Patient is receiving a total of 5 mg of parenteral hydromorphone in a hour period via a PCA pump. The goal is to convert this to oral morphine for discharge. When converting from PCA administration, add the total amount of opioid that the patient received in the last 24 hours, including. Basal infusion.
Demand boluses administered by the patient. The equianalgesic chart indicates that 1. Opioid overdose:. If given IV, each 0. Opioid-induced respiratory depression. Continue looking for other causes of sedation and respiratory depression. Special considerations. Depending on amount and type of opioid given and time interval since last opioid administration, the duration of action of some opioids may exceed that of naloxone. Use of Oral Methadone for Chronic Pain.
Methadone Conversion Ratios. Conversion ratio. Conversion factor. For difficulties with pain management, contact the Pain Medicine Service at clinic or on call pager. American Society of Health-System Pharmacists. American Pain Society Principles of analgesic use in the treatment of acute pain and cancer pain 5 th ed. Glenview, IL: Author. If too much of this medicine is taken for a long time, it may become habit-forming causing mental or physical dependence.
It is very important that you understand the rules of the Opioid Analgesic REMS program to prevent addiction, abuse, and misuse of hydromorphone. This medicine should also come with a Medication Guide. Read and follow these instructions carefully. Read it again each time you refill your prescription in case there is new information. Ask your doctor if you have any questions. Measure the oral liquid with a marked measuring spoon, oral syringe, or medicine cup.
The average household teaspoon may not hold the right amount of liquid. Do not switch from the extended-release tablets to the immediate-release tablets unless your doctor tells you to. Be careful not to handle crushed or broken tablets. If you have contact with broken or crushed tablets or spilled oral liquid, wash your skin or the affected areas with soap and water right away. The dose of this medicine will be different for different patients.
Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions. It may reduce pain by acting on certain opioid receptors in the brain and spinal cord, which make up your central nervous system.
Hydromorphone oral tablet can cause drowsiness and dizziness. These effects may be more likely in the first few hours after you take it. This drug can also cause other side effects. Hydromorphone can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking hydromorphone. For more information on the possible side effects of hydromorphone or tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.
If these effects are mild, they may go away within a few days or a couple of weeks. Call your doctor right away if you have serious side effects. The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.
Your doctor will tell you what dosage of hydromorphone you should take. They may increase your dosage by 4—8 mg every 3—4 days if needed. This medication has not been studied in children. It should not be used in people younger than 18 years.
The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time.
This raises your risk of side effects. Your doctor may start you on a lowered dosage or a different schedule.
This can help keep levels of this drug from building up too much in your body. People with kidney disease: Your doctor may start you at a dose that is 25 percent to 50 percent lower than the typical starting dose. People with liver disease: Your doctor may start you at a dose that is 25 percent to 50 percent lower than the typical starting dose.
If you have severe liver problems, your doctor may use another drug for pain relief instead of the extended-release tablet, or they may give you a lower dosage of another form of this drug.
Hydromorphone oral tablet is generally used for short-term treatment. For this drug to work well, a certain amount needs to be in your body at all times.
If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:. But if your symptoms are severe, call or go to the nearest emergency room right away. What to do if you miss a dose: Take your dose as soon as you remember. If you remember just a few hours before your next scheduled dose, take only one.
Never try to catch up by taking two doses at once. This could result in dangerous side effects. This drug may cause a sudden drop in blood pressure. This may cause lightheadedness, dizziness, and even fainting. Your risk may be higher if you have a low blood volume and have trouble keeping a normal blood pressure.
Your risk may also be higher if you take certain medications. These include drugs called phenothiazines or general anesthetics. If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call or go to the nearest emergency room. Taking it again could be fatal cause death. Drinking alcohol can increase your risk of side effects from this drug. These can include breathing problems, low blood pressure, extreme drowsiness, and coma. If you drink alcohol, talk to your doctor.
For people with head injury and increased head pressure: This drug can increase intracranial pressure blood pressure in your brain.
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