Methadone

Question 1

What type of drug is methadone

Answer 1

It is a full agonist to mu receptors

Long acting

Question 2

How is methadone metabolize

Answer 2

Liver

Question 3

Cytochrome for methadone

Answer 3

CYP3A4

Question 4

Why won’t you pick up methadone in a urine screen

Answer 4

It is a synthetic drug

Question 5

Half life of methadone

Answer 5

15 - 60 hours

Question 6

Type of affinity of methadone

Answer 6

Weak

It can be displaced by partial agonist and antagonist

Question 7

Why does Methadone take constant monitoring

Answer 7

QT prolongation issues

Significant respiratory suppression

Question 8

Special considerations for methadone

Answer 8

QT interval - we want to potentially get an EKG and due a good intake to rule out consistent abnormal heart rhythm.

Multiple drug interactions

Question 9

Benefits of methadone

Answer 9

Retention

Question 10

Usual dosage

Answer 10

80 - 100

Question 11

Drugs to consider that may cause inhibition to Methadone

Answer 11

SSRIs

Question 12

Which SSRI pose the highest risk of causing Methadone blood levels to rise

Answer 12

Luvox

Question 13

Recommendations when treating a patient who may be on an SSRI

Answer 13

Watch for the blood levels of methadone

Question 14

Drug to consider which may cause Methadone inducing (less methadone in the blood).

Answer 14

The anticonvulsant carbamazepine - this can lead to severe withdrawal

Question 15

Recommendations when someone is on carbamazepine but wants tx with methadone

Answer 15

Ask about a change to Valproic acid

Question 16

Methadone acts as an inhibitor for this specific drug. (Inhibitor = elevate drug levels in the blood.)

Answer 16

Tricyclic antidepressants

Response: Monitor closely and dose change as needed