Quit carefully. When you're ready to stop taking sleeping pills, follow your health care provider's or pharmacist's instructions or the directions on the label.
Monitor all patients on controlled substances by checking the state prescription drug monitoring program report with each prescription. Perform periodic urine drug testing. Pill counts are appropriate for the highest risk patients.
Having a baby can sometimes trigger a thyroid disorder. This is known as postpartum thyroiditis. It is usually temporary but can return each time you have a baby.
Although not completely understood, the pathophysiology is thought to involve the following two mechanisms:
Obtain a thorough social history of interpersonal relationships at home, work, or in other environments that may improve or negatively impact the adjustment to chronic pain. Consider screening patients with chronic pain for a history of trauma and for adverse childhood experiences.
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Transdermal buprenorphine Shop Now (Butrans and generic) is FDA-approved for treating pain. It does not require an XDEA number or training to prescribe. The transdermal form is a good alternative for patients who have developed tolerance to other opioids, had a benefit from opioid treatment but wish to escalate treatment, and are taking ≤ 80 MME/day. Start with a 5 or 10 mcg patch (changed weekly), and discontinue other opioids.
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Social, personal, and family risks. Being an opioid user carries a risk for social stigma. Additional risks are inherent to possessing opioids, including becoming a target for home invasion. Insecure storage may put other family members and pets at risk for opioid poisoning.
Advise patients to avoid alcohol while using an opioid. For patients who are pregnant or may become pregnant, discuss the risk of neonatal abstinence syndrome.
Pain diary: regular documentation of the pain intensity to identify peaks and triggers; enables treatment optimization
Discontinue all ineffective medications to avoid polypharmacy, minimize toxicity, and limit unrealistic beliefs about the benefit of medications.
Adhere to recommended guidelines and carefully document medical decision-making when prescribing opioids.
Ensure caregiver receives education on appropriate Intranasal Narcan use and administration to the patient if indicated