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The Curbsiders Internal Medicine Podcast

REBOOT #146 Pain Meds in CKD

The Curbsiders Internal Medicine Podcast

The Curbsiders Internal Medicine Podcast

Health & Fitness, Medicine, Science, Higher Education, Education

4.83.1K Ratings

🗓️ 21 March 2022

⏱️ 67 minutes

🧾️ Download transcript

Summary

We tackle the complexities of pain management in patients with chronic kidney disease in this reboot from @NephMadness 2019 that, on a scale of 1-10, will leave you feeling very relieved in addressing pain. Topics: Opioids, gabapentinoids, NSAIDS, pain ladders, why tramadol is tramadont, and more!


Credits
  • Written and produced by: Justin Berk MD
  • NephMadness Pain Region: Samantha Gelfand MD
  • NephMadness Pun Contest produced by: Hannah R Abrams
  • Cover art by: Kate Grant MBChB, Dip GUMed
  • Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD
  • Edited by: Matthew Watto MD (audio), Emi Okamoto MD (show notes)
  • Guests: Samantha Gelfand MD, Matthew Sparks MD, David Juurlink MD

Show Segments
  • Kidney Pun
  • Disclaimer, intro and guest bios
  • Guest one-liners
  • Clinical Case and Pain Management Disclaimer
  • Modalities for pain meds in ckd
  • Opioids for pain and their metabolites
  • Dave Juurlink reframes the question, “what is our real goal with pain management?”
  • Matt Sparks reiterates the dangers of morphine and codeine in patients with advanced CKD
  • Communicating meds that are contraindicated or relatively contraindicated in CKD
  • Buprenorphine
  • What about the WHO Pain Ladder for CKD?
  • Should we use more cannabinoids? Ketamine?
  • Dave Juurlink rants on Tramadol
  • NSAIDS and CKD
  • Gabapentinoids (gabapentin and pregabalin) for neuropathic pain and driving?!
  • Estimating eGFR in CKD and AKI. Which equation is best?
  • How would each of our experts treat this patient with CKD and knee pain
  • Outro


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Transcript

Click on a timestamp to play from that location

0:00.0

How do nephrologists know if their research is going well?

0:03.9

Low P values.

0:05.9

Are we talking about urine?

0:08.6

We should probably just start the episode.

0:19.8

You should just leave that long stretch of silence in.

0:24.8

That is perfect.

0:29.5

The curbsiders podcast is for entertainment, education, and information purposes only.

0:32.3

And as far as I've discussed, it should not be used to lead diet and street cure or prevent

0:34.7

a disease as more conditions.

0:35.7

For the more the views and statements expressed on this podcast are solely those that

0:37.8

should not be interpreted for a professional policy or physician of any entity, the

0:39.8

psychrompossibly, cash like more hospital and affiliate outreach programs.

0:42.1

If indeed there are any, in fact, there are none.

0:43.9

Pretty much we aren't responsible if you screw up.

0:44.9

You should always do your own homework and let's know what we're going to do.

0:55.6

Welcome back to the curbsiders.

0:56.6

I'm Dr. Matthew Otto here with my great friend, Dr. Paul Nelson Williams.

1:00.8

Hey, Paul, how are you doing tonight?

1:02.6

I am well enough Matt.

1:03.9

How are you doing?

1:04.9

Good.

1:05.9

And I know you're a little bit bewildered about what we're doing here.

...

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