Dilaudid/ Hydromorphone

Question 1

Dilaudid Class

Answer 1

• Narcotic Analgesic
• Opiate
• Schedule II Controlled Substance

Question 2

Dilaudid Action

Answer 2

Interacts with opiate receptors decreasing pain impulse transmission at the spinal cord level and higher in the CNS. Dilaudid is a potent μ- opiate receptor agonist. Also causes peripheral vasodilation increasing venous capacitance and decreases venous return (chemical phlebotomy) by depressing the responsiveness of alpha-adrenergic receptors.

Question 3

Dilaudid Indication

Answer 3

• Moderate to severe pain in place of Fentanyl Citrate

* When morphine is contraindicated

Question 4

Dilaudid Contraindication

Answer 4

• Hypovolemia
• Patients with status asthmaticus
• Hypotension
• Hypersensitivity
• Head injury with altered mental status

Question 5

Dilaudid Precautions

Answer 5

• Approximately 7 times more potent that morphine
• Not to be used in pediatrics
• Monitor for respiratory depression
• Use extreme care in geriatrics, pregnancy, hepatic or renal failure situations, patient with unstable or ongoing cardiac associated chest pain.
• Use cautiously in patients with renal impairment
• Continuous pulse oximetry is necessary with admin

Question 6

Dilaudid Dosage

Answer 6

Adult: IV/IM: 0.5 mg, SIVP over 2-3 min, q 10 min PRN. Max 2 mg.
Peds: do not give to peds.

Question 7

Dilaudid Onset/ Duarion

Answer 7

• Onset: ~ 10 to 15 min w/ peak effect in 30 min to 1 hour.

* Duration: 2-3 hours for typical patient(can be 4-6), 40 hours in patients with renal impairment

Question 8

Dilaudid Side Effects

Answer 8

• Dizziness
• Drowsiness
• Altered LOC
• Hallucinations
• Euphoria
• Mental Impairment
• Lightheadedness
• Bradycardia
• Tachycardia
• Hypotension
• N/V
• CNS Depression
• Respiratory Depression
• Transient Hyperglycemia

Question 9

Dilaudid Interactions

Answer 9

CNS depressants may enhance effects of antihistamines, antiemetics, sedatives, hypnotics, barbiturates, and alcohol.