Dilaudid
Hydromorphone
Class:
Analgesic; opiate agonist.
Analgesic; opiate agonist.
Mechanism of Action:
Hydromorphone is a semisynthetic analog of morphine used to relieve moderate to severe pain in cancer, surgery, trauma, burn, and cardiac patients. The drug works at opioid receptors to produce analgesia and euphoria. It may also produce respiratory depression, miosis, decreased gastrointestinal motility, and physical dependence. Hydromorphone is a schedule-II controlled substance.
Hydromorphone is a semisynthetic analog of morphine used to relieve moderate to severe pain in cancer, surgery, trauma, burn, and cardiac patients. The drug works at opioid receptors to produce analgesia and euphoria. It may also produce respiratory depression, miosis, decreased gastrointestinal motility, and physical dependence. Hydromorphone is a schedule-II controlled substance.
Indications:
- Moderate to severe pain Analgesia.
- Preoperative medication.
Contraindications:
- Asthma.
- GI obstruction.
- Hypersensitivity to narcotics.
- Respiratory depression.
- Status asthmaticus.
Adverse reactions:
- Respiratory depression.
- Nausea and vomiting.
- Euphoria.
- Delirium.
- Agitation.
- Hallucination Seizures.
- Headache.
- Hypotension.
- Visual disturbances.
- Coma.
- Facial flushing.
- Circulatory collapse.
- Dysrhythmias.
- Allergic reaction.
- Drowsiness.
- Rash.
Drug Interactions:
- Respiratory depression, hypotension or sedation may be potentiated by central nervous system depressants.
- Therapeutic doses of hydromorphone have caused additive CNS or respiratory depression and hypotension in patients taking MAO inhibitors.
Adult Dosage and Administration
1-2 mg SC/IM or slow IV every 6 hr.; titrate to pain relief.
1-2 mg SC/IM or slow IV every 6 hr.; titrate to pain relief.
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Pediatric Dosage and Administration:- >50 kg: 1 mg IV/SC every 4 hr.
- < 50 kg or >6 months of age: 0.015-0.02 mg/kg IV/SC every 2-4 hr; titrate to pain relief.
Duration of Action:
- Onset (IV/IM): Within 15min (dose related).
- Duration: 4-5 hr in nondependent patients.
Special Considerations:
- Pregnancy safety: Category C.
- High potential for abuse, use with extreme caution in patients with head trauma, increased intracranial pressure (ICP), or a preexisting seizure disorder. Use with caution in patients with cardiac dysrhythmias, hypotension, circulatory shock, or hypovolemia. Elderly patients may be more suceptible to adverse reactions.
- Can induce vasovagal syncope or orthostatic hypotension. Naloxone should be readily available.