Tag Archives: Hydromorphone

Pharmacological Treatment of Pain

While medications are often prescribed for all types of chronic pain, research has consistently shown that several classes have proven efficacy for the treatment of neuropathic pain. Ideally, pharmacotherapy of pain would be specifically selected on the basis of considerations of etiology (e.g., ischemic, neuropathic), pathophysiology (e.g., demyelination, central pain), and anatomy (e.g., C fibers,… Read More »

Opioids In Chronic Pain

The use of opioids in pain of non-malignant origin is controversial and depends on a proper understanding of the nature of chronic pain, and the strategy of its management. Patients with chronic pain who take opioids must understand the rationale for the use and be prepared to be an active partner in the management of… Read More »

Opioid Analgesics

Pharmacologic Profile General Use Management of moderate to severe pain. Fentanyl is also used as a general anesthetic adjunct. General Action and Information Opioids bind to opiate receptors in the CNS, where they act as agonists of endogenously occurring opioid peptides (eukephalins and endorphins). The result is alteration to the perception of and response to… Read More »

Using Narcotics Appropriately

State and federal clinical practice guidelines do indicate that it is appropriate to ameliorate pain and that the use of pain medications to do so is not illegal. A set of so-called frequently asked questions (FAQ) was released by the Federal Drug Enforcement Agency (DEA) along with pain specialists from the University of Wisconsin, in… Read More »

Drugs for Treatment of Chronic Pain

The purpose of this post is to go over the various types of medications that can be used for the treatment of pain. Many of the medications have been discussed previously, but this post attempts to consolidate these various medications. There are two more pain states that need to be discussed: chronic pain, which persists… Read More »

Opioids

The antinociceptive pain pathways have been described in detail in site. The descending pathways are opioid and monoaminergically based. The opioid analgesics appear to produce analgesia by inhibiting the ascending pain pathways (which carry nociceptive information to the brain), and activate the descending pain control pathways, which go from the CNS down the ventromedial medulla… Read More »

Weak Opiates

• Codeine — has a weak affinity to mu opioid receptors; it is about 15% as potent as morphine (the opiate “gold standard”). It has a 2.5 to 3 hour half-life; major side effects include constipation and nausea; dosages greater than 65 mg every four to six hours are not appropriate. • Hydrocodone (Vicodin, Vicoprofen,… Read More »

Strong Opiates

• Morphine — the prototypical opiate; half-life of two hours, but an analgesic effect lasting 4 to 5 hours; 50% of oral morphine reaches the central compartment within 30 minutes; it has active metabolites morphine-6-glucuronide (M6G) and morphine-3-glucuronide (M3G). M6G is found to be more potent than morphine when given intrathecally as well as less… Read More »