Unique Plan Description: Palliative Care Methadone
Plan Selection Display: Palliative Care Methadone
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2019-09-27 16:07:00
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2021-12-21 10:39:42
Available at all facilities: Yes

Palliative Care Methadone
Laboratory
	Potassium Level
		T;N, Stat, spec type = Blood
	Magnesium Level
		T;N, Stat, spec type = Blood
Diagnostic Tests
	ECG
		T;N, Stat
		T+14;0700, Routine, ECG to be done 2 weeks after initiation of methadone
	Discharge Diagnostics
		T;N, ECG to be done 2 weeks after initiation of methadone
IV Solutions
	Narcan 0.8 mg/NS 250 mL
		0.8 mg, EVERY BAG
		250 mL, IV, Routine, ml/hr
Medications
	methadone
		2.5 mg, Tab, By Mouth, Q12H
			Comment: Do not give and notify provider if QTc >/=450. Do not give and notify provider if respirations </= 10, SBP </= 90, RASS >/=2, patient is somnolent.
		5 mg, Tab, By Mouth, Q12H
			Comment: Do not give and notify provider if QTc >/=450. Do not give and notify provider if respirations </= 10, SBP </= 90, RASS >/=2, patient is somnolent.
		7.5 mg, Tab, By Mouth, Q12H
			Comment: Do not give and notify provider if QTc >/=450. Do not give and notify provider if respirations </= 10, SBP </= 90, RASS >/=2, patient is somnolent.
		10 mg, Tab, By Mouth, Q12H
			Comment: Do not give and notify provider if QTc >/=450. Do not give and notify provider if respirations </= 10, SBP </= 90, RASS >/=2, patient is somnolent.
		12.5 mg, Tab, By Mouth, Q12H
			Comment: Do not give and notify provider if QTc >/=450. Do not give and notify provider if respirations </= 10, SBP </= 90, RASS >/=2, patient is somnolent.
		15 mg, Tab, By Mouth, Q12H
			Comment: Do not give and notify provider if QTc >/=450. Do not give and notify provider if respirations </= 10, SBP </= 90, RASS >/=2, patient is somnolent.
		17.5 mg, Tab, By Mouth, Q12H
			Comment: Do not give and notify provider if QTc >/=450. Do not give and notify provider if respirations </= 10, SBP </= 90, RASS >/=2, patient is somnolent.
		20 mg, Tab, By Mouth, Q12H
			Comment: Do not give and notify provider if QTc >/=450. Do not give and notify provider if respirations </= 10, SBP </= 90, RASS >/=2, patient is somnolent.
		2.5 mg, Solution, By Mouth, Q12H
			Comment: Do not give and notify provider if QTc >/=450. Do not give and notify provider if respirations </= 10, SBP </= 90, RASS >/=2, patient is somnolent.
		5 mg, Solution, By Mouth, Q12H
			Comment: Do not give and notify provider if QTc >/=450. Do not give and notify provider if respirations </= 10, SBP </= 90, RASS >/=2, patient is somnolent.
		7.5 mg, Solution, By Mouth, Q12H
			Comment: Do not give and notify provider if QTc >/=450. Do not give and notify provider if respirations </= 10, SBP </= 90, RASS >/=2, patient is somnolent.
		10 mg, Solution, By Mouth, Q12H
			Comment: Do not give and notify provider if QTc >/=450. Do not give and notify provider if respirations </= 10, SBP </= 90, RASS >/=2, patient is somnolent.
		12.5 mg, Solution, By Mouth, Q12H
			Comment: Do not give and notify provider if QTc >/=450. Do not give and notify provider if respirations </= 10, SBP </= 90, RASS >/=2, patient is somnolent.
		15 mg, Solution, By Mouth, Q12H
			Comment: Do not give and notify provider if QTc >/=450. Do not give and notify provider if respirations </= 10, SBP </= 90, RASS >/=2, patient is somnolent.
		17.5 mg, Solution, By Mouth, Q12H
			Comment: Do not give and notify provider if QTc >/=450. Do not give and notify provider if respirations </= 10, SBP </= 90, RASS >/=2, patient is somnolent.
		20 mg, Solution, By Mouth, Q12H
			Comment: Do not give and notify provider if QTc >/=450. Do not give and notify provider if respirations </= 10, SBP </= 90, RASS >/=2, patient is somnolent.
	methadone IVPB
		1 mg, INT, IVPB, Q12H
			Comment: Do not give and notify provider if QTc >/=450. Do not give and notify provider if respirations </= 10, SBP </= 90, RASS >/=2, patient is somnolent.
		2.5 mg, INT, IVPB, Q12H
			Comment: Do not give and notify provider if QTc >/=450. Do not give and notify provider if respirations </= 10, SBP </= 90, RASS >/=2, patient is somnolent.
		5 mg, INT, IVPB, Q12H
			Comment: Do not give and notify provider if QTc >/=450. Do not give and notify provider if respirations </= 10, SBP </= 90, RASS >/=2, patient is somnolent.
		7.5 mg, INT, IVPB, Q12H
			Comment: Do not give and notify provider if QTc >/=450. Do not give and notify provider if respirations </= 10, SBP </= 90, RASS >/=2, patient is somnolent.
		10 mg, INT, IVPB, Q12H
			Comment: Do not give and notify provider if QTc >/=450. Do not give and notify provider if respirations </= 10, SBP </= 90, RASS >/=2, patient is somnolent.
		12.5 mg, INT, IVPB, Q12H
			Comment: Do not give and notify provider if QTc >/=450. Do not give and notify provider if respirations </= 10, SBP </= 90, RASS >/=2, patient is somnolent.
		15 mg, INT, IVPB, Q12H
			Comment: Do not give and notify provider if QTc >/=450. Do not give and notify provider if respirations </= 10, SBP </= 90, RASS >/=2, patient is somnolent.
		17.5 mg, INT, IVPB, Q12H
			Comment: Do not give and notify provider if QTc >/=450. Do not give and notify provider if respirations </= 10, SBP </= 90, RASS >/=2, patient is somnolent.
		20 mg, INT, IVPB, Q12H
			Comment: Do not give and notify provider if QTc >/=450. Do not give and notify provider if respirations </= 10, SBP </= 90, RASS >/=2, patient is somnolent.
	Pharmacy Consult
		T;N, Review medications for drugs that alter methadone pharmacodynamics including prolonging QTc or are CYP inducers/inhibitors and notify provider.
	Narcan
		0.2 mg, Injection, IV Push, Q2MIN, PRN for see comment
			Comment: If patient has received opiate agents in the past 24 hours and/or if patient becomes somnolent with minimal or no response to stimuli or respiratory rate is 10 or less per minute.  RN may administer naloxone prior to contacting MD.  Notify MD immediately upon administration of naloxone.  May give 0.2mg every 2 min up to 1mg total dose.

*Report Legend:
DEF - This order sentence is the default for the selected order
GOAL - This component is a goal
IND - This component is an indicator
INT - This component is an intervention
IVS - This component is an IV Set
NOTE - This component is a note
Rx - This component is a prescription
SUB - This component is a sub phase