Not nsaid Action: analgesic(pain reliever), antipyretic

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Morphine Sulfate

Class: Narcotic/Opioid analgesic

Action: Mode – Sev Pain Relieves pain by depressing the central nervous system.

Adverse reactions/side effects: RESPIRATORY DEPRESSION, Constipation, vertigo, fatigue

Dose: IM IV 2.5 – 10mg q2-3 hr, initial 10-30 mg

Notes: Rash/hives – from iv or epidural morphine. Don’t stop because of little itching.

Note: MAO alert Step III. Binds to CNS receptors. For Heart Patients: chest pain, pulm edema. Cancer, anxiety, nonproductive cough.

Meperidine (Demerol)

Class: Opioid Analgesics

Action: Moderate to severe pain metabolized to normeperidine and accumulated in renal insufficient clients. Toxic increases seizure risk

Adverse reactions/side effects: SEIZURES, confusion, sedation, hypotension, constipation, nausea, vomiting

Dose: p. o,. 50-100 q3-4 hr, IV 15-35 mg/hr NOT for clients > 65yrs. Avoid > 48hrs.

Note: MAO alert, Contraindicated w/impaired renal function. Short acting, irritating to tissues.

Hydromorphone (Dilaudid)

Class: Opioid Analgesic

Action: mod – severe pain. Lower doses for suppressing cough

Adverse reactions/side effects: confusion, sedation, hypotension, constipation

Dose: PO 1-4 mg q4-6

Note: MAO alert – risk for hypertension, resp. depression. Muscle ridigidity, coma, sezieures, deth.

Hydrocodone (Vicodin, Norco, Lortab)
Vicodin, Norco, Lortab – special consideration?

Class: Opioid Analgesic, antitussive

Action: mod – severe pain. Lower doses for suppressing cough.

Adverse reactions/side effects: confusion, dizziness, sedation, hypotension, constipation, dyspepsia, nausea

Dose: PO 2.5-5 mg q4 hr

Note: MAO alert

Be aware of acetaminophen when used in combination drugs.Vicodin, Norco, Lortab


Class: Opioid Analgesic,

Action: Mild – Moderate Pain. Not as effective as morphine.

Adverse reactions/side effects: constipation

Dose:15-60 mg q4-6

Step III Drug

Fentanyl (duragesic)

Class: Opioid Analgesic, Anesthetic Adjunct

Action: Transdermal Patch for chronic-terminal cancer pain


Dose- 0.5 – 1 mcg/kg patch, transmucosal(Buccal)

Note: MAO alert

Propoxyphene (Darvon)

Class: Opioid Analgesic,

Action: mild-moderate pain

Adverse reactions/side effects: dizziness, weakness, nausea

Dose: PO 65mg q 4 hr (1 T)

Notes: MAO alert
Avoid with older adults, toxic metabolic

Gabapentin (Neurotin)

Class: Analgesic Adjunct

Action: Chronic pain. anticonvulsants

Adverse reactions/side effects: confusion, depression, drowsiness, ataxia

Dose: PO adults 300mg tid

Notes: Renal Impairment

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