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PHO 1
Generic | Brand | Pharmacologic Category | Common Indications | Essential Knowledge | |
---|---|---|---|---|---|
fentanyl (transdermal, IV) | Transdermal: Duragesic, IV: Sublimaze | Opioid analgesic | Pain | KSE: dizziness, drowsiness, itching, nausea, vomiting, constipation, respiratory depression (dose-related) USBW (all opioid analgesics): risk of opioid addiction, abuse, and misuse which can lead to overdose and death; serious, life-threatening, or fatal respiratory depression may occur; accidental ingestion may result in fatal overdose; prolonged use in pregnancy may result in neonatal opioid withdrawal syndrome; | 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 |
hydromorphone (PO, IV) | Dilaudid | Opioid analgesic | Pain | KSE: dizziness, drowsiness, itching, nausea, vomiting, constipation, respiratory depression (dose-related) USBW (all opioid analgesics): risk of opioid addiction, abuse, and misuse which can lead to overdose and death; serious, life-threatening, or fatal respiratory depression may occur; accidental ingestion may result in fatal overdose; prolonged use in pregnancy may result in neonatal opioid withdrawal syndrome; | 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 |
morphine (extended release) (PO) | MS Contin, Kadian | Opioid analgesic | Pain | KSE: dizziness, drowsiness, itching, nausea, vomiting, constipation, respiratory depression (dose-related) USBW (all opioid analgesics): risk of opioid addiction, abuse, and misuse which can lead to overdose and death; serious, life-threatening, or fatal respiratory depression may occur; accidental ingestion may result in fatal overdose; prolonged use in pregnancy may result in neonatal opioid withdrawal syndrome; | 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 |
morphine (immediate release) (PO, IV, IM, PR) | IV: Duramorph | Opioid analgesic | Pain | KSE: dizziness, drowsiness, itching, nausea, vomiting, constipation, respiratory depression (dose-related) USBW (all opioid analgesics): risk of opioid addiction, abuse, and misuse which can lead to overdose and death; serious, life-threatening, or fatal respiratory depression may occur; accidental ingestion may result in fatal overdose; prolonged use in pregnancy may result in neonatal opioid withdrawal syndrome; | 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 |
oxycodone (PO) | Oxycontin, Roxicodone | Opioid analgesic | Pain | KSE: dizziness, drowsiness, itching, nausea, vomiting, constipation, respiratory depression (dose-related) USBW (all opioid analgesics): risk of opioid addiction, abuse, and misuse which can lead to overdose and death; serious, life-threatening, or fatal respiratory depression may occur; accidental ingestion may result in fatal overdose; prolonged use in pregnancy may result in neonatal opioid withdrawal syndrome; | 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 |
methadone (PO, IV) | Dolophine | Opioid analgesic | Opioid use disorder, severe chronic pain | Key Side Effects: dizziness, drowsiness, nausea, vomiting, constipation, respiratory depression (dose-related), QTc prolongation US Boxed Warnings (all opioid analgesics): See above US Boxed Warnings (only for methadone): QTc interval prolongation and serious arrhythmia (Torsades de Pointes) have occurred during treatment | |
acetaminophen (PO, PR, IV) * | PO/PR: Tylenol, IV: Ofirmev | Analgesic (nonopioid), 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 | Central analgesic; partial opioid agonist | Pain | Key Side Effects: dizziness, drowsiness, nausea, vomiting, constipation, respiratory depression (dose-related) US Boxed Warnings: serious or fatal respiratory depression may occur Other Notes: lowers seizure threshold | |
hydrocodone and acetaminophen (PO) | Lortab, Vicodin, Norco | Opioid and nonopioid analgesic combination | Pain | Key Side Effects: dizziness, drowsiness, nausea, vomiting, constipation, respiratory depression (dose-related) US Boxed Warnings (all opioid analgesics): See above | |
oxycodone and acetaminophen (PO) | Percocet, Endocet, Roxicet | Opioid and nonopioid analgesic combination | Pain | Key Side Effects: dizziness, drowsiness, nausea, vomiting, constipation, respiratory depression (dose-related) US Boxed Warnings (all opioid analgesics): See above | |
codeine and acetaminophen (PO) | Tylenol with Codeine #3, Tylenol with Codeine #4 | Opioid and nonopioid analgesic combination | Pain | Key Side Effects: dizziness, drowsiness, nausea, vomiting, constipation, respiratory depression (dose-related) US Boxed Warnings (all opioid analgesics): See above | |
naloxone (IV, IM, SQ, intranasal) | Narcan | Opioid antagonist | Opioid overdose | Key Side Effects: headache, opioid withdrawal syndrome in opioid- dependent populations, pain, diaphoresis Other Notes: potentially life-threatening respiratory depression (when combined with other CNS and respiratory depressants); addition of naloxone to buprenorphine reduces possibility of parenteral misuse by producing opioid withdrawal symptoms when injected | |
buprenorphine and naloxone (SL) | Suboxone | Partial opioid agonist and opioid antagonist | Opioid use disorder | Key Side Effects: headache, opioid withdrawal syndrome in opioid- dependent populations, pain, diaphoresis Other Notes: potentially life-threatening respiratory depression (when combined with other CNS and respiratory depressants); addition of naloxone to buprenorphine reduces possibility of parenteral misuse by producing opioid withdrawal symptoms when injected |