Matters of the Heart
Methadone can prolong this ECG interval, increasing the risk for deadly arrythmias, especially in patients with underlying cardiac disease or those on other cardiac medications.
What is the QTc interval?
Patients with this type of organ dysfunction may require methadone dose adjustments and closer monitoring.
What is the Liver? (will accept "What is hepatic impairment?")
Patients with opioid use disorder are at increased risk for these two viral infections, which should be screened for at admission to a methadone clinic.
What are HIV and hepatitis C?
Methadone can cause this potentially fatal respiratory complication, especially during induction or dose escalation.
What is respiratory depression?
Methadone may alter levels of this hormone, sometimes leading to hypogonadism in long-term users.
What is testosterone?
Before starting methadone, clinicians should assess for a history of this arrhythmia, which is a contraindication to therapy.
What is torsades de pointes?
Methadone can cause this common gastrointestinal side effect, which may require management in long-term therapy.
What is constipation?
Methadone metabolism can be increased by certain antibiotics, such as this part of TB therapy, potentially leading to withdrawal symptoms.
What is rifampin?
Patients with this sleep-related breathing disorder may be at higher risk for adverse effects from methadone.
What is sleep apnea?
Methadone can interact with medications for this common endocrine disorder, requiring careful monitoring.
What is diabetes mellitus? (Can interact with oral hypoglycemics)
Methadone’s risk for cardiac arrhythmias is increased when combined with medications that cause this electrolyte abnormality.
What is hypokalemia?
Methadone binds to receptors in the GI tract that inhibit acetylcholine release, reducing motility. Name that receptor type.
What are mu-opioid receptors?
Methadone treatment programs are a key part of harm reduction, helping prevent infectious disease spread by reducing this specific high-risk behavior.
What is injection drug use (or needle sharing)?
Patients on methadone who develop hypoxia are often co-using substances that act on this neurotransmitter system, compounding respiratory suppression.
What is the GABAergic system (e.g., benzodiazepines, alcohol, barbiturates)?
Chronic methadone use has been associated with this potentially serious endocrine disorder, characterized by fatigue, weight loss, hypotension, and hyponatremia, due to suppression of the hypothalamic-pituitary-adrenal axis.
What is adrenal insufficiency?
Cases of adrenal insufficiency have been reported with chronic opioid use, including methadone, typically after more than one month of therapy. Methadone can inhibit the secretion of adrenocorticotropic hormone (ACTH) and cortisol, leading to symptoms of adrenal insufficiency that may require endocrinologic evaluation and management.