Medications

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Pain meds

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Content

Trade
Names

Codeine

Hydrocodone

Morphine

Oxycodone

+acetami

Hydrocan
Tussigon

MS Contin,
Kadian,
Avinza,
Oramorph,
MSIR,
Roxonal,

OxyIR,
OxyContin

+IB:Ibudone,
Reprexian,
Vicoprofen

Action

Indication

Depresses
pain
impulse
transmissi
on at SC
by
interactin
g with
opioid
receptors;
decreases
cough
reflex, GI
motility
Mild to
moderate

+aspirin:
Percodon,
endodan

+acetaminophe DepoDur:IC
n:Duocet
P and
Norco, Vicodin
increase
CNS
depression
Acts directly on Depresses
the cough
pain
center in the
impulse
medulla to
transmissio
suppress
n at the SC
cough; binds to level by
opiate
interacting
receptors in
with opioid
CNS to reduce
receptors
pain

+acetaminophe
n:Endocet,
Percocet

Mild to
moderate pain

Moderate to
severe pain

Moderate to
severe pain

Merperidin
e
Demerol,

+IB
Inhibits
ascending pain
pathways in
CNS, increases
pain threshold,
alters pain
perception

Proxyp
hene
Darvoc
et
Mild
agonist

Depresses
pain
impulse at
the SC
level by
interacting
with opioid
receptors

Moderate
to severe

pain
Bone/dent
al pain,
headache,
migraine,
myalgia,
nonprodu
ctive
cough
Contra/Ca
ution

Breastfee
ding,
hypersens
itivity to
opiates,
respirator
y
depressio
n, ICP,
seizure
disorders,
severe
respirator
y
disorders

Hyperactive
and non
productive
cough,

Agitation,
bone and
dental pain,
dyspnea in
end stage
cancer or
pulmonary
disease,
rapid
sequence
incubation
Acne,
Hypersensiti
rosacea/vulgari vity,
s, Cushing’s,
addiction (
measles,
opioid/alcoh
perioral
ol),
dermatitis,
hemorrhage
varicella,
, bronchial
abrupt
asthma,
discontinuation, ICP,
benzyl allergy
paralytic
ileus,
hypovolemi
c shock,
MAOI
therapy
Renal
Impairment
?

Postherpetic
neuralgic

Hypersensitivity,
addiction
(opiate),
asthma, ileus

pain
preoperati
vely,
postoperat
ively
Acute pain
postop
ER:
migrane
Obstertic
Hypersensi
tivity,
severe
respiratory
insufficien
cy, MAOI
therapy
CAUTION:
elderly,
patients
require
long term
analgeis,
kidney
dysfunctio
n

Side
Effects

Seizures,
circulatory
collapse,
respirator
y
paralysis
GI upset

Circulatory
depression,
cardiac
arrest(children)
syncope,
pulmonary
edema,
bronchopneum
onia,
respiratory
arrest (children)
Depressant
effect on CNS
and cause
sedation <

Insomnia,
Tinnitus,
seizures,
gastritis,
shock,
dysepsia
cardiac
arrest,
chest pain,
edema,
tachycardia,
blurred
vision,
miosis,
diploia,
gynecomast
ia, biliary
tract
pressure,
gonadal
suppression
,
thrombocyt
openia,
repiratory
arrest,
apnea
DepoDur:
increase ICP
and CNS
depression

ICP,
seizures,
serotonin
syndrome,
depressed
corneal
reflex,
blurred
vision,
tinnitus,
diaphoresi
s
CNS
toxcitiy:
tremor,
confusion,
seizure
Resp
depression
, seizures,
hypo

Morphine 6
glucuronide:
renal
impairment
more likely
to
accumulate
metabolite
Caution:
Respiatory Inssuficenty
Elevated ICP
Morbid obesity
Sleep apnea
Paraltic ilelus
Myasthenia gravis
preganacy
Naloxone HCL

Naltrexone HCL

Trade Name

Narcan

Revia

Action

Compete with opioids for CNS
receptor site
Complete or partial reversal of
opioid induced respiratory
depression

Compete with opioids for CNS
receptor site
Used as an adjunct for the
maintenance of an opioid free
state for addicts

Opioid overdose

Adjunct to psychosocial

Indication

treatments of alcoholism

Contraindication/caution

Hypersensitivity

Side Effect

Does NOT cause respiratory
depression or produce analgesia
Withdrawal syndrome:Raised or
lower blood pressure, dyshythias,
pulmonary edema, withdrawal

Reversal of postop opioid induced
respiratory depression
Hypersensitivity, hepatitis, severe
liver dysfunction
Nausea and tachycardia
Nervousness headache N V
pulmonary edema, withdrawal

NonOpiod analgesic
NSAIDS ( asprin, Ibprofuen, naproxen, cyclooxygenase 2 inhibitor, and others)
Acetaminophen
NonOpiod analegesix

Tramadol Hydrochloride
Miscellaneous analgesic

Lidocaine

Trade Name

Tylenol

Ultram

Lidoderm

Action

+hydrocodone:Vicodin
+Oxycodone: Perocet
Blocks peripheral pain
impulses by inhibiting
prostaglandin synthesis

+acetaminophen:Ultrac
et
Creates a weak bond to
the mu opioid receptors
and inhibits the
reuptake of NE and
serotonin

Indication

Lowers febrile
temperature by acting
on hypothalamus
Lacks antiinflam effect
Mild to moderate pain
and fever

Contraindication/caution Alcoholics, hepatic
disease
Known drug allergy,

Moderate to moderately
severe pain
Known drug allergy
( allergy to opioids),
intoxication of alchol,

G6PD deficiency

Side Effects

Rash nasuesa vomiting
Blood disorders or
dyscrasias (anemias)
and nephrotoxicities,
hepatoxicity

hypnotics, centrally
acting analgesiscs,
opiods, or psychotropic
drugs
Drowseiness dizziness
headache nausea
constipation respiratory
depression seizures
Serotonin syndrome

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