Resource Canada MAiD Report: Med Protocols

[cornflowerblue]

https://camapcanada.ca/wp-content/uploads/2019/01/OralMAiD-Med.pdf

 

[LifeIsNotFun]

https://camapcanada.ca/wp-content/uploads/2019/01/OralMAiD-Med.pdf

Thanks for posting this

 

[lululoo]

Thank you for posting. Interesting that they propose using meto along with another anti-emetic, both stat dose. This makes me feel better about stat dose, which I may need to use because the 48 hour protocol is pretty harrowing.

It says meto 20 mg plus either ondansetron 8-24mg or dexamethasone 8mg. I wonder if the latter are easy to get.

 

[cornflowerblue]

Thank you for posting. Interesting that they propose using meto along with another anti-emetic, both stat dose. This makes me feel better about stat dose, which I may need to use because the 48 hour protocol is pretty harrowing.

It says meto 20 mg plus either ondansetron 8-24mg or dexamethasone 8mg. I wonder if the latter are easy to get.

The normal stat dose is 30mg meto. I think this alternative of 20mg meto + other anti-emetics is to reduce the likelihood of EPS from the high meto dose. 30mg meto is also too high of a dose for people below a certain weight (around 130lb) and in terms of mg/kg is above the daily maximum allowed dose. So the recommendation for 20mg can also be to accommodate for that and make the regimen more universally applicable. I'm sure that many elderly or terminally ill people don't weigh as much as all of the young people here.

Dexmethasone would be hard to get if you're not already ill. The only reason for healthy people to have it is if they're going mountain climbing and want to prevent altitude sickness.

Odanestron is the same type of problem. In healthy people it is mostly only used for airplane motion sickness.

 

[LifeIsNotFun]

The normal stat dose is 30mg meto. I think this alternative of 20mg meto + other anti-emetics is to reduce the likelihood of EPS from the high meto dose. 30mg meto is also too high of a dose for people below a certain weight (around 130lb) and in terms of mg/kg is above the daily maximum allowed dose. So the recommendation for 20mg can also be to accommodate for that and make the regimen more universally applicable. I'm sure that many elderly or terminally ill people don't weigh as much as all of the young people here.

Dexmethasone would be hard to get if you're not already ill. The only reason for healthy people to have it is if they're going mountain climbing and want to prevent altitude sickness.

Odanestron is the same type of problem. In healthy people it is mostly only used for airplane motion sickness.

I only have meto though, and weigh approx 106kg. Meto should be sufficient with N no?

 

[cornflowerblue]

I only have meto though, and weigh approx 106kg. Meto should be sufficient with N no?

Yes I haven't seen any sources saying meto isn't sufficient.

This guide is for elderly and terminally ill, so my thoughts were that this combo with the lower meto amount is just an alternative to avoid a "meto OD", since the patients could be very light from illness and being bedridden, or maybe can't tolerate EPS.

I lost the link and just searched and couldn't find it again, but today I read two articles about vomiting. One was about 26-ish N deaths. Only 12 used anti-emetics and only 3 used meto. All died without signs of vomiting. The other was from the updated German or danish version of that yellow book, I'm not sure the title, which said that out of around 161 assisted suicide patients some large proportion didn't use anti-emetics, and vomiting was very rare.

 

[lululoo]

The normal stat dose is 30mg meto. I think this alternative of 20mg meto + other anti-emetics is to reduce the likelihood of EPS from the high meto dose. 30mg meto is also too high of a dose for people below a certain weight (around 130lb) and in terms of mg/kg is above the daily maximum allowed dose. So the recommendation for 20mg can also be to accommodate for that and make the regimen more universally applicable. I'm sure that many elderly or terminally ill people don't weigh as much as all of the young people here.

Dexmethasone would be hard to get if you're not already ill. The only reason for healthy people to have it is if they're going mountain climbing and want to prevent altitude sickness.

Odanestron is the same type of problem. In healthy people it is mostly only used for airplane motion sickness.

Crap! I wish I had thought to order that before. I just looked on ebay and bonanza and it seems you can't get them. Does anyone know of a source?

Also where are you getting the info on 130 lbs? I am under that so if you're correct then for a stat dose I should just take 20 mg meto even if I don't have one of the other anti-emetics to go with it? But the PPeH doesn't mention this weight cutoff I thought...

 

[cornflowerblue]

Crap! I wish I had thought to order that before. I just looked on ebay and bonanza and it seems you can't get them. Does anyone know of a source?

Also where are you getting the info on 130 lbs? I am under that so if you're correct then for a stat dose I should just take 20 mg meto even if I don't have one of the other anti-emetics to go with it? But the PPeH doesn't mention this weight cutoff I thought...

I can't remeber where it's from, I read so many things today and didn't save links. It was just about the maximum meto dose in a 24hr period, using mg/kg. I think the cutoff for 30mg came out around 130lb but I honestly don't remember exactly. I'll post the link if I can find it again.

Crap! I wish I had thought to order that before. I just looked on ebay and bonanza and it seems you can't get them. Does anyone know of a source?

Also where are you getting the info on 130 lbs? I am under that so if you're correct then for a stat dose I should just take 20 mg meto even if I don't have one of the other anti-emetics to go with it? But the PPeH doesn't mention this weight cutoff I thought...

I'm not sure what I was looking at earlier, the max dose is 60mg.

https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/017854s062lbl.pdf

Here is an article about the 20-ish deaths that I posted about earlier. My summary from memory was a little off. https://onlinelibrary.wiley.com/doi/full/10.1111/1556-4029.13828

 

[LifeIsNotFun]

I can't remeber where it's from, I read so many things today and didn't save links. It was just about the maximum meto dose in a 24hr period, using mg/kg. I think the cutoff for 30mg came out around 130lb but I honestly don't remember exactly. I'll post the link if I can find it again.

I'm not sure what I was looking at earlier, the max dose is 60mg.

https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/017854s062lbl.pdf

Here is an article about the 20-ish deaths that I posted about earlier. My summary from memory was a little off. https://onlinelibrary.wiley.com/doi/full/10.1111/1556-4029.13828

The first PDF link isn't working for me, its saying Access denied. In terms of 30mg meto being at 130 lb, do I need to take more cause I am 234lb?

 

[cornflowerblue]

The first PDF link isn't working for me, its saying Access denied. In terms of 30mg meto being at 130 lb, do I need to take more cause I am 234lb?

It's just the package insert for meto, you can google "metocloperamide package insert" and it should turn up

 

[LifeIsNotFun]

It's just the package insert for meto, you can google "metocloperamide package insert" and it should turn up

Ok thanks.