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Narcotics: Dosing Flashcards

1
Q

BUPRENORPHINE:

What is PEDIATRIC dosing for ACUTE PAIN (moderate-severe)?

A

Children 2-12 years:

IM, slow IV: 2-6mcg/kg every 4-6 hours

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2
Q

BUPRENORPHINE:

What is the ADULT USUAL DOSING?

A

0.15-0.6mg every 4-8 hours PRN

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3
Q

BUPRENORPHINE:

What is the ADULT dosing for ACUTE PAIN?

A

IM, IV: 0.3mg every 6-8 hours PRN

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4
Q

BUPRENORPHINE:

What is the INITIAL ADULT dosing for CHRONIC PAIN with the TD PATCH in OPIOID-NAÏVE patients?

A

5mcg/hour applied once every 7 days

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5
Q

BUPRENORPHINE:

What is the ADULT dosing for CHRONIC PAIN with the TD PATCH in patients receiving daily dose of 30-80mg of oral morphine equivalent?

A

10mcg/hour applied once every 7 days

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6
Q

BUPRENORPHINE:

What is the MAX ADULT dosing for CHRONIC PAIN with the TD PATCH?

A

20mcg/hour applied once every 7 days

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7
Q

BUPRENORPHINE:

What is the INITIAL ADULT dosing for CHRONIC PAIN with the BUCCAL FILM in OPIOID-NAÏVE patients?

A

75mcg once daily

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8
Q

BUPRENORPHINE:

What is the INITIAL ADULT dosing for CHRONIC PAIN with the BUCCAL FILM in patients receiving daily dose of 30-89mg of oral morphine equivalent?

A

150mcg every 12 hours

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9
Q

BUPRENORPHINE:

What is the INITIAL ADULT dosing for CHRONIC PAIN with the BUCCAL FILM in patients receiving daily dose of 90-160mg of oral morphine equivalent?

A

300mcg every 12 hours

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10
Q

BUPRENORPHINE:

What is the ADULT dosing for OPIOID DEPENDENCE with the SL TABLETS on DAY 1?

A

8mg

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11
Q

BUPRENORPHINE:

What is the ADULT USUAL dosing range for OPIOID DEPENDENCE with the SL TABLETS?

A

12-16mg/day during induction with a target dose of 16mg/day for maintenance

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12
Q

BUPRENORPHINE:

What is the ADULT dosing for OPIOID WITHDRAWAL IN HEROIN-DEPENDENT HOSPITALIZED PATIENTS (unlabeled-use)?

A

IV: 0.3-0.9mg every 6-12 hours

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13
Q

BUPRENORPHINE:

How does dosing CHANGE in severe hepatic impairment (Child-Pugh class C) with the BUCCAL FILM and SL TABLET?

A

Reduce starting dose and reduce titration dose by 50%

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14
Q

FENTANYL:

What is PEDIATRIC dosing for SURGERY adjunct to anesthesia?

A

Children 2 years and older and adolescents:

IV: 2-3mcg/kg/dose every 1-2 hours PRN

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15
Q

FENTANYL:

What is the ADULT TD PATCH dosing?

A

25-300mcg/hour every 72 hours

-depending on 24 hour morphine equivalent (mg/day)

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16
Q

FENTANYL:

What is the ADULT IV LOW DOSE for ADJUNCT to GENERAL anesthesia?

A

1-2mcg/kg

-depending on the indication

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17
Q

FENTANYL:

What is the INITIAL ADULT IV MODERATE DOSE (fentanyl plus a sedative-hypnotic) for ADJUNCT to GENERAL anesthesia?

A

2-4mcg/kg

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18
Q

FENTANYL:

What is the MAINTENANCE ADULT IV DOSE (BOLUS or INFUSION) for ADJUNCT to GENERAL anesthesia?

A

25-50mcg every 15-30 minutes

or

0.5-2mcg/kg/hour

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19
Q

FENTANYL:

What is the ADULT IV HIGH DOSE (opioid anesthesia) for ADJUNCT to GENERAL anesthesia?

A

4-20mcg/kg bolus

then

2-10mcg/kg/hour

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20
Q

FENTANYL:

What is the ADULT DOSE for ADJUNCT to REGIONAL anesthesia?

A

IM: 50-100mcg

or

slow IV: 50-100mcg over 1-2 minutes

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21
Q

FENTANYL:

What is the ADULT DOSE for POSTOPERATIVE RECOVERY?

A

IM, slow IV: 50-100mcg every 1-2 hours PRN

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22
Q

FENTANYL:

What is the ADULT DOSE for POSTOPERATIVE PAIN using the TD DEVICE?

A

Apply 1 device

-to chest or upper outer arm only

23
Q

FENTANYL:

What is the ADULT LOZENGE DOSE for BREAKTHROUGH CANCER PAIN?

A

200mcg by mouth
-consumed over 15 minutes

  • redose 15 minutes after completion of first dose if pain not relieved
  • max of 1 additional dose can be given per pain episode
24
Q

FENTANYL:

What is the INITIAL ADULT BUCCAL FILM DOSE for BREAKTHROUGH CANCER PAIN?

25
Q

FENTANYL:

What is the INITIAL ADULT BUCCAL TABLET DOSE for BREAKTHROUGH CANCER PAIN?

A

100mcg

-for all patients unless patient already using Actiq

26
Q

FENTANYL:

What is the ADULT SL TABLET DOSE for BREAKTHROUGH CANCER PAIN?

27
Q

FENTANYL:

What is the INITIAL ADULT NASAL AND SL SPRAY DOSE for BREAKTHROUGH CANCER PAIN?

A

100mcg/dose/spray

28
Q

FENTANYL:

How does dosing CHANGE in MILD TO MODERATE RENAL-HEPATIC IMPAIRMENT with the TD patch?

A

Reduce dose by 50%

29
Q

HYDROCODONE:

What is the INITIAL DOSE of HYSINGLA ER?

A

PO: 20mg once daily

30
Q

HYDROCODONE:

Describe DOSE ADJUSTMENTS of HYSINGLA ER?

A

In increments of 10-20mg

-every 3-5 days as needed to achieve adequate analgesia

31
Q

HYDROCODONE:

What is the INITIAL DOSE of ZOHYDRO ER?

A

PO: 10mg every 12 hours

32
Q

HYDROCODONE:

Describe DOSE ADJUSTMENTS of ZOHYDRO ER?

A

In increments of 10mg every 12 hours

-every 3-7 days as needed to achieve adequate analgesia

33
Q

HYDROCODONE:

How does dosing CHANGE in MODERATE, SEVERE, and ESRD RENAL IMPAIRMENT with HYSINGLA ER?

A

Start with 50% of initial dose

34
Q

HYDROCODONE:

How does INITIAL dosing CHANGE in SEVERE HEPATIC IMPAIRMENT with HYSINGLA ER?

A

Start with 50% of initial dose

35
Q

HYDROCODONE:

How does INITIAL dosing CHANGE in SEVERE HEPATIC IMPAIRMENT with ZOHYDRO ER?

A

PO: 10mg every 12 hours

36
Q

HYDROMORPHONE:

What is PEDIATRIC ORAL dosing (children and adolescents weighing LESS than 50kg)?

A

PO: 0.03-0.08 mg/kg per dose every 4 hours PRN

37
Q

HYDROMORPHONE:

What is PEDIATRIC IV dosing (children and adolescents weighing LESS than 50kg)?

A

IV: 0.015 mg/kg per dose every 3-4 hours PRN

38
Q

HYDROMORPHONE:

What is PEDIATRIC CONTINUOUS IV INFUSION dosing (children and adolescents weighing LESS than 50kg)?

A
  1. 003-0.005 mg/kg/hour

- max: 0.2mg/hour

39
Q

HYDROMORPHONE:

What is PEDIATRIC ORAL dosing (children and adolescents weighing GREATER than 50kg)?

A

PO: 1-4mg/dose every 3-4 hours PRN

40
Q

HYDROMORPHONE:

What is PEDIATRIC IV dosing (children and adolescents weighing GREATER than 50kg)?

A

0.2-0.6mg/dose every 2-4 hours PRN

41
Q

HYDROMORPHONE:

What is PEDIATRIC IM, SC dosing (children and adolescents weighing GREATER than 50kg)?

A

0.8-2mg every 4-6 hours PRN

42
Q

HYDROMORPHONE:

What is PEDIATRIC RECTAL dosing (children and adolescents weighing GREATER than 50kg)?

A

3mg every 4-8 hours PRN

43
Q

HYDROMORPHONE:

What is INITIAL ADULT ORAL dosing?

A

PO: 2-4mg every 4 hours PRN

44
Q

HYDROMORPHONE:

What is INITIAL ADULT IV dosing?

A

IV: 0.2-1mg every 2-4 hours PRN

45
Q

HYDROMORPHONE:

What is INITIAL ADULT IM, SC dosing?

A

1-2mg every 2-3 hours PRN

46
Q

HYDROMORPHONE:

What is INITIAL ADULT EPIDURAL dosing?

A

Bolus: 0.4-1mg

Infusion Rate: 0.03-0.3mg/hour

47
Q

HYDROMORPHONE:

What is MAINTENANCE ADULT ORAL dosing?

A

PO: 2-8mg every 3-4 hours PRN

48
Q

HYDROMORPHONE:

What is MAINTENANCE ADULT IV CONTINUOUS INFUSION dosing?

A

0.5-3mg/ hour

49
Q

HYDROMORPHONE:

What is MAINTENANCE ADULT RECTAL dosing?

A

3mg (1 suppository) every 6-8 hours PRN

50
Q

HYDROMORPHONE:

What is MAINTENANCE ADULT EXTENDED-RELEASE dosing?

A

PO: 8-64mg every 24 hours

-in opioid tolerant patients ONLY

51
Q

HYDROMORPHONE:

How does IMMEDIATE-release ORAL and INJECTABLE dosing CHANGE in RENAL IMPAIRMENT?

52
Q

HYDROMORPHONE:

How does EXTENDED-release ORAL and INJECTABLE dosing CHANGE in RENAL IMPAIRMENT?

53
Q

HYDROMORPHONE:

How does IMMEDIATE-release ORAL and INJECTABLE dosing CHANGE in HEPATIC IMPAIRMENT?

54
Q

HYDROMORPHONE:

How does EXTENDED-release ORAL and INJECTABLE dosing CHANGE in HEPATIC IMPAIRMENT?

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