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Pain/Heme/Onc 1

with essential knowledge

GenericBrandCategoryIndicationSide EffectsUS Box WarningOther NotesUS Box Warning (2)
fentanyl (transdermal, IV) (CS-II) Transdermal: Duragesic IV: Sublimaze Opioid analgesic Pain dizziness, drowsiness, nausea, vomiting, constipation, pruritus, respiratory depression (dose-related) Opioids risk addiction, misuse, fatal overdose, respiratory depression, accidental-ingestion death, neonatal or abrupt-discontinuation withdrawal, and when combined with benzodiazepines, alcohol, or other CNS depressants, sedation, coma, and death. potential for medication errors when converting between dosage forms; use with CYP34A inhibitors (or stopping CYP3A4 inducers) can increase fentanyl concentrations; avoid exposing transdermal patch to external heat
hydromorphone (PO, IV) (CS-II) Dilaudid Opioid analgesic Pain dizziness, drowsiness, nausea, vomiting, constipation, pruritus, respiratory depression (dose-related) Opioids risk addiction, misuse, fatal overdose, respiratory depression, accidental-ingestion death, neonatal or abrupt-discontinuation withdrawal, and when combined with benzodiazepines, alcohol, or other CNS depressants, sedation, coma, and death. risk of medication errors with high-potency hydromorphone, use in opioid-tolerant patients only
morphine (extended-release) (PO) (CS-II) MS Contin, Kadian Opioid analgesic Pain dizziness, drowsiness, nausea, vomiting, constipation, pruritus, respiratory depression (dose-related) Opioids risk addiction, misuse, fatal overdose, respiratory depression, accidental-ingestion death, neonatal or abrupt-discontinuation withdrawal, and when combined with benzodiazepines, alcohol, or other CNS depressants, sedation, coma, and death. coingestion with alcohol may result in potentially fatal overdose of morphine
morphine (immediate-release) (PO, IV, IM, PR) (CS-II) IV: Duramorph, Infumorph Opioid analgesic Pain dizziness, drowsiness, nausea, vomiting, constipation, pruritus, respiratory depression (dose-related) Opioids risk addiction, misuse, fatal overdose, respiratory depression, accidental-ingestion death, neonatal or abrupt-discontinuation withdrawal, and when combined with benzodiazepines, alcohol, or other CNS depressants, sedation, coma, and death.
oxycodone (PO) OxyContin, Roxicodone Opioid analgesic Pain dizziness, drowsiness, nausea, vomiting, constipation, pruritus, respiratory depression (dose-related) Opioids risk addiction, misuse, fatal overdose, respiratory depression, accidental-ingestion death, neonatal or abrupt-discontinuation withdrawal, and when combined with benzodiazepines, alcohol, or other CNS depressants, sedation, coma, and death. use with CYP3A4 inhibitors (or stopping CYP3A4 inducers) can increase oxycodone concentrations
methadone (PO, IV) (CS-II) Dolophine Opioid analgesic Opioid use disorder, severe chronic pain dizziness, drowsiness, nausea, vomiting, constipation, respiratory depression (dose-related), QTc prolongation Opioids risk addiction, misuse, fatal overdose, respiratory depression, accidental-ingestion death, neonatal or abrupt-discontinuation withdrawal, and when combined with benzodiazepines, alcohol, or other CNS depressants, sedation, coma, and death. QTc interval prologation and serious arrhythmia (Torsades de Pointes) have occurred during treatment; concomitant use with CYP3A4, 2B6, 2C19, or 2D6 (or stopping the same inducers) can increase methadone concentrations
acetaminophen (PO, PR, IV) (OTC) PO/PR: Tylenol IV: Ofirmev Analgesic (non-opioid), antipyretic Pain, fever nausea, vomiting, increase hepatic transaminases total daily dose from all sources should not exceed maximum daily limit; hepatotoxicity
tramadol (PO) (CS-IV) Ultram, Ultram ER Central analgesic; partial opioid agonist Pain dizziness, drowsiness, nausea, vomiting, constipation, respiratory depression (dose-related) Risks: Addiction, abuse, and misuse may cause overdose and death. Serious or fatal respiratory depression and fatal accidental ingestion may occur. Prolonged use during pregnancy may cause neonatal opioid withdrawal syndrome. lowers seizure threshold Opioids & benzos/alcohol/CNS depressants = sedation, respiratory depression, coma/death; check CYP3A4/2D6 changes; tramadol = fatal respiratory depression in ultra-rapid-metabolizer children after tonsil/adenoidectomy.
Created by: salmouie
 

 



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