Re: Random Med Questions-narcotics and IV push
Dilaudid (hydromorphone) is 8-10X stronger than morphine. Fentanyl is 100X stronger than morphine.
I think methadone is the same strength as morphine but has the advantage of a a 24hr half life (though this can vary from 15-50hr depending on the pt) and you only need Qday adimnistration.
Depends on the MD usually some like to give hydromorphone some like morphine.
Also IV meds are 5-6 times more potent than oral drugs so giving 5mg of say morphine orally is the same as giving 1mg IV.
There are also exteneded release oral narcos like oxycontin and MS contin. In which chronic pain/cancer patients can often take up to 100+mg Q12H. Have to remember its an oral drug and its time release so if you say give a 60mg MS contin pill that patient is actually getting 5mg/hr. Had to educate a few RNs the other day about this (it was a 40mg tab of MS contin) b/c they thought they were giving the whole 40mg dose at once and almost didn't give it.
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