Category: Education

Timely consultations relevant for family medicine, primary care, and general internal medicine topics for physicians, nurse practitioners, physician assistants, and residents. Offering CME credit for most episodes at https://ce.mayo.edu/podcast. Produced by @MayoMedEd.

June 1, 2021

Watching Out for Loperamide Abuse

Guest: Tyler S. Oesterle, M.D., M.P.H. (@OesterleMD)

Host: Darryl S. Chutka, M.D. (@ChutkaMD)

Opioid abuse remains a significant problem, and as law enforcement and regulatory agencies tighten access to prescription analgesics, individuals are seeking alternatives. It’s been discovered that when taken at very high doses, loperamide can produce similar effects to the opioid analgesics and the drug is inexpensive when compared to the price of both illicit and prescription opioids. As a result, loperamide abuse has become a significant problem. In this episode we discuss loperamide abuse with Tyler Oesterle, M.D., M.P.H., a psychiatrist at Mayo Clinic’s Rochester campus. We’ll review the typical central nervous system effects of high dose loperamide and the associated safety issues.

Specific topics:

  • Current status of the opioid crisis in the U.S.
  • Effects of loperamide in both therapeutic and excessive doses
  • Reasons behind taking high dose loperamide in excessive doses
  • Safety issues associated with high dose loperamide
  • Potential of high dose loperamide leading to drug dependence

Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.

February 26, 2019

What you Need to Know About Medical Cannabis

Guest: Thomas P. Pittelkow, D.O., M.P.H. 

Host: Darryl S. Chutka, M.D. (@ChutkaMD

Does medical marijuana have proven benefits? Who can prescribe it? What are the potential harms in using it? Dr. Thomas Pittelkow, a Mayo Clinic anesthesiologist specializing in pain management for cancer patients and advanced interventions in end of life care, discusses the differences between recreational and medical marijuana. Listen in for more on hopes and limitations in cannabis research, best practices for patient conversations, state vs. federal regulations, and the importance of communication with dispensaries. 

Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd

Deeper Dive: 

April 10, 2018

Opioid Edition 10: Side Effects Management

Guest: Molly A. Feely, M.D. (@mollyfeelymd)

Host: Tracy McCray

Episode 10 of 10: Dr. Molly Feely, who is board certified in palliative care, internal medicine, and family medicine now practicing full time palliative care at Mayo Clinic in Rochester, talks about best practices for Management of Opioid Side Effects. 

Claim CME credit at ce.mayo.edu/opioidpc. This episode is required to be compliant with controlled substance prescribing guidelines in the state of Minnesota.

Episode transcript: https://mcdn.podbean.com/mf/web/gt8znj/Ep_27-Opioid_Edition_10_Side_Effects_Management.pdf

April 3, 2018

Opioid Edition 9: Monitoring and Considerations for Tapering

Guest: Halena M. Gazelka, M.D. (@hmgazelkamd

Host: Tracy McCray

Episode 9 of 10: Dr. Halena Gazelka, an anesthesiologist boarded in pain and palliative medicine at Mayo Clinic in Rochester, talks about best practices for Opioid Monitoring and Considerations for Tapering. This podcast is brought to you by the Opioid conference held each year as a part of Mayo Clinic’s Continuing Medical Education.

Claim CME credit at ce.mayo.edu/opioidpc. This episode is required to be compliant with controlled substance prescribing guidelines in the state of Minnesota.

Episode transcript: https://mcdn.podbean.com/mf/web/hu4nsg/Ep_26-Opioid_Edition_9_Monitoring_and_Considerations_for_Tapering.pdf

January 4, 2018

Opioid Edition 1: The Opioid Crisis and Pain Management

Guest: Halena M. Gazelka, M.D. (@hmgazelkamd)

Host: Tracy McCray

Episode 1 of 10: Dr. Halena Gazelka, an anesthesiologist boarded in pain and palliative medicine at Mayo Clinic in Rochester walks us through the basics of opioids and the current state of this national crisis. What is an opioid? How bad is the opioid epidemic and how did we get here?

Claim CME credit at ce.mayo.edu/opioidpc. This episode is required to be compliant with controlled substance prescribing guidelines in the state of Minnesota.

Episode transcript: https://mcdn.podbean.com/mf/web/5d7ztu/Ep_15-Opioid_Edition_1_The_Opioid_Crisis_and_Pain_Management.pdf

January 4, 2018

Opioid Edition 2: Managing Acute and Chronic Pain

Guest: Halena M. Gazelka, M.D. (@hmgazelkamd)

Host: Tracy McCray

Episode 2 of 10: What are the different guidelines when treating chronic versus acute pain with opioid therapy? Dr. Halena Gazelka, an anesthesiologist boarded in pain and palliative medicine at Mayo Clinic in Rochester, talks about the importance of “starting low and going slow.” What are the alternatives for chronic pain management? Dr. Gazelka also covers non-pharmacological and implantable device alternatives for the treatment of pain.

Claim CME credit at ce.mayo.edu/opioidpc. This episode is required to be compliant with controlled substance prescribing guidelines in the state of Minnesota.

Episode transcript: https://mcdn.podbean.com/mf/web/bkc6ac/Ep_16-Opioid_Edition_2_Managing_Acute_and_Chronic_Pain.pdf

January 4, 2018

Opioid Edition 3: Family Practitioners - Assessing the Patient

Guest: David C. Patchett, D.O.

Host: Tracy McCray

Episode 3 of 10: Dr. David Patchett, family practitioner at Mayo Clinic in Arizona, answers common questions family practitioners often face when treating patients with pain management issues. What are best practices when prescribing opioid therapy? How do you weigh the potential benefits of opioid therapy with the identified risks? 

Claim CME credit at ce.mayo.edu/opioidpc. This episode is required to be compliant with controlled substance prescribing guidelines in the state of Minnesota.

Episode transcript: https://mcdn.podbean.com/mf/web/vgd4rt/Ep_17-Opioid_Edition_3_Family_Practitioners-Assessing_the_Patient.pdf

January 4, 2018

Opioid Edition 4: Treating Special Populations & Situations

Guest: David C. Patchett, D.O.

Host: Tracy McCray

Episode 4 of 10: Family practitioner, Dr. David Patchett, from Mayo Clinic in Arizona shares the additional challenges associated with prescribing opioids to special populations, and discusses how and when to reassess a patient’s therapy. How do you know when to taper a patient? What are the symptoms of opioid withdrawal and how can you mitigate them? 

Claim CME credit at ce.mayo.edu/opioidpc.

Episode transcript: https://mcdn.podbean.com/mf/web/pxsjez/Ep_18-Opioid_Edition_4_Treating_Special_Populations_Situations.pdf

January 4, 2018

Opioid Edition 5: Acute Prescribing: Emergency Room Prescribing

Guest: Casey M. Clements, M.D., Ph.D. (@CaseyClmnts)

Host: Tracy McCray

Episode 5 of 10: Dr. Casey Clements, an emergency physician and practice leader, who works in the opioid stewardship program at Mayo Clinic-Rochester, shares his insights on opioid therapy from the Emergency Department perspective. What is drug diversion? How do you know a patient isn’t receiving prescriptions from multiple physicians?

Claim CME credit at ce.mayo.edu/opioidpc. This episode is required to be compliant with controlled substance prescribing guidelines in the state of Minnesota.

Episode transcript: https://mcdn.podbean.com/mf/web/z7mbxj/Ep_19-Opioid_Edition_5_Acute_Prescribing_Emergency_Room_Prescribing.pdf

January 4, 2018

Opioid Edition 6: Assessing & Treating Opioid Misuse in the ED

Guest: Casey M. Clements, M.D., Ph.D. (@CaseyClmnts)

Host: Tracy McCray

Episode 6 of 10: How do you assess whether a patient has become addicted? What do you do if you suspect opioid use disorder or addiction? Dr. Casey Clements, an emergency physician and practice leader, who works in the Opioid Stewardship Program at Mayo Clinic in Rochester, shares his insights on treating opioid misuse in the emergency setting.

Claim CME credit at ce.mayo.edu/opioidpc.

Episode transcript: https://mcdn.podbean.com/mf/web/9rje3e/Ep_20-Opioid_Edition_6_Assessing_Treating_Opioid_Misuse_in_the_ED.pdf

January 4, 2018

Opioid Edition 7: Treating Opioid Addiction

Guest: Holly L. Geyer, M.D.

Host: Tracy McCray

Episode 7 of 10: Dr. Holly Geyer, an internal medicine physician, who serves on the Opioid Stewardship Program at Mayo Clinic in Arizona, discusses issues of dependency and addiction. What’s the difference between dependency and addiction? 

Claim CME credit at ce.mayo.edu/opioidpc.

Episode transcript: https://mcdn.podbean.com/mf/web/xvt7i9/Ep_21-Opioid_Edition_7_Treating_Opioid_Addiction.pdf

January 4, 2018

Opioid Edition 8: Family & Patient Counseling

Guest: Holly L. Geyer, M.D.

Host: Tracy McCray

Episode 8 of 10: What legal and ethical obligations do physicians have when prescribing opioids? How can we address systemic issues that need improvement? Dr. Holly Geyer, internal medicine physician at Mayo Clinic in Arizona, shares her thoughts on what is currently being done to combat the opioid crisis and what additional steps can be taken to make a difference.

Claim CME credit at ce.mayo.edu/opioidpc.

Episode transcript: https://mcdn.podbean.com/mf/web/jit3rx/Ep_22-Opioid_Edition_8_Family_Patient_Counseling.pdf