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How Strong are Different Painkillers: Equianalgesia Introduction

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Intro to how strong/potent different painkillers are

Hey guys so good to see you all again this video is going to be introduction to this concept known as equi analgesia what this means is equal pain killing now a lot of people think that pain killers you know whether it’s aspirin or fentanyl they think that these painkillers they might be a little bit different but how different are they this video is going to kind

Of introduce you to the system or the chart by which providers keep them all separate and really try and give you an appreciation of how very strong some of the different drugs that we have so i chose some examples here these are ones that you’ve probably heard of and i guess my goal here is to make you aware of just how strong some our painkillers are and how

This stuff is not going to be messed around with also i kind of want to talk about the gold standard which is a good introduction or good segue here we kind of compare the efficacy or how well a painkiller works by how it compares to oral morphine so that’s taking like 10 milligrams of oral morphine by mouth or hydrocodone now those are kind of our two like gold

Standards so really when we’re talking about the strength of a painkiller you want to know hey man isn’t stronger than oral morphine and that’s really what we’re talking about so i have these listed up here i’m just going to quickly go through them again these are probably ones you’ve heard of and i’ll try and you know yell out any trade names if if it comes up acetyl

Salicylic acid is actually aspirin and this is going to be the weakest one i’m going to talk about this is one 360th as strong as hydrocodone so people you know they come into the hospital and they ask for hydrocodone or that sort of thing and they say well hey i mean i’ve been taking aspirin it hasn’t really even been touching this pain maybe some hydrocodone that

Is a big step it’s a big step from aspirin to oral morphine it’s one and one three hundred and sixtieth as powerful so we usually taper this down compared to aspirin so if you’re taking like you know another ends it might be like ibuprofen you might be taking 400 milligrams i pro fionn and then they only give you ten milligrams of morphine err you know that would

Even be huge but they’re going to the doses will be different to try and compensate for this huge difference in potency the next one our list is going to be coding which is an antitussive or knocks out your coughing so a lot of people have it in cough syrup form this is one-tenth as strong as hydro or oral morphine next one’s going to be tramadol this is a very very

Very popular painkiller right now supposed to be less addictive and also have some sedative properties so they’ve been handing out tramadol like candy lately that’s also one tenth just like coding the next one is meperidine which isn’t used as much anymore but it used to be used quite a bit still used by some people in this commonly called demerol you might have

Heard of that that’s one third as potent or as strong as hydrocodone oral morphine this was cry one over one because obviously they’re in there as to the gold standard that’s the botes you were going for next list this is gonna be awks ecotone oxycontin percocet those sort of things that’s going to be 1.5 times as strong as hydrocodone or ol marking so if someone

Said well i took a hydro last night can i have an oxy today well they’re actually bumping up the scale those aren’t synonymous with each other before i move too far ahead i wanted to mention real quick you might have heard of hydrocodone in its mixture form with acetaminophen or tylenol as lortab or no norco that sort of thing that’s how it’s commonly prescribed

Try to get that extra pain killing kick from acetaminophen iv morphine is actually three times as potent as oral morphine that’s because we’re injecting it as a high bioavailability which without going in too much in the farm what we’re talking about here is if we pump it straight into your bloodstream it’s going to hit you a lot peer without being broken down or

Metabolized versus oral morphine has to you know be absorbed from your gastrointestinal tract that sort of thing next one up in the list here’s hydromorphone hydromorphone you might have heard of as dilaudid and that’s five times as potent as the gold standard here this is commonly used for post-op analgesia so like someone that just had a colectomy or some major

Surgery we might give them some dilaudid in the pacu the post anesthesia carry any that sort of thing next on the list is fentanyl you almost everyone’s heard of that that’s 500 dual or excuse me 50 to a hundred times as potent as hydro or morphine and the last one i put on here just kind of for trivia is tor fein all some of those m99 and this you might recognize

Is the drug that dexter in the tv show called dexter used to knock out his victims it hits you so fast it’s so rapid acting is so strong that it’s knocked you unconscious that’s why dexter uses it to knock out the people he’s after we don’t really use it in human medicine but you know veterinarians people that are knocking out grizzly bears that sort of thing

Might have it in their arsenal this right here is a quick chart to the most common painkillers you’ll encounter and what the relative potencies are so just to kind of give you an idea of how we account for these differences in potencies is like if i give you 10 milligrams of oral morphine and you want to know well how much fentanyl would you give me to get that

Same effect it would take 10 milligrams of these things whereas i only take point one or point two milligrams of fentanyl so you can just kind of divide out you know the potencies and find it out but i’m just trying to really hit this point home whereas if you’re taking tram at all you would need ten times as much tram it ought to be the same effect so i’d have to

Give you a hundred milligrams of tramadol to get the same effect as 10 milligrams of hydrocodone that sort of thing so don’t make the mistake of saying hey i was on whatever 400 milligrams of ibuprofen can’t you just give me 400 milligrams of oxycodone it doesn’t work like that different painkillers hit your different strengths and that’s the instruction to equate

On jie jie let us know getting questions thank

Transcribed from video
How Strong are Different Painkillers: Equianalgesia Introduction By Med School Made Easy