Does anyone have an existing protocol addressing the use of hydromorphone (dosing/frequency) for patients prior to delivery? I am a hospital pharmacist and I had a conversation with an OB/GYN nurse today regarding an order for 2mg IV every 3 hours prn. She was concerned that the dose may not have been appropriate in this setting.
We talked about what we know: it cosses the placenta and thus can cause respiratory compromise in newborns. However, since hydromorphone is Category C and the manufacturer lists pregnancy as a contraindication, I can find very little published information regarding use in this specialty.
Many thanks for your thoughts and/or experience with this med.