NCTI- Pharmacology- Drug List J- Hydromorphone Hydrochloride

Dilaudid

Narcotic Analgesic

• 1. Binds with opiate receptors in brain, altering perception and emotional response to pain.
• 2. suppresses the cough reflex by direct action on the cough center in the medulla oblongata.

• 1. moderate to severe pain
• 2. persistent cough

• 1. increased intracranial pressure
• 2. respiratory depression / inadequacy – such as in COPD, status asthmaticus
• 3. circulatory compromise

• CNS: sedation, dizziness, lightheadedness, somnolence, blurred vision, nystagmus
• Cardiovascular: hypotension, bradycardia
• Respiratory: respiratory depression or arrest, bronchospasm
• GI: nausea / vomiting, constipation

Use with caution in head injuries; the elderly, debilitated or immuno-compromised patients; COPD or other respiratory problems and those with kidney or liver dysfunction.

Other CNS depressants, general anesthetics, MAO inhibitors, other opioid analgesics, sedatives, tranquilizers, and tricyclic antidepressants may potentiate the effects of Dilaudid.

IV, IO, IM, SQ, PR and PO

IV and IM administration most common in the hospital setting – IV: onset in 10-15 minutes, peaks in 15-30 minutes and lasts 2-3 hours. IM: onset in 15 minutes, peaks in 30-60 minutes, and lasts 4-5 hours.

• For Pain Control:
• Adults: 1-4 mg IM, SQ or SLOW IV push (over at least 2-5 minutes) every 4-6 hours
• Pediatrics: Rarely given for pain control – primarily for cough suppressant effects.

• For Cough:
• Adults and children > 12 years: 1 mg cough syrup PO every 3-4 hours
• Children ages 6-12 years: 0.5 mg of cough syrup every 3-4 hours

Often used in the clinical internship setting.