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PHO 1

Generic NameBrand NameClassificationPharmacologic CategoryCommon IndicationsEssential Knowledge
fentanyl (transdermal, IV) Transdermal: Duragesic, IV: Sublimaze CS-II Opioid analgesic Pain Side Effects: dizziness, drowsiness, nausea, vomiting, constipation, itching, dose-related respiratory depression Boxed Warning (Fentanyl): dosing errors between forms; CYP3A4 interactions may raise levels; avoid heat with patch
hydromorphone (PO, IV) Dilaudid CS-II Opioid analgesic Pain Key Side Effects: dizziness, drowsiness, nausea, vomiting, constipation, pruritus, respiratory depression (dose-related) US Boxed Warning: risk of medication errors with high-potency hydromorphone, use in opioid-tolerant patients only
morphine (extended release) (PO) MS Contin, Kadian CS-II Opioid analgesic Pain Key Side Effects: dizziness, drowsiness, nausea, vomiting, constipation, pruritus, respiratory depression (dose-related) US Boxed Warning (only for morphine, extended release): congestion with alcohol may result in potentially fatal overdose of morphine
morphine (immediate release) (PO, IV, IM, PR) IV: Duramorph, Infumorph CS-II Opioid analgesic Pain Key Side Effects: dizziness, drowsiness, nausea, vomiting, constipation, pruritus, respiratory depression (dose-related)
oxycodone (PO) OxyContin, Roxicodone CS-II Opioid analgesic Pain Key Side Effects: dizziness, drowsiness, nausea, vomiting, constipation, pruritus, respiratory depression (dose-related) US Boxed Warning (only for oxycodone): use with CYP3A4 inhibitors (or stopping CYP3A4 inducers) can increase oxycodone concentrations
methadone (PO, IV) Dolophine CS-II Opioid analgesic Opioid use disorder, severe chronic pain SE: dizziness, drowsiness, N/V, constipation, dose-related respiratory depression BBW: QTc prolongation & serious arrhythmias (Torsades de Pointes). Caution with CYP3A4, 2B6, 2C19, or 2D6 inhibitors or when stopping inducers, this can ↑ methadone levels.
acetaminophen (PO, PR, IV) PO/PR: Tylenol, IV: Ofirmev PO, PR: OTC Analgesic (non-opioid), antipyretic Pain, fever Key Side Effects: nausea, vomiting, increased hepatic transaminases US Boxed Warnings: total daily dose from all sources should not exceed maximum daily limit; hepatotoxicity
tramadol (PO) Ultram, Ultram ER CS-IV Central analgesic; partial opioid agonist Pain SEs: dizziness, drowsiness, N/V, constipation, dose-related resp. depression BBW: caution with CYP3A4/2D6 inhibitors or inducers; risk of fatal resp. depression in ultra-rapid metabolizer kids post-tonsil/ adenoidectomy Note: lowers seizure threshold
US Boxed Warnings (all opioid analgesics) (1/2) Risk of addiction, abuse, and fatal overdose; life-threatening respiratory depression; accidental ingestion can be fatal; prolonged use in pregnancy may cause neonatal withdrawal (2/2) abrupt discontinuation may result in serious opioid-induced withdrawal syndrome; concomitant use of opioids with benzodiazepines or CNS depressants (including alcohol) may result in profound sedation, respiratory depression, coma, and death
Created by: user-1745497
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