Pain

Question 0

Fentanyl (Sublimaze)

Narc.

Answer 0

50 mcg IV/IM q 3-5 min as needed, max 200 mcg. (WaCo)
PEDS:
1mcg/kg IV/IM q 0.5-1mcg/kg as needed, max 4mcg/kg not to exceed adult dosing.

25-100 mcg SIVP (2-3min) q 30 min
PED: 1-2mcg/kg SIVP/IM (1-12y/o)

• Mod-sev Pn: Chest pn, burns, isolated extremity trauma.
• Sedation prior to intubation.

C: Narc Analgesic, CNS Depressant

CI: MAOI’S past 14 days; Myosthenia Gravis ?

Cautions: head trauma, ICP, unDx’d And Pn, Elderly, Debilitated. Reduce Dose: COPD, Resp problems, Renal problems.

Question 1

Aspirin

Answer 1

324mg

Analgesic, Antipyretic, Anti-inflammatory, Platelet aggregation inhibitor.

Question 2

Nalbuphine (Nubain)

Narc.

Answer 2

2-10 mg S-IVP OT 5-10 mg D-IM
Onset 2-min, Duration 3-6 hrs.
Compare to Morphine

I: Mod-Sev Acute Pn; Chest Pn associated w MI; Chronic Pn Syndromes.

C:Synthetic Narcotic Analgesic
A:CNS Depressant, Decreases sensitivity to pain.

CI: Hypotension, Hypovolemia, Head Injury.

Question 3

Morphine Sulfate

Narc.

Answer 3

2-20 mg in 2mg increments S-IVP (titrate to Pn relief & Resp response)
PEDS: 0.1-0.2mg/kg, max mg

C: Narc Analgesic, CNS Depressant

I: Cardiac Chest Pn after Nitro; Mod-Sev Pn (Burns, isolated extremity trauma); Abd Pn suspected kidney stone; Discomfort 2• to Trans-Q pacing in awake pt.

CI: head injury; unstable V/S; MAOI’s past 14 days; suspected pregnancy, abruptio placenta, AAA