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Basic Opioid based Pain Medications [UndergroundMed]

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I’m going to start by saying that opiate pain medications are incorrectly complex and extends the topic and that we’re no way try and teach you all of it however what we want to do in this video is break that down and do something digestible so that you aren’t overwhelmed by tidal wave of knowledge now we’re gonna focus on four common opiate based pain medications

Morphine hydromorphone oxycodone and oxycontin there are numerous methods of delivery for these medications but i’m just gonna focus on oral aka pio delivery as well as iv delivery and en i will talk briefly about how to convert dosages between these medications as well as give you a basic basic idea of the dosages that you might see for these we’re gonna start

With morphine which is considered a gold standard for opiate pain medications not because it’s superior but because many other opiate-based pain medications are derived directly from it since most opiates are derived from morphine they have similar side effects which include nausea vomiting sedation euphoria constipation urinary retention dependency depression

Among other things now morphine can be given both by an iv or by epo where the pio doses having to be three to six times higher than the iv doses because of issues with metabolism and absorption from a gi tract but that’s another topic entirely wharfing generally works well to control pain for three to seven hours which is why you often see it written to be given

Every four or six hours as needed via iv morphine will reaches max effect at around twenty to thirty minutes and via pio morphine will reach its max effect around 60 minutes next up we have hydromorphone aka dilaudid this medication is very similar to morphine but is more potent meaning it requires less to achieve the same effect in fact iv dilaudid is about eight

Times as potent as iv morphine bell on it is thought to have less of a side-effect profile as well as a smaller risk for dependency which is why it’s often a good alternative if your patient cannot tolerate morphine in terms of delivery it can be delivered by a iv or pio with the pio doses having to be about five times higher for two reasons we discussed before it

Generally works about a control pain for four to five hours which is why you’ll often see it written to be given every four hours as needed by a pio hydromorphone will achieve its max if x between 30 and 60 minutes via iv hydromorphone will achieve its max of fact between 15 to 30 minutes oxycodone is our next contestant again a very similar to morphine but what’s

Known as the boe about this drug is that it’s in oral medication and you often transition your patients from an iv pain medication such as morphine to oxycodone for expectation of outpatient management it is in no way the best one or only one but it’s a very commonly used one for pio transition oxycodone generally works well for four to six hours we’ve already talked

About oxycodone being apo pain medication because of its good oral absorption its doses are generally twice that of iv morphine for example 20 milligrams of pio oxy is about equal to 10 milligrams of iv morphine it takes about one to two hours for oxycodone to achieve its max of fact oxycontin is next and it’s just really extended police version of oxycodone what

This means is that oxycontin is also a pio medication but works well for about 12 hours instead of a four to six hours with oxycodone which is why you’ll often see oxycontin written to be given twice a day or every 12 hours because of its extended release –mess it can take up to three for oxycontin to reach its max effect in terms of dosages oxycontin is absorb

Just as well oxycodone but because it’s given every 12 hours instead of every four or six each dose will be higher for example let’s say a patient is on five milligrams of oxycodone every four hours which means that he gets six times five or thirty milligrams of oxycodone in 24 hours this will mean that he would require a dose of 15 milligrams of oxycontin twice a

Day in order to achieve the same effect over the course of one day now when you’re in the hospital the following scenario will come up pretty often your patient is going to go home from the hospital tomorrow and you need to transition him from iv pain medications to pio pain medications as an outpatient how in the world you do that you do this with help from what

We call equal energies of charts which you can easily look up what they tell you is what dosages of medications are needed to achieve the same pain control effect across different medications and delivery mechanisms so for example 10 milligrams of iv morphine requires about 20 milligrams pio of oxycodone in order to achieve the same effect similarly 10 milligrams

Of iv morphine is equal to about seven point five milligrams of pio hydromorphone just to give you an idea of what dosages you might see so an opiate a naive person might require one to five milligrams of iv morphine in order to achieve good analgesic effects and you can convert this to the other medications based on this table now fair warning this is again just

To show you how to use the table calculating pain regimen and actuality it can be much more complicated and require consideration of numerous other factors but if you can use this conversion table you’re off to a good start lastly orbit pain medications are affected by kidney as well as hepatic function so if your patient has damaged ivs organs think carefully

Now here are take-home points along with few tables that summarize all of our main topics thank you

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Basic Opioid based Pain Medications [UndergroundMed] By UndergroudMed