clinical pearls in symptom management and palliative care
... 1. Increase base dose by 25% of daily amount 2. Another rule is to calculate the total breakthroughs used in 24 hours and add it to the standing dose (not recommended) *titrate up the standing dose of opioid not more frequently ...
... 1. Increase base dose by 25% of daily amount 2. Another rule is to calculate the total breakthroughs used in 24 hours and add it to the standing dose (not recommended) *titrate up the standing dose of opioid not more frequently ...
Equianalgesic Dosing It`s not just about the math
... The reduction in pain scores from baseline was statistically significant for the abdominal surgery subgroup and for all surgeries combined. The factor of 3 previously reported was consistent with a previous thoracic/abdominal post-operative pain study. Where it might be expected that patients requir ...
... The reduction in pain scores from baseline was statistically significant for the abdominal surgery subgroup and for all surgeries combined. The factor of 3 previously reported was consistent with a previous thoracic/abdominal post-operative pain study. Where it might be expected that patients requir ...
About the Guide - American Chemical Society
... Morphine and the opiates are probably some of the most valuable drugs in medicine. Their ability to alleviate pain and suffering led Thomas Sydenham, an English doctor in the nineteenth century to call them “God’s own medicine”. As noted in the ChemMatters article, there is a long history involving ...
... Morphine and the opiates are probably some of the most valuable drugs in medicine. Their ability to alleviate pain and suffering led Thomas Sydenham, an English doctor in the nineteenth century to call them “God’s own medicine”. As noted in the ChemMatters article, there is a long history involving ...
Guidelines For The Use Of Fentanyl Patches
... appropriate for patients on high doses but specialist advice should be sought first). It will take up to 24 hours for any increased dose to take effect. However, in a small percentage of patients, the effect of dose changes may not be seen until after 48hours, and dose increases should not be made a ...
... appropriate for patients on high doses but specialist advice should be sought first). It will take up to 24 hours for any increased dose to take effect. However, in a small percentage of patients, the effect of dose changes may not be seen until after 48hours, and dose increases should not be made a ...
Narcotics
... Tramadol is 5-10 times less potent than morphine and reported to cause less respiratory depression Approximately 50 mg tramadol = 60 mg codeine ...
... Tramadol is 5-10 times less potent than morphine and reported to cause less respiratory depression Approximately 50 mg tramadol = 60 mg codeine ...
Opioids
... antagonistic activity • elicit dysphoric and psychotomimetic effects • increase in blood pressure and heart rate Uses• moderate to severe pain • as a preoperative medication and • as a supplement to anesthesia ...
... antagonistic activity • elicit dysphoric and psychotomimetic effects • increase in blood pressure and heart rate Uses• moderate to severe pain • as a preoperative medication and • as a supplement to anesthesia ...
Factors Influencing the Extent of the Inflammatory Response to
... proliferation to T- and B-cell mitogens, natural killer cell cytotoxicity, and the production of IL-2 and interferon- .Morphine also increases the secretion of CRH, ACTH, and glucocorticoids, i.e., substances with inhibitory effects on the immune system. Certain immunomodulatory actions of morphine, ...
... proliferation to T- and B-cell mitogens, natural killer cell cytotoxicity, and the production of IL-2 and interferon- .Morphine also increases the secretion of CRH, ACTH, and glucocorticoids, i.e., substances with inhibitory effects on the immune system. Certain immunomodulatory actions of morphine, ...
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)
... morphine requirements in patients undergoing laparoscopic cholecystectomy, so that optimum analgesia is achieved with a concomitant reduction in opioid related side effects. The overall pain after laparoscopic cholecystectomy is a conglomerate of three different components: incisional pain (somatic ...
... morphine requirements in patients undergoing laparoscopic cholecystectomy, so that optimum analgesia is achieved with a concomitant reduction in opioid related side effects. The overall pain after laparoscopic cholecystectomy is a conglomerate of three different components: incisional pain (somatic ...
PowerPoint - Palliative.info
... crossed over to an alternative opioid = Incomplete Cross-Tolerance • cannot use conversion tables to determine the dose of an alternative opioid without considering the clinical context • might consider decreasing the calculated dose by 50%, but even that depends on the situation ...
... crossed over to an alternative opioid = Incomplete Cross-Tolerance • cannot use conversion tables to determine the dose of an alternative opioid without considering the clinical context • might consider decreasing the calculated dose by 50%, but even that depends on the situation ...
File
... acting MOR agonist potent & clinically useful analgesic (oral BA better than morphine) Relieves difficult to treat pain Used in the treatment of opioid abuse (long t1/2) OPIOID ROTATION to methadone provides superior analgesia For detoxification of a heroin-dependent addict, low doses of m ...
... acting MOR agonist potent & clinically useful analgesic (oral BA better than morphine) Relieves difficult to treat pain Used in the treatment of opioid abuse (long t1/2) OPIOID ROTATION to methadone provides superior analgesia For detoxification of a heroin-dependent addict, low doses of m ...
Opioid Conversion Chart
... work through a calculation to support their use of the chart. They should calculate with the aim of confirming to themselves what the new drug means in terms of the familiar oral morphine. By doing a calculation, they are able to confirm accurate reading of the chart. If prescribers and advisors hav ...
... work through a calculation to support their use of the chart. They should calculate with the aim of confirming to themselves what the new drug means in terms of the familiar oral morphine. By doing a calculation, they are able to confirm accurate reading of the chart. If prescribers and advisors hav ...
6-作用于神经系统的药物
... pain(except biliary colic 胆绞痛). Because it is very easy to addiction, ①Only treat to acute megalgia(急性剧痛), such as severe wound, large area of burn, etc. The aim is to prevent painful shock, but contraindication for shock. ②Treat to pain of later period of cancer also. ...
... pain(except biliary colic 胆绞痛). Because it is very easy to addiction, ①Only treat to acute megalgia(急性剧痛), such as severe wound, large area of burn, etc. The aim is to prevent painful shock, but contraindication for shock. ②Treat to pain of later period of cancer also. ...
Opioid Pharmacology: How to choose and how to use
... – sc ~ 30 minutes – IV ~ 5-10 minutes • This indicates how frequently you can give breakthrough doses ...
... – sc ~ 30 minutes – IV ~ 5-10 minutes • This indicates how frequently you can give breakthrough doses ...
Rita Mannarino - Opioids for the Non
... * Pete is an ex-smoker, having quit about 12 years ago just prior to the birth of his first grandchild and after he started having issues with dyspnea for which he required the use of puffers ...
... * Pete is an ex-smoker, having quit about 12 years ago just prior to the birth of his first grandchild and after he started having issues with dyspnea for which he required the use of puffers ...
Opioid Agonist
... but continue to experience constipation and miosis. 2. Terminal cancer patients and others requiring high doses for analgesia are also tolerant to respiratory depression (cf. p. 6), but they frequently require treatment for constipation. 9. Physical Dependence -Adaptation which produces stereotyped ...
... but continue to experience constipation and miosis. 2. Terminal cancer patients and others requiring high doses for analgesia are also tolerant to respiratory depression (cf. p. 6), but they frequently require treatment for constipation. 9. Physical Dependence -Adaptation which produces stereotyped ...
04 Pharmacological correction of pain
... • Acts longer than morphine (approximately 6 hours) • Analgesic activity is higher than of morphine, that’s why it’s used in doses of 0,3-0,6 mg • In case of breathing depression, which it causes, naloxon is less effective since buprenorphine is slowly released from the connection with mu-receptors ...
... • Acts longer than morphine (approximately 6 hours) • Analgesic activity is higher than of morphine, that’s why it’s used in doses of 0,3-0,6 mg • In case of breathing depression, which it causes, naloxon is less effective since buprenorphine is slowly released from the connection with mu-receptors ...
key concepts in acute pain management
... postural changes in BP or HR – vascular patients may have marked discrepancy between arms – establish baseline pre-op Surgical complications Medical complications Side-effect of Epidural induced sympathetic block – decreased venous return and decreased SVR Combination of any 4 above ...
... postural changes in BP or HR – vascular patients may have marked discrepancy between arms – establish baseline pre-op Surgical complications Medical complications Side-effect of Epidural induced sympathetic block – decreased venous return and decreased SVR Combination of any 4 above ...
morphine (mor-feen) - DavisPlus
... Explain therapeutic value of medication prior to administration to enhance the analgesic effect. Regularly administered doses may be more effective than prn administration. Analgesic is more effective if given before pain becomes severe. Coadministration with nonopioid analgesics may have additive a ...
... Explain therapeutic value of medication prior to administration to enhance the analgesic effect. Regularly administered doses may be more effective than prn administration. Analgesic is more effective if given before pain becomes severe. Coadministration with nonopioid analgesics may have additive a ...
narcotics - The Podiatry Institute
... applied to any drug that induced sleep, was for a number of years used to refer to morphine-like analgesics. Today, the term narcotic is no longer useful in a pharmacological context. With the advent of mixed agonist-antagonists, some of which do not suppress morphine-like physical dependence, and w ...
... applied to any drug that induced sleep, was for a number of years used to refer to morphine-like analgesics. Today, the term narcotic is no longer useful in a pharmacological context. With the advent of mixed agonist-antagonists, some of which do not suppress morphine-like physical dependence, and w ...
Chapter 18 Opioid Analgesics
... retention caused by respiratory depression results in cerebral vasodilation; in patients with elevated intracranial pressure, this may lead to lethal alterations in brain function. • 2. Use in patients with impaired pulmonary function : The respiratory depression properties of the opioid analgesics ...
... retention caused by respiratory depression results in cerebral vasodilation; in patients with elevated intracranial pressure, this may lead to lethal alterations in brain function. • 2. Use in patients with impaired pulmonary function : The respiratory depression properties of the opioid analgesics ...
document
... with morphine and thousands became addicted. Laudanum was widely sold. By the late 1800s, an estimated 4.59 per 1,000 people were dependent on opiates. ...
... with morphine and thousands became addicted. Laudanum was widely sold. By the late 1800s, an estimated 4.59 per 1,000 people were dependent on opiates. ...
Fatality Involving the Ingestion of Phenazepam and Poppy Seed Tea Case Report
... detected, and the concentrations observed may not have been lethal. Although reliable information pertaining to the interpretation of blood thebaine concentrations is limited, the detection of thebaine in the urine and blood corroborates the decedent’s reported consumption of PST (23,24). Phenazepam ...
... detected, and the concentrations observed may not have been lethal. Although reliable information pertaining to the interpretation of blood thebaine concentrations is limited, the detection of thebaine in the urine and blood corroborates the decedent’s reported consumption of PST (23,24). Phenazepam ...
Drugs for the Treatment of Heroin Addiction
... mechanism as heroin, methadone, and LAAM Metabolized in the liver to metabolites that are more effective The effects increase linearly, but only to a certain dosage – after that, the effects plateau (the “ceiling ...
... mechanism as heroin, methadone, and LAAM Metabolized in the liver to metabolites that are more effective The effects increase linearly, but only to a certain dosage – after that, the effects plateau (the “ceiling ...
Opioid Dosing and Conversions
... patient response. Excess naloxone can cause seizures, tachycardia, hypertension, and withdrawal. ...
... patient response. Excess naloxone can cause seizures, tachycardia, hypertension, and withdrawal. ...
Morphine
Morphine, sold under many trade names, is a pain medication of the opiate type. It acts directly on the central nervous system (CNS) to decrease the feeling of pain. It can be used for both acute pain and chronic pain. Morphine is also frequently used for pain from myocardial infarction and during labour. It can be administered orally, intramuscularly, subcutaneously, intravenously, into the space around the spinal cord, or rectally. Maximum effect is around 20 min when given intravenously and 60 min when given by mouth while duration of effect is between three and seven hours. Long acting formulations also exist.Potentially serious side effects include a decreased respiratory effort and low blood pressure. Morphine has a high potential for addiction and abuse. If the dose is reduced after long term use withdrawal may occur. Common side effects include drowsiness, vomiting, and constipation. Caution is advised when used during pregnancy or breast feeding as morphine will affect the infant.Morphine was first isolated between 1803 and 1805 by Friedrich Sertürner. This is generally believed to be the first isolation of an active ingredient from a plant. Merck began marketing it commercially in 1827. Morphine was more widely used after the invention of the hypodermic syringe in 1853–1855. Sertürner originally named the substance morphium after the Greek god of dreams, Morpheus, for its tendency to cause sleep.The primary source of morphine is isolation from poppy straw of the opium poppy. In 2013 an estimated 523,000 kilograms of morphine were produced. About 45,000 kilograms were used directly for pain, an increase over the last twenty years of four times. Most use for this purpose was in the developed world. About 70% of morphine is used to make other opioids such as hydromorphone, oxycodone, heroin, and methadone. It is a Schedule II drug in the United States, Class A in the United Kingdom, and Schedule I in Canada. It is on the WHO Model List of Essential Medicines, the most important medications needed in a basic health system.