Had never given this medication before.... Had a pt the night before last who had SEVERE biliary colic, jaundiced... Dr had him on 6mg Dilaudid IVP q 2hours!!!! Believe me, he was requesting (and needing) this every 2 hours on the dot. I was very hesitant to give such a LARGE amount of a drug of which I had no prior experience. Gave it very slowly IVP (over 15 minutes) each time, while staying at the bedside to observe. Pt on continuous EKG telemetry, 02 and pulse ox.
Know from the drug book that hydromorphone hydrochloride is 7-10 times more analgesic than morphine, with a shorter duration of action. Manifests less sedation, less vomiting, and less nausea than morphine, and can induce pronounced respiratory depression and hypotension.
Any of you more experienced nurses out there with anecdotal information on Dilaudid??? By the way, pt had some very funky EKG rhythms (bigeminal PJC couplets with BBB which very closely resembled PVC's). BP, respiratory status was fine. Pt generally stayed awake and fully oriented, dozing briefly between injections
(Had been on methodone at home for chronic pain syndrome from a devastating MVC.)