Methadone and buprenorphine are the most common medications for opioid use disorder. Buprenorphine is often the preferred medication because of fewer drug-drug interactions and fewer regulatory barriers. For these reasons, patients often desire to transition from methadone to buprenorphine, but this can be difficult because of the risk of precipitated withdrawal. There are protocols designed to minimize withdrawal; however, these can be time-consuming or infeasible due to formulation and dosage availability of buprenorphine. We describe an inpatient transition from methadone to buprenorphine using a hydromorphone bridge over a 7-day period. This method used commonly available dosages and formulations of buprenorphine. To our knowledge, this is the first time a method has been described that transitions a patient from methadone to buprenorphine using a short-acting opioid agonist bridge and readily available opioid dosages and formulations. This case provides a viable alternative for rapidly transitioning a patient from methadone to buprenorphine that can be used as a template for an alternative method to transitions between these medications.

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. (1972). Archives of Disease in Childhood, 47, 927. Clinical pharmacology of gentamicin in the newborn infant. Newborn infants with suspected bacterial infection were treated with intramuscular gentamicin. Serum levels of the drug were measured 1 hour after the first dose, immediately before the second dose, and immediately before and 1 hour after a dose given on the third day.On a low dosage regimen (1 mg/kg every 8 hours) 9 of 17 infants had serum gentamicin levels below the required minimum level of 1 ,ug/ml immediately before the second dose, and 5 of 19 infants had similarly low levels on the third day. On a high dosage regimen (3 mg/kg initially, then 2 mg/kg every 8 hours) 2 of 10 infants had preinjection serum gentamicin levels below 1 ,ig/ml on the first day, and 3 out of 16 had similar levels on the third day. The mean ( + SE) serum gentamicin level on the high dosage regimen was 5 0 0 ±05 jg/ml 1 hour after the first injection, 1 9±0 4 Fg/ml just before the second injection, and on the third day 1 9 ±03 ,ug/ml just before an injection and 5 1 ±0 * 5 [Lg/ml 1 hour after injection. The highest serum gentamicin level recorded in any of the 40 infants studied was 8 2 ,ug/ml.On the first day of treatment with the low dose regimen, a mean of 21 % (range 9-68%) of the injected dose was recovered from the urine; and on the third or fourth day a mean of 44% (range 17-76%) of the gentamicin injected on that day was recovered.In 4 infants who died tissue gentamicin levels were measured in the liver, lungs, heart, kidneys, and brain, the highest concentration being in the kidney with low levels in the heart, liver, and brain, while levels in the lungs were intermediate. Neonatal renal and pulmonary infections are thus likely to be suitably treated with gentamicin.Bacteriological studies confirmed the effectiveness of gentamicin in the treatment of neonatal infection, but a dosage regimen derived by extrapolation from older children frequently resulted in inadequate serum levels, and a higher dosage regimen giving more satisfactory results was therefore defined.The effectiveness of gentamicin in vitro against Pseudomonas pyocyanea and other bacterial species commonly found in hospital nurseries (Barber and Waterworth, 1966)