Template:General opioid chart

General Opioid Analgesics Chart

DRUG

TYPICAL ADULT DOSE

PHARMACOKINETICS

COMMENTS

Morphine

0.1 mg/kg IV

10mg IM

0.3 mg/kg PO

Onset: 1-2 min (IV), 10-15 min (IM/SC)

Peak effect: 3-5 min (IV), 15-30 min (IM)

Duration: 1-2 h (IV), 3-4 h (IM/SC)

  • Histamine release may produce transient hypotension or nausea and emesis,
    • neither require routine adjunctive treatment

Hydromorphone

(Dilaudid)

0.015 mg/kg IV

1-2 mg IM

Onset: 3-5 min (IV)

Peak effect: 7-10 min (IV)

Duration: 2-4 h (IV)

Fentanyl

1.0 mcg/kg IV

Onset: <1 min (IV)

Peak effect: 2-5 min (IV)

Duration: 30-60 min (IV)

  • High doses can cause chest wall rigidity (>5 mcg/kg IV)

Meperidine

(Demerol)

1.0-1.5 mg/kg IV/IM

Onset: 5 min (IV)

Peak effect: 5-10 min (IV)

Duraction 2-3 h (IV)

  • Contraindicated when patient taking a MAOI
  • Neurotoxicity occur when multiple doses given in the presence of renal failure

Oxycodone

5-10 mg PO

30 mg PR

Onset: 10-15 min (PO)

Duration 3-6 h (PO)

  • Possible inadvertent acetaminophen overdose with combination agents

Hydrocodone

5-10 mg PO

Onset: 30-60 min (PO)

Duraction 4-6 h (PO)

  • Lower incidence of nausea
  • Possible inadvertent acetaminophen overdose with combination agents

Codeine

30-60 mg PO

30-100 mg IM

Onset: 30-60 min (PO)

Duraction: 4-6 h (PO)

  • High incidence of GI side effects
  • Some patients cannot convert to codeine-6-glucuronide and morphine
  • Possible inadvertent acetaminophen overdose with combination agents

Tramadol

(Ultram)

50-100 mg PO

Onset: 10-15 min (PO)

Duration: 4-6 h (PO)

  • Central nervous system side effects