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PHO 1
| Generic Name | Brand Name | Classification | Pharmacologic Category | Common Indications | Essential 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 |