Clinical Coping with Prescribing Opioids within the Context of Obesity and Diabetes Mellitus

The purpose of this article is to provide podiatric physicians with the strategies for identifying, assessing and responding to patients who may have changes in opioid pharmacokinetics and pharmacodynamics due to sex and age differences and disease states. First of all, possible opioid drug interactions that exist within the context of patient demographics and disease states are presented and described. Secondly, both pharmacokinetic and pharmacodynamics changes of opioid agents within certain patient demographics are presented. Lastly, the art of clinical coping mechanism to prescribe opioids to patients that may be elderly or presenting with disease states that may alter opioid pharmacokinetics.