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Introduction to Week 2

This week is about opioids in practice. In this video Dr Victoria Hewitt introduces the Week 2 topic “Principles in to Practice” for safe opioid prescribing. Safe opioid prescribing requires …

Which opioid to choose?

Terry and his GP agree that he needs a strong opioid but which opioid to choose? Morphine is the strong opioid of choice The most common reason to start with …

Pain is complex….

We recognise that pain management is complex. Therefore, we have provided some links to pain problems which are beyond the scope of this course. We will not cover neuropathic pain …

WHO analgesic ladder

The World Health Organization (WHO) published the Analgesic Ladder for Cancer Pain in 1986 and it has since been translated into 22 languages. The simple, stepped approach was revolutionary because …

Opioid elimination

Almost all opioids and their associated metabolites are excreted renally. The effect of renal function on the elimination of an opioid differs between individuals and the opioid concerned. If kidney …

Principles of dosing intervals

In order to prescribe opioids safely and effectively it is important to understand the principles of prescribing intervals. Half life The duration of a drug’s effect on the body depends …

Routes of administration and absorption

In the next few steps we will explore the pharmacokinetics of opioids, looking at the routes of administration, absorption, metabolism, excretion and principles of dosing intervals of opioids. Absorption is …

Opioid metabolism

Opioids are metabolised by the liver, primarily so that they can be converted from lipophilic to hydrophilic molecules which are then excreted in urine. Some “parent” opioid molecules have little …

Common side effects

Studies suggest that up to 80% of patients taking an opioid experience at least one side effect, often leading to the discontinuation of treatment. Understanding how and why they arise …

Opioid binding

Opioids produce their biological effects by binding to opioid receptors. Depending on the opioid concerned, the biological effect can be activated or deactivated. Safe opioid management demands a basic understanding …

Terry’s story: Introducing our case study

Throughout this course we will follow the story of Terry McArdle, a fictional patient based on real scenarios that are common in clinical practice. Terry is a very independent and …

Role of opioids in pain transmission

To fully appreciate the role of opioids in pain management, it helps to understand how they work on at a cellular level to disrupt pain signalling. In this video animation …

What are opioids?

Opioids are naturally occurring and synthetic substances which bind to opioid receptors in the central and peripheral nervous systems. They are primarily prescribed as analgesics in a range of painful …

The problem with opioids….

Opioids are classed as high-risk drugs because they have the potential to cause addiction and serious, life-threatening harm if misused, prescribed inappropriately or administered incorrectly (Institute for Safe Medication Practices, …

Introduction to Week 1

In the first week, we explore the pharmacodynamics and pharmacokinetics of opioids. Pharmacodynamics describes a drug ‘s effects on the body. Pharmacokinetics is concerned with how the body affects the …