Had a young patient the other day with pancreatitis, pretty much from drinking so much. Patient was receiving Dilaudid 2 mg Q 4 hours prn pain. Was getting it every four hours pretty much but would freak out everytime I was ten minutes late or so. (God forbid I have six other patients that need me) Called the house officer to see patient about pain meds, the doc came up and started saying something about Demerol being the drug of choice for pancreatitis because of dilaudid and morphine and the spinchter of oddi. I started to cite Nursing 2007 which stated that Dilaudid was the med of choice for pancreatitis, b/c it was believed that all opiods cause relaxation of the spinchter of oddi but dilaudid is preferred because demerol can cause seizures. (Demerol convertes to the antimetabolite normeperidine, which is known to cause seizures.) I also pointed out that he was already at risk for seizures due to his drinking. Anyway intern left the meds alone, even though I wanted an increase in either frequency or dose. Patient was in pain evidenced by increased b/p and lipase of 1,000. Had to wait for attending to make rounds at 5pm. Anyway wanted to know what your thoughts were on dilauded or demerol for pancreatitis.
If I am not mistaken, I think Dilaudid and morphine causes the sphinter to spasm and that is why the demerol is the drug of choice. But Q4hrs that is a long time. Esp w/ acute pancreatitis..they are in sooooo much pain.
Last edit by grantyRN06 on Oct 1, '07