Insight on Dilaudid?

Nurses Medications

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Hi everyone,

Forgive me for being new to all these things that happen (still a student), but during clinicals my patient asked for Dilaudid. I let the RN know, and he rolled his eyes and said "oh, he wants Dilaudid? Everyone wants Dilaudid" quite sarcastically. I've heard that in the ER, drug-seekers frequently ask for the magical "medication that starts with a D."

What exactly is the history with Dilaudid in nursing?

Specializes in Public Health, TB.

Never had Dilaudid, had Demerol PCA after hysterectomy, hated it. If I remember correctly, when post op patients got IM analgesics routinely, they got better, longer pain relief and switched to po faster. I wonder what would happen if we stopped giving Dilaudid IM?

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Moved to the Nursing & Patient Medications forum.

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I was switched from morphine to diluadid as the morphine wasn't enough to knock out the pain.

The dikaudid still left me in pain but I was able to sleep for at least 20-30 min after each dose.

I had the nurses push it super slowly because it got very nauseous and sick when it was pushed quickly.

I didn't get any high feelings and did not get any addiction

but when I was switched to tramadol (preventing bowel perforation with megacolon) I had terrible cold sweats and couldn't stop shaking.

tip: reduce dosage slowly when possible. Give Ativan a few hours after last dose of diluadid

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I had a horrible gall bladder attack. I got dilaudid. No idea how much but i got a wonderful warm feeling and I think I saw heaven for a moment, no pain! yeah! I suddenly got why all those clients asked for it! But all good things must come to end, at least in this scenario!:yes:

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Specializes in Med-Surg.

When I was hospitalized years ago, I received morphine (no idea on dosage) and instantly threw up everywhere and it did nothing for the pain, but it made me very foggy and confused. Then they gave me a small dose of dilaudid, followed by phenerghan for the nausea. First time for any IV narcotic, first time being hospitalized, weighed about 105lbs. That combo put me in another realm. Instant relief, happiness, peace. I smiled blissfully through several painful tests then slept on/off for three days, during which I had the most painful headache of my life (doctors guessed that was from the morphine).

Dilaudid was bliss but I want to avoid it in the future. It was TOO good.

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Interesting fact: a study recently determined that, in folks living with severe heroin addiction, they determined that study participants largely couldn't tell the difference between medical-grade heroin and Dilaudid. More info here: Study to Assess Long-term Opioid Maintenance Effectiveness (SALOME) (also FYI on the front page they use the term "HDM" which stands for hydromorphone, the generic name for Dilaudid).

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Specializes in Emergency Department.
The one time I had morphine, I almost clawed my skin off---the itching was so severe. Fortunately it's now on my allergies list so I'm usually given Dilaudid. Honestly, though, I'd rather have Toradol because it's great for pain and doesn't make me stupid.

The itching you got from the morphine was due to histamine release from the morphine. If someone wants to give you morphine or that's all they have, ask that you be given diphenhydramine first because of your very strong histamine reaction. That same reaction is also why it's often used in patients with cardiac chest pain.

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Specializes in Emergency Department.
Give me dialudid over morphine any day. Morphine gets me as high as a kite but does not stop my pain at all. I Will be flying 20 feet off the ground but hurt like crazy still. Give me 2 MG of dialudid and my pain will be gone for up to 12 hours. I know this from personal experience. As for fentanyl, it just makes me sick. I get pain relief but I get sick to my stomach from it.

If possible I prefer to give patients ondansetron before I give them fentanyl because of the nausea problem. If I can't, I'll dilute the fentanyl as much as I can and give it fairly slowly to try to avoid the nausea.

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Specializes in Med-Tele; ED; ICU.
they prefer (Dilaudid) undiluted push together with benadryl (also push fast for the high)... .
Don't forget the phenergan because they're terribly nauseous and allergic to Zofran, Reglan, and compazine.
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Don't forget the phenergan because they're terribly nauseous and allergic to Zofran, Reglan, and compazine.

When benadryl is pushed quickly it can cause a terrible episode of chest pain in some patients and a feeling of overwhelming fear

being allergic to reglan is no fun! Zofran is not always enough to kick fentanyl nausea

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Specializes in Med-Tele; ED; ICU.
When benadryl is pushed quickly it can cause a terrible episode of chest pain in some patients and a feeling of overwhelming fear

being allergic to reglan is no fun! Zofran is not always enough to kick fentanyl nausea

Point taken but I was speaking entirely facetiously in regard to the super-seekers who are looking for the Dilaudid-Benedryl-phenergan cocktail because of the synergistic effects.

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Point taken but I was speaking entirely facetiously in regard to the super-seekers who are looking for the Dilaudid-Benedryl-phenergan cocktail because of the synergistic effects.

ya I got that. I just thought I'd share that cuz it's a really good tidbit to know

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