Understanding Equianalgesics

[AussieKylie]

Hi,

I was wondering if anyone can help me understand Equianalgesics and how to convert by using an equianalgesic chart. Or can give me any examples to help me understand clearer.

thanks :paw: :nuke:

[AudryC]

Found one more website that you might find helpful:

http://www.childcancerpain.org/content.cfm?content=pharm18

WAW, thanks so much !! This is going to help ....

Audry

[AussieKylie]

no one that I know in Oncology unit can help me. I do have a friend from work who does work some shifts in oncology but she never had to do the conversion as the doctors on the unit did the work.

So yah, I guess more practice and I should be good.

[painnurse]

Do you still need help with equianalgesic charts? If so here are a few pointers that will help you (and your patients). All nurses should understand how to convert opioids because believe me the docs only guess. They do not learn how to doit in school. Simply put, remember 2 routes for all meds 1. Oral and 2. Everything else. Then concentrate on a few numbers/drugs:

Name Oral Other routes

Morphine 30 10

Dilaudid 7.5 1.5

Oxycodone 20 ----

Hydrocodone 30 ----

Forget Demerol, Darvocet and Codeine you do NOT want to use them for your patients. Advocate for the patient in this matter, even if it is against the doc. So to use the chart you can move horizontally, vertically or diagonally. Ex. 1, your pt. is using 3 mg of iv dilaudid you want to change routes, so to change to po, He will use 15 mg. you moved horizontally on the chart Or 2. you want to change the 3 mg iv dilaudid to another med, say Morphine. the 3mg iv dilaudid will convert to 20 of morphine, you just moved vertically on the chart. or 3. You want to change the 3mg. iv dilaudid to oxycodone he will now need 40mg to take care of the 3 mg. dose of dilaudid. It is very easy to use.

Good luck, be a good patient advocate and remember we are only real world link between the patient and the doc. we have to do the work!!!!

[Daytonite, BSN, RN]

What? Sorry, your explanation just isn't registering in my brain.

[leslie :-D]

equianalgesic tables are only approximations.

with ea conversion, one always has other considerations, i.e., age, cross-tolerances, renal/hepatic function.

here are a few links from reputable and up-to-date sites.

there really is no quick way of explaining it.

it's all about memory.

the 3rd link (eperc-end of life/palliative education resource center) is a site i refer to often, as a hospice nurse.

http://www.medscape.com/viewarticle/547122_2

http://www.ons.org/publications/journals/CJON/Volume5/Issue4/0504163.asp

http://www.eperc.mcw.edu/fastFact/ff_036.htm

leslie

[painnurse]

Think of equianalgesics as a table. you have a drug listed on the left, then you have amounts for oral and amounts for other routes. If you want to give 1.5 of dilaudid iv, you can convert it to po, or another drug or another drug and another route by moving around on the table. unfortunately when i typed in the 4 drugs/routes/amounts it did not space well and may have been confusing. Yes, there is much to consider as earl pointed out but that is true with all drugs. Write the 4 meds and the doses down on a sheet of paper with 3 columns. 1 drug, 2 oral route, 3 other routes. line up the names/numbers that i gave you under the column name. then move about 1.5 dilaudid iv is equal to 7.5 dilaudid po or to 10 morphine iv. 30 morphine po is equal to 20 po oxycodone or 7.5 dilaudid po. does this make more sense? Good luck