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Butorphanol (Stadol)
- Synthetic Narcotic Analgesic
- Description: Butorphanol is a centrally acting synthetic narcotic analgesic about 5 times more potent than morphine. A schedule IV narcotic.
- Indications: Moderate to severe pain
- Contraindications: Hypersensitivity, head injury, or undiagnosed abdominal pain
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Fentanyl (Sublimaze)
- Narcotic Analgesic
- Description: Fentanyl is a potent synthetic narcotic analgesic similar to morphine and meperidine but with a more rapid and less-prolonged action.
- Indications: Induce sedation for endotracheal intubation, severe pain.
- Contraindications: MAO inhibitors within 14 days, myasthenia gravis.
- Precautions: Increased intracranial pressure, elderly, debilitated, COPD, respiratory problems, hepatic and renal insufficiency.
- - Dosage/Route: 25 to 100 mcg slowly IV (2 to 3 mins)
- - Pedi: 2 mcg/kg slow IV/IM
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Ketorolac (Toradol)
- Nonsteroidal antiinflammatory Drug (NSAID)
- Description: Ketorolac is an injectable NSAID that exhibits analgesic, antiinflammatory, and antipyretic properties without sedative effects.
- Indications: Mild or moderate pain
- Contraindications: Hypersensitivity to aspirin or other NSAIDs, and asthma
- Precautions: Peptic ulcers, renal or hepatic impairment, or elderly
- Dosage/Route: 30-60 mg IV/IM
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Meperidine (Demerol)
- Narcotic Analgesic
- Description: Meperidine is a synthetic narcotic with analgesic and sedative properties comparable to morphine but without hemodynamic side effects.
- Indications: Moderate to Severe pain
- Contraindications: Seizure disorders, or acute abdomen without diagnosis.
- Precautions: Increased intracranial pressure, asthma or other respiratory conditions, supraventricular tachycardias, prostatic hypertrophy, urethral stricture, glaucoma, elderly or debilitated patients, renal or hepatic impairment, hypothyroidsim, or Addison's disease.
- - Dosage/Route: 25 to 50 mg IV, 50 to 100 mg IM.
- - Pedi: 1 mg/kg IV/IM
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Morphine Sulfate (Morphine)
- Narcotic Analgesic
- Description: Morphine sulfate is a potant analgesic and sedative that causes some vasodilation, reduced venous return, and reduced myocardial oxygen demand.
- Indications: Moderate to severe pain, and in MI, and to reduce venous return in pulmonary edema.
- Contraindications: Hypersensitivity to opiates, undiagnosed head or abdominal injury, hypotension, or volume depletion, acute bronchial asthma, COPD, severe respiratory depression, or pulmonary edema due to chemical inhalation.
- Precautions: Elderly, children, or debilitated patients. Naloxone should be readily available to counteract the effects of morphine.
- - Dosage/Route: Pain: 2.5 to 15 mg IV; 5 to 20 mg IM/subcutaneous.
- -Pedi: 0.05 to 0.1 mg/kg IV
- - AMI/PE: 1 to 2 mg/6 to 10 min to response.
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Nalbuphine (Nubain)
- Narcotic Analgesic
- Description: Nalbuphine is a synthetic narcotic analgesic equivalent to morphine, though it respiratory depression does not increase with higher doses.
- Indications: Moderate to Severe Pain
- Contraindications: Hypersensitivity, undiagnosed head or abdominal injury.
- Precautions: Impaired respirations, narcotic dependency.
- - Dosage/Route: 5 mg IV/IM/subcutaneous, repeat 2 mg doses as needed up to 20 mg.
- - Pedi: 0.1 to 0.15 mg/kg IV/IM/subcutaneous (rarely used)
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