Dilaudid vs. Fentanyl?

  1. 0
    In my ICU for sedation/pain management we usually use Fentanyl gtts, but recently I have been seeing more Dilaudid gtts. My orientee asked me the other day which medication was stronger, and what is the advantage of using one over the other? I really didn't have a good answer for her. Can anyone compare/contrast the 2 drugs for me? I know they are both much stronger than Morphine. I'm looking forward to taking the Pain Management course as part of my MSN program! Thanks guys.

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  2. 11 Comments...

  3. 0
    narcotic analgesic dosage conversion chart

    http://www.globalrph.com/narcotic.htm

    http://www.massgeneral.org/painrelie..._equichart.htm

    includes sustained release meds:
    http://www.endpain.org/dosage.html


    parenteral dose
    dilaudid (hydromorphone) 1.5 mg = fentanyl 0.1mg (100mcg)


    nifty tool:
    narcotic analgesic converter

    http://www.globalrph.com/narcoticonv.htm


    list drug prices (canadian) too !
    opioid analgesics comparison
    Last edit by NRSKarenRN on Oct 19, '04
  4. 0

    fox chase cancer center has excellent "pain resource nurse program"

    next class is november 11, 12, 2004 if you can fit it into your schedule.

    chemotherapy induced acute and chronic pain syndromes
    an independent self study program




    other fox chase courses:
    http://www.fccc.edu/nursing/education/
    Last edit by NRSKarenRN on Oct 19, '04
  5. 0
    you can't really use the word stronger as it has no meaning in pharmacology...

    which one is more potent? fentanyl > dilaudid > morphine...

    however there is really no point to fentanyl drips... since it has a relatively long half-life ( a bit longer then morphine), running it as a drip for any prolonged period will give you pretty much the same effect as running a dilaudid drip.
  6. 0
    Huh.... then I wonder why we use Fentanyl gtts so much in my ICU. That's what our docs seem to prefer for sedation when we can't use Propofol d/t hypotension. I have also seen people develop a tolerance to Fentanyl REALLY quickly. I've seen some of my patients on enormous doses, like 800 mcg/hour (and they still weren't adequately sedated/pain controlled). And then it just takes forever to wean them off, because we aren't allowed to transfer patients to the floor on Fentanyl gtts.

    Anyway, thanks for the info. Karen and Tenesma.
  7. 0
    I disagree that there isn't a point to Fentanyl gtts... we use them a lot, and tend to see a lot less hypotension with them. Now, there are pts who I don't think they are effective on - but my experience has been that as long as the pt has the appropriate amount of anti-anxiety meds, they work well for the most part.
  8. 0
    Quote from Tenesma
    you can't really use the word stronger as it has no meaning in pharmacology...

    which one is more potent? fentanyl > dilaudid > morphine...

    however there is really no point to fentanyl drips... since it has a relatively long half-life ( a bit longer then morphine), running it as a drip for any prolonged period will give you pretty much the same effect as running a dilaudid drip.
    Fentanyl does not have a long half life. It is shorter than both morphine and dilaudid. It is great for conscious sedation for that very reason. Fast in and fast out of the system.

    Both Fentanyl and Dilaudid are great for IV drips. Both are cleaner drugs than Morphine ie they do not have any known active metabolites.
  9. 0
    dhudzinski: please read up on your pharmacology before you print misinformation.

    1) fentanyl has a long half-life, but has a short duration of action due to its lipophilic structure and rapid redistribution - hence the advantage of using it in conscious sedation, but if you run it as a drip you fill your reservoir and then the long half-life comes into play thus making a fentanyl drip in the ICU setting equivalent to a dilaudid drip (from a pharmacokinetic point of view).

    2) all three have active metabolites, that is how they work, however you are right that fentanyl and dilaudid are cleaner than morphine, in as much as morphine as a metabolite that can accumulate in the setting of renal dysfunction.
  10. 0
    Quote from Tenesma
    dhudzinski: please read up on your pharmacology before you print misinformation.
    Wow, that is kind of mean. I am sure the poster was trying to help, no need to belittle him/her.
  11. 0
    I have been doing pain management for over 20 years and I know what I know... And I also have developed thick skin since I deal with Docs who do not know how to use these drugs...But they also know who :spin: to call when they have a pain problem...

    Thank you for recognizing!


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