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Demystifying Opioid Conversion Calculations: A Guide to Effective Dosing , Mary Lynn McPherson, PharmD, BCPS, CPE
Kevin L. Zacharoff, MD
This book was written to be a guide for all levels of clinicians with regard to what is often considered to be a complex subject -- the process of appropriately converting opioids in a manner that is safe, consistent, and rooted in well thought-out calculations and principles.

Dr. McPherson has successfully taken her thoughts and lectures and transformed them into an invaluable reference that clinicians who treat pain with opioids will want to have close at hand. In addition to being written in a very disarming and warm style (as if she is speaking directly to the reader), the text often refers to clinical situations and rationale that can be easily identified with, and extrapolated into everyday practice.

Goals and objectives are clearly identified at the beginning of each chapter, so the reader may head right to the subject or chapter of interest. Terminology is clearly explained throughout, and a thorough glossary is included at the end of the book. A variety of learning points are clearly laid out along the way, including "Pitfalls", "Fast Facts", "Practice Problems", and a term we can all relate to "Pearls".

The book is very well referenced, and additional recommended readings are offered as well. Topics often not covered are included, such as patient-controlled analgesia (PCA), neuraxial opioids, and dose calculations from oral solutions and suspensions.

The assumption is made that the clinician already has the idea as to what they want to do, and this text goes into detail about how to do it. The calculations are presented in ways that although not simplistic, are practical, and more importantly reproducible.

What type of clinician would likely benefit most from this book?
This book has the potential to become an invaluable resource to anyone who manages acute or chronic pain when opioids are an appropriate component of therapy, considering the fact that rotation may always play a role in the continuum of care.

How would you recommend this book be used to enhance the care of patients with pain?
A safe, effective, and rational approach to converting opioids is a mandate for quality care of pain. This book provides a handy resource for clinicians to refer to, again and again, to ensure that goal.

Are there any features or sections of the book you liked most or least?
This book was written in "colleague to colleague" manner, and leaves the impression that you’ve just had a discussion or consultation or discussion with Dr. McPherson. This is an approach that clearly resonates with clinicians at every discipline level. It is never demeaning in any manner, and is actually encouraging in its tone.



Mary Lynn McPherson, PharmD, BCPS, CPE

Dr. McPherson is a Professor and Vice Chair of the Department of Pharmacy Practice and Science at the University of Maryland School of Pharmacy in Baltimore, Maryland. She is also an Adjunct Professor at the University of Maryland School of Nursing. She serves as a consultant pharmacist for both local and national hospice and palliative care programs, and has designed a critical thinking process for appropriate drug use in end of life patients.

She serves on the Board of the Hospice Network of Maryland, chairing the Education and Outreach Committee. She also serves on the Board of the Maryland Pain Initiative and is the Chair of the Board of the American Society of Pain Educators. Dr. McPherson also serves as a primary care pharmacist and Director of Pharmacotherapy Services at University Care Waxter in Baltimore. She also developed one of the first and few palliative care pharmacy residencies in the U.S.


Demystifying Opioid Conversion Calculations: A Guide to Effective Dosing. Mary Lynn McPherson. Published by the American Society of Health-System Pharmacists. September, 2009.

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