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    Pain Card v31

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    srajnic
    This document provides a table comparing opioid equivalents for different routes of administration including morphine, hydromorphone, oxycodone, and fentanyl. It also includes additional conversions between these opioids administered intravenously or orally. Common medication uses at Rush hospital are provided comparing hydrocodone combinations to morphine equivalents intravenously and orally. Additional tips are given for the Illinois Prescription Monitoring Program, uses of naloxone, risk factors for respiratory depression, and prevention and management of common opioid side effects like constipation, nausea, pruritus, sedation, and respiratory depression.

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    Pain Card v31

    Uploaded by

    srajnic
    79 views2 pages
    This document provides a table comparing opioid equivalents for different routes of administration including morphine, hydromorphone, oxycodone, and fentanyl. It also includes additional conversions between these opioids administered intravenously or orally. Common medication uses at Rush hospital are provided comparing hydrocodone combinations to morphine equivalents intravenously and orally. Additional tips are given for the Illinois Prescription Monitoring Program, uses of naloxone, risk factors for respiratory depression, and prevention and management of common opioid side effects like constipation, nausea, pruritus, sedation, and respiratory depression.

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    opioid equivalents

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    This document provides a table comparing opioid equivalents for different routes of administration including morphine, hydromorphone, oxycodone, and fentanyl. It also includes additional conversions between these opioids administered intravenously or orally. Common medication uses at Rush hospital are provided comparing hydrocodone combinations to morphine equivalents intravenously and orally. Additional tips are given for the Illinois Prescription Monitoring Program, uses of naloxone, risk factors for respiratory depression, and prevention and management of common opioid side effects like constipation, nausea, pruritus, sedation, and respiratory depression.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    79 views2 pages

    Pain Card v31

    Uploaded by

    srajnic
    This document provides a table comparing opioid equivalents for different routes of administration including morphine, hydromorphone, oxycodone, and fentanyl. It also includes additional conversions between these opioids administered intravenously or orally. Common medication uses at Rush hospital are provided comparing hydrocodone combinations to morphine equivalents intravenously and orally. Additional tips are given for the Illinois Prescription Monitoring Program, uses of naloxone, risk factors for respiratory depression, and prevention and management of common opioid side effects like constipation, nausea, pruritus, sedation, and respiratory depression.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 2

    TABLE OF OPIOID EQUIVALENTS FOR

    DIFFERENT ROUTES OF ADMINISTRATION

    NAME IV DOSE PO DOSE RATIO IV:PO


    Morphine 2 mg 6 mg 1:3
    Hydromorphone (Dilaudid) 0.3 mg 1.5 mg 1:5
    Oxycodone 4 mg
    Fentanyl 20 mcg

    ADDITIONAL CONVERSIONS:
    Hydrocodone PO: morphine PO = 1:1
    Dilaudid IV: morphine IV = 1: 7 (ie 1 mg IV Dilaudid = 7 mg IV morphine)
    Morphine IV: Dilaudid IV = 1: 0.14 (ie 1 mg IV morphine = 0.14 mg IV Dilaudid)
    Dilaudid PO: morphine PO = 1: 4 (ie 1 mg PO Dilaudid = 4 mg PO morphine)
    Morphine PO: Dilaudid PO = 1: 0.25 (ie 1 mg PO morphine = 0.25 mg PO Dilaudid)

    COMMON MED USE AT RUSH:


    Norco 5 (hydrocodone/acetaminophen) = Morphine PO 5 mg = Morphine IV 1.67 mg
    Norco 10 (hydrocodone/acetaminophen) = Morphine PO 10 mg = Morphine IV 3.33 mg
    MSIR 15 mg (15 mg PO morphine) = Morphine IV 5 mg = 3 doses of Norco 5/325 mg PO at once
    ADDITIONAL TIPS Constipation Patients with scheduled opioids
    should have stimulant laxitive
    Illinois Prescription Monitoring Program: (e.g. senna, bisacodyl) + stool
    https://www.ilpmp.org/ softener (e.g. docusate)
    Naloxone (Narcan) Nausea/ Add antiemetics
    Indications: Vomiting (e.g. ondansetron, prochlorpera-
    Most important role: reversal of respiratory zine, metoclopramide). Decrease
    depression opioid dose & increase frequency;
    If RR less than 8, hypoxemic, or cyanotic: add non-opioid to reduce opioid
    dilute a 0.4mg vial in 9 ml NS and administer load; change opioid
    1 ml every 10 to 30 seconds over 3 minutes
    Pruritus Diphenhydramine 12.5-25 mg
    Adverse Effects:
    PO/IV. Decrease opioid dose
    Opioid withdrawal & pain
    & increase frequency; add
    Nausea, vomiting
    non-opioid to reduce opioid
    Abrupt i in LES sphincter tone: aspiration
    load; change opioid
    pneumonia
    Cardiac arrhythmias including VT & VF Sedation Monitor. Decrease opioid dose
    Unopposed seizure activity of normeperidine & increase frequency; add
    Risk Factors for Respiratory Depression non-opioid to reduce opioid
    BMI >30 load; change opioid.
    CrCl <30 mL/min
    Respiratory Monitor. Stop opioid, if necessary
    Concomitant benzodiazepine use
    Depression titrate naloxone to avoid with-
    Prevention and Management of opioid drawal, seizures, and severe pain.
    side effects (see right)

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