The Royal Marsden Hospital Manual of Clinical Nursing Procedures - Lisa Dougherty [347]
—should be accompanied by an experienced driver as this may be helpful.
(c) Patients do not need to inform the DVLA about starting an opioid but may need to inform them of other aspects relating to their illness. The patient should be encouraged to inform their insurance company about their current state of health and current medications.
Complications
The use of opioids in renal failure
Renal failure can cause significant and dangerous side-effects due to the accumulation of the drug. Basic guidelines for pain management in renal failure include the following.
Reduce analgesia dose and/or dose frequency (6-hourly instead of 4-hourly).
Select a more appropriate drug (non-renally excreted).
Avoid modified-release preparations.
Seek advice from a specialist pain/palliative care team and/or pharmacist (Farrell and Rich 2000).
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