Opioids Dosage Conversion vs Steroid Taper Calculator TM

Opioids by Chris Marcellino MD and Norris Vivatrat MD is an opioid analgesic dosage conversion calculator for use by trained medical professionals. The application supports conversion to and from opioids commonly prescribed and used in U.S. hospitals orally, parenterally, or transdermally, including morphine, codeine, hydromorphone, hydrocodone, fentanyl, methadone, oxycodone and oxymorphone. The application is intended to help and instruct in the process of conversion of opioid regimens. • Native support for iPhone, iPad and iPod touch • Multiple route support • Multiple drug support • Incomplete cross tolerance option • Breakthrough dosing calculator • Provides instructional details about each calculation • Saves last calculation on exit • Supports landscape and portrait modes • Reference guide By Professor EBM, the Internal Medicine Residency Teaching Resource for Evidence-Based Medicine: http://www.professorebm.com/, a resource of the Santa Clara Valley Medical Center. While effort has been made to ensure that calculations are accurate and that conversion factors are in accordance with current accepted medical practices, use of this application is entirely at your own risk. This application should only be used by trained medical professionals and all results should be double checked by hand. Use of the app requires acceptance of the terms of use that are included with the application. Please send support requests and feedback using the link in the About tab of the app, though as a free academic tool we only have limited resources to address new feature requests. Opioid equipotency data is taken from CAPC conversion values except where noted (see the reference tab in the app.) CAPC values are as published in the Center to Advance Palliative Care Prescribing Opioids: A Reference Guide curriculum, which are adapted from McPherson ML. Demystifying Opioid Conversion Calculations: A Guide for Effective Dosing, 2nd ed. American Society of Health-System Pharmacists, Bethesda, Maryland, 2018. EPEC values are as published in EPEC-O Participants Handbook, 2005. Chris Marcellino, MD — Mayo Clinic Norris Vivatrat, MD — UCSD Medical Center Special thanks to Dr. Tom Mouser (EveryStep, Des Moines, IA) and Dr. David Rand (UVM Medical Center).

The primary features of the Steroid Taper App are: 1) Calculates a taper of steroids by a fixed dose. 2) Calculates a taper of steroids by a fixed percentage of the previous dose. 3) Allows the user to create a manual pill taper by specifying the pill strength, number of pills and duration of each step of the taper. 4) Allows the user to create a manual liquid taper by specifying the liquid concentration, dose volume and duration of each step of the taper. 5) Creates an easy-to-read, patient-friendly calendar from any of the above tapers that can be emailed and printed. 6) Creates an easy-to-read summary of the taper to facilitate review by the user. 7) Creates tapers for the most common pill and liquid forms of steroids (predniSONE and prednisoLONE, respectively) The Steroid Taper App also has the following features: 1) Allows entry of patient height and weight to alert the user if starting steroid dose is above 3mg/kg (higher than standard outpatient regimens) 2) Calculates body surface area to determine at what dose taper should be slowed down due to potential adrenal insufficiency (“adrenal point”). 3) Allows entry of height and weight in either metric and English units 4) Rounds pill doses to nearest half pill, except for 1mg pills, which cannot be split. 5) Rounds liquid doses to volumes easily measured by families at home. (Nearest 0.2ml for doses 0-1 ml, nearest 0.5 ml for doses 1-10 ml and nearest 1 ml for doses greater than 10 ml) 6) Allows user to select up to two pill strengths of prednisone per taper. 7) Allows user to set a loading dose (strength and duration) 8) Generates a “pharmacy summary” that calculates the total number of predniSONE pills or total volume of prednisoLONE liquid needed for each 30 day period. Notes about App operation/limitations: 1) Printing: A pdf calendar is generated on a server and emailed to the email address set up in settings. It can then be printed from any computer/device with access to the email and to printing. 2) In order to remain HIPAA compliant, the App does NOT have fields for entering patient identifying information. 3) App output does NOT sync with mobile device calendars. 4) Only one or two pill sizes are allowed per step of pill-based tapers. 5) When calculating a taper by a fixed percentage, if the App calculates that the dose will repeat for two consecutive taper periods, the App will terminate the taper after the first of the duplicate taper periods. For training please follow this link: http://media.mcw.edu/app-challenge/steriodtaperappv2/story_html5.html