Page 146 - 2023 SMOG Digital

HYDROMORPHONE Lactation Yes(Not Recommended) Trade Name: Dilaudid
Class / Mechanism of Action
Opioid Analgesic
Binds to opioid receptors within the CNS increasing pain threshold and altering pain reception; inhibits
ascending pain pathways (blocking painful stimulus); produces CNS depression
Onset: IV 10-20 minutes. Duration 2-4 hours
Indications
Labeled Indications: Moderate to severe pain.
Contraindications
• Hypersensitivity to hydromorphone or any component of the formulation
• Severe respiratory depression (in absence of resuscitative equipment or ventilator support)
• Acute or severe asthma
• Paralytic ileus
Adverse Reactions / Precautions
• Always be prepared for use of paralytic and intubation (maintain positive control of airway).
• Head trauma: Use with extreme caution in head injury, or suspected increased ICP;
exaggerated increase in ICP may occur.
• May cause Hypotension, Use with caution in hypovolemic patients.
• May cause life-threatening Reparatory depression
• CNS depression: Impairs physical and mental abilities
Dose and Administration: ADULT PEDIATRIC Always Reference BROSELOW Tape
Acute pain (moderate-to-severe): Acute pain (moderate-to-severe):
IV: (Slow) IV: (Slow)
• 0.5mg (range 0.25-2mg) IV/IO q1-6hr prn • Children: 0.015mg/kg IV q4-6hr prn
• Critically ill require lower dose, opioid • Adolescents >50kg: Refer to adult dosing
tolerant may require higher dose
• Continuous infusion: Usual dosage range:
0.5-3mg/hr (See infusion chart next
page)

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