindyPharMPH #Methadone #Hospice #PalliativeCare #Pharmacology #Management
