Winning the Wean: Developing and managing sedation weans

Saturday, May 4, 2024

2:00 PM – 3:30 PM ET

Location: Metro Toronto Convention Centre: 715 A

CE: Live CME: 1.5

Leader(s)

KT

Katherine Tang, MD (she/her/hers)

Assistant Professor of Pediatrics
Columbia University Vagelos College of Physicians and Surgeons
New York, New York, United States

Slides

Co-Leader(s)

Leanne Svoboda, PharmD (she/her/hers)

Pediatric Lead Clinical Pharmacy Manager
NewYork Presbyterian, Morgan Stanley Children’s Hospital
New York, New York, United States
Zarema Muratova, BS Pharm, BCPPS (she/her/hers)

Pediatric Progressive Care Unit Pharmacist
Morgan Stanley Children’s Hospital, Columbia University Medical Center, New York-Presbyterian Hospital
Brooklyn, New York, United States
NM

Nicole Meyers, MD (she/her/hers)

Pediatric Hospital Medicine Fellow
NewYork-Presbyterian Morgan Stanley Children's Hospital
New York, New York, United States
Hadley Brighton, MA, MD (she/her/hers)

Assistant Professor of Pediatrics
Weill Cornell Medicine, United States
DL

Divya Lakhaney, MD (she/her/hers)

Associate Professor of Pediatrics
Columbia University Vagelos College of Physicians and Surgeons
New York, New York, United States
Taylor Sewell, MD, MBA (he/him/his)

Assistant Professor of Pediatrics at CUMC
Columbia University Vagelos College of Physicians and Surgeons
New Hope, Pennsylvania, United States
Mirna Giordano, MD, FAAP, FHM (she/her/hers)

Associate Professor of Pediatrics
Columbia University
New York City, New York, United States
TM

Teresa McCann, MD (she/her/hers)

Columbia University Irving Medical Center
Bronx, New York, United States
Senayit Demie, MD (she/her/hers)

Assistant Professor of Pediatrics
Morehouse School of Medicine
Decatur, Georgia, United States
AR

Alex Ramirez, MD (he/him/his)

Pediatric Hospital Medicine Fellow
NewYork-Presbyterian Hospital
Yonkers, New York, United States

Disclosure(s):

Katherine Tang, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Leanne Svoboda, PharmD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Zarema Muratova, BS Pharm, BCPPS: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Nicole K. Meyers, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Hadley Brighton, MA, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Divya Lakhaney, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Taylor B. Sewell, MD, MBA: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Mirna Giordano, MD, FAAP, FHM: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Teresa McCann, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Senayit Demie, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Alex A. Ramirez, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Workshop

Description: Long-term sedation and analgesia with medications such as opioids, benzodiazepines, and alpha-2 agonists are required for a variety of hospitalized patients. These patients often have prolonged hospitalizations and are at risk of withdrawal when those medications are weaned. Tools, such as the Withdrawal Assessment Tool (WAT), are validated to characterize withdrawal severity. However, there is no validated, standardized method for how to apply these tools to wean sedative and analgesic medications. This workshop will discuss the challenges in developing weaning regimens for inpatient and outpatient monitoring, strategies to meet unique patient needs, and diagnostic difficulties when facing withdrawal symptoms. Participants will learn how to implement strategies to wean sedative and analgesic medications safely while monitoring for withdrawal and other complications.

Workshop content will focus on familiarizing participants with the commonly used medication classes noted above and common dosing regimens. The workshop will include a step-by-step approach based on best practices and literature. Workshop leaders will guide participants through small group discussions with case-based scenarios focused on how to wean different classes of medications. The cases will highlight various considerations to make when facing complicated patient and illness factors as well as management post-discharge. The participants will have the opportunity to create concrete patient plans in a group setting and will receive a pocket reference card for easy access to the sedation weaning techniques discussed. At the conclusion of the workshop, materials will be distributed through a QR code to allow participants to share the lessons learned at their home institutions.

Learning Objectives:

Describe commonly used sedative/analgesic medications (opioids, benzodiazepines, and alpha-2 agonists) and their properties
Analyze different approaches to tapering sedative/analgesic medications (opioids, benzodiazepines, and alpha-2 agonists) based on various clinical scenarios, patient needs, and goals for discharge
Evaluate and manage adverse effects, withdrawal, and other complications of tapering sedative/analgesic medications using validated tools