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PAIN, HM, ONC 1-4
Pain, Hematology, Oncology 1-4
| Generic Name | Brand Name | Pharmacologic Category | Common Indication | Key Side Effects | US Boxed Warning | Other Notes |
|---|---|---|---|---|---|---|
| morphine (extended release) (PO) | MS Contin, MorphaBond, Kadian | Opioid analgesic | Pain | dizziness, drowsiness, nausea, vomiting, constipation, respiratory depression (dose-related) | avoid alcohol consumption with ER capsules as alcohol may increase plasma morphine levels. several formulations available including concentrated solution, take care to avoid dosing errors among strengths and between mg and mL | ISMP-high alert medication |
| morphine (immediate release) (PO, IV) | PO: Roxanol, IV: Duramorph | Opioid analgesic | Pain | dizziness, drowsiness, nausea, vomiting, constipation, respiratory depression (dose-related) | avoid alcohol consumption with ER capsules as alcohol may increase plasma morphine levels. several formulations available including concentrated solution, take care to avoid dosing errors among strengths and between mg and mL | ISMP-high alert medication |
| oxycodone (PO) | Oxycontin, Roxicodone, Oxaydo, Xtampza ER | Opioid analgesic | Pain | dizziness, drowsiness, nausea, vomiting, constipation, respiratory depression (dose-related) | several formulations available including concentrated solution, take care to avoid dosing errors among strengths and between mg and mL. concomitant use with cytochrome P450 3A4 inhibitors may increase serum concentrations | ISMP-high alert medication |
| methadone (PO, IV) | Dolophine, Methadose | Opioid analgesic | Opioid use disorder, severe chronic pain | dizziness, drowsiness, nausea, vomiting, constipation, respiratory depression (dose-related), QTc prolongation | exposes to risks of opioid addiction, abuse/misuse which can lead to OD or death; serious or fatal respiratory depression; accidental ingestion, in children, may result in fatal OD; prolonged use in pregnancy may result in neonatal opioid withdrawal | for detoxification/maintenance of opioid dependence, administer w documented treatment standards, incld limitations on unsupervised administration; QTc interval prolongation and arrhythmia (torsades de pointes) have occurred during treatment |
| acetaminophen (PO, IV) | PO: Tylenol IV: Ofirmey | Analgesic (non-opioid), antipyretic | Pain, fever | nausea, vomiting, increased hepatic transaminases | dosing errors (confusion with mg and mL) can lead to accidental overdose and death; total daily dose from all sources should not exceed maximum daily limit; hepatotoxicity | |
| tramadol (PO) | Ultram, Ultram ER | Central analgesic | Pain | dizziness, drowsiness, nausea, vomiting, constipation, respiratory depression (dose-related) | serious, life-threatening, or fatal respiratory depression may occur | lowers seizure threshold (use caution in patients with a seizure history, those at risk of seizures, and those on other drugs that may lower seizure threshold) |
| tramadol and acetaminophen (PO) | Ultracet | Central analgesic and nonopioid analgesic combination | Pain | dizziness, drowsiness, nausea, vomiting, constipation, respiratory depression (dose-related) | products containing acetaminophen have been associated with acute liver failure (maximum daily dose is 4,000mg from all sources). concomitant use with cytochrome P450 3A4 inhibitors may increase serum concentrations | |
| hydrocodone and acetaminophen (PO) | Lortab, Vicodin, Norco, Xodol | Opioid and nonopioid analgesic combination | Pain | dizziness, drowsiness, nausea, vomiting, constipation, respiratory depression (dose-related) | products containing acetaminophen have been associated with acute liver failure (maximum daily dose is 4,000mg from all sources). concomitant use with cytochrome P450 3A4 inhibitors may increase serum concentrations | |
| oxycodone and acetaminophen (PO) | Percocet, Endocet, Roxicet, Xartemis XR | Opioid and nonopioid analgesic combination | Pain | dizziness, drowsiness, nausea, vomiting, constipation, respiratory depression (dose-related) | products containing acetaminophen have been associated with acute liver failure (maximum daily dose is 4,000mg from all sources). concomitant use with cytochrome P450 3A4 inhibitors may increase serum concentrations | |
| codeine and acetaminophen (PO) | Tylenol with Codeine #3, Tylenol with Codeine #4 | Opioid and nonopioid analgesic combination | Pain | dizziness, drowsiness, nausea, vomiting, constipation, respiratory depression (dose-related) | products containing acetaminophen have been associated with acute liver failure (maximum daily dose is 4,000mg from all sources). | |
| buprenorphine (PO, IV, IM, transdermal) | Subutex | Partial opioid agonist | Opioid use disorder, pain | headache, opioid withdrawal syndrome in opioid-dependent populations, pain, diaphoresis | respiratory depression combined w/ CNS and resp depressants; treatmnt of opioid use disorder limited to physicians meeting criteria w/ a DEA number begins w “X”; naloxone and buprenorphine reduces parenteral misuse produces opioid withdrawal symptoms | |
| naloxone (IV, IM, subcutaneous, intranasal) | Narcan | Opioid antagonist | Opioid overdose | headache, opioid withdrawal syndrome in opioid-dependent populations, pain, diaphoresis | respiratory depression combined w/ CNS and resp depressants; treatmnt of opioid use disorder limited to physicians meeting criteria w/ a DEA number begins w “X”; naloxone and buprenorphine reduces parenteral misuse produces opioid withdrawal symptoms | |
| buprenorphine and naloxone (PO) | Suboxone | Partial opioid agonist and opioid antagonist | Opioid use disorder | headache, opioid withdrawal syndrome in opioid-dependent populations, pain, diaphoresis | respiratory depression combined w/ CNS and resp depressants; treatmnt of opioid use disorder limited to physicians meeting criteria w/ a DEA number begins w “X”; naloxone and buprenorphine reduces parenteral misuse produces opioid withdrawal symptoms | |
| methotrexate (PO, IV) | Trexall, Rheumatrex | Antimetabolite (folic acid antagonist) | Rheumatoid arthritis, psoriasis, various hematologic and solid tumors | stomatitis, diarrhea, nausea, vomiting, thrombocytopenia, leukopenia, increased hepatic transaminases, pulmonary fibrosis (rare), pneumonitis (rare) | serious toxic reactions - neoplastic disease, psoriasis, rheumatoid arthritis); cancause fetal death and/or congenital abnormalities (avoid in pregnancy); severe bone marrow suppression, aplastic anemia, and toxicity have been reported with methotrexate | ISMP-high alert medication, folic acid supplemnt taken during use to reduce hematologic, gastrointestinal, and hepatic side effects; errors with incorrect dosing (verify frequency based on indication – for most, oral doses are often given once weekly) |
| anastrozole (PO) | Arimidex | Aromatase inhibitor | Hormone receptor positive breast cancer | rash, flushing, hot flashes, arthralgia, nausea, vomiting, hypertension, peripheral edema, osteoporosis | cardiovascular side effects (i.e., hypercholesterolemia, CAD); fetal toxicity (CI in pregnancy) | |
| butalbital, acetaminophen and caffeine (PO) | Fioricet, Esgic, Zebutal | Analgesic | Tension headaches | dizziness, drowsiness, lightheadedness | products containing acetaminophen have been associated with acute liver failure (maximum daily dose is 4,000mg from all sources) | |
| phentermine (PO) | Adipex-P, Lomaira | CNS stimulant | Obesity | hypertension, nausea, dizziness, xerostomia, primary pulmonary hypertension (rare) | only approved for short-term use (a few weeks); CI in those with a history of cardiovascular disease or drug abuse, pregnancy, hyperthyroidism, or within 14 days of MAOI inhibitor therapy | |
| cyanocobalmine) | --- | Water-soluble vitamin | Vitamin B12 deficiency (manifests as macrocytic anemia) | no major side effects | ||
| folic acid (PO, IV) | --- | Water-soluble vitamin | Folic acid deficiency (manifests as macrolytic anemia), prevention of neural tube defects in pregnancy | no major side effects | ||
| fentanyl (transdermal, IV) | Transdermal: Duragesic IV: Sublimaze | Opioid analgesic | Pain | dizziness, drowsiness, nausea, vomiting, constipation, respiratory depression (dose-related) | exposure of application site to direct external heating sources (e.g., heating pads, heating lamps, hot baths, saunas) may increase absorption and lead to overdose or death. concomitant use w cytochrome P450 3A4 inhibitors may incrs. serum concentration | ISMP-high alert medication |
| hydromorphone (PO, IV) | PO: Exalgo, IV: Dilaudid | Opioid analgesic | Pain | dizziness, drowsiness, nausea, vomiting, constipation, respiratory depression (dose-related) | several formulations available including concentrated solution, take care to avoid dosing errors among strengths and between mg and mL. | ISMP-high alert medication |
Created by:
lnduta
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