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What are the indications for morphine?
Moderate to severe acute or chronic pain
acute pulmonary odema
relief of severe dyspnoea
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Precautions for Opioids?
Renal impairment - reduce dosage
respiratory patients
elderly
children
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Adverse effects from morphine/ codeine?
nausea, vomiting, dyspepsia, constipation
SIAHD, anaphylaxis, seizures
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Dosage of Morphine?
5-30mg, upto 100mg
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Counselling for morphine?
Controlled relase must be swallowed whole
Do not take kapanol with alcohol
Medication may make you feel drowsy or faint - get up slowly
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Dose of oxycodone?
- 5–15 mg every 4–6 hours.
- Start with 5 mg dose in patients >70 years
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Indications for buprenorphine?
- Moderate-to-severe pain
- Opioid dependence
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Adverse effects from buprenorphine?
- Local irritation from the patch
- Delayed local allergic reaction
- Nausea, vomiting, constipation, drowsniess
- confusion, seizure
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Dose of buprenorphine?
5mcg/hour patch, increasing upto 20mcg/hour if required
200-400mcg every 6-8 hours
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Counselling for buprenorphine?
patch?
Sublingual tablet
Change patch every 7 days
Write the time and date patch was applied with a permenant marker and apply patch to clean dry skin on the upper torso
Don't let patch come into contact with any direct sourced of heat ie heatlamps or electric blankets
Place tablet under the tongue and let it dissolve, do not chew it
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Indications for codeine?
- Mild-moderate pain
- Cough supressant
- Diarrhoea
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Precautions for codeine?
Renal
epilepsy
respiratory depression
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Dose of codeine?
30-60mg every 4 hours max 240mg
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Counselling of codeine?
medication may make you feel drowsy and increase the effects of alcohol
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Indications of diclofenac?
- Rheumatoid arthritis
- Osteoarthritis
- Pain, especially due to inflammation (eg period pain)
- Local pain and inflammation in soft tissues (1% gel)
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Precautions of NSAIDs?
Asthma patients - increased risk of bronchospasm
Cardiovascular patients - increases risk of cardiovascular events
GI disorders - avoid use!
Acute flare of gout
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Adverse effects of NSAIDs?
nausea, dyspepsia, GI ulceration or bleeding, dizziness
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Dose of diclofenac?
75-100mg daily in 2 or 3 doses
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Counselling for diclofenac?
If you develop swollen ankles, difficulty in breathing, black stools or dark coffee-coloured vomit, stop taking the medicine and tell your doctor immediately.
Do not take aspirin for pain relief as it will increase the risk of side effects with this medicine.
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Analgesic dose of aspirin?
300-900mg every 4-6 hours
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Counselling for aspirin?
If you develop swollen ankles, difficulty in breathing, black stools or vomit that looks like coffee grounds, stop taking the medicine and contact your doctor without delay.
Remove tablets from packaging just before use as aspirin can break down rapidly if it isn't protected by the packaging.
- Mix dispersible tablets in water immediately before use
- It may be advisable to stop taking aspirin 7 days before planned surgery and some dental procedures; discuss with your doctor or dentist.
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Indications for meloxicam?
- Osteoarthritis
- Rheumatoid arthritis
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Dose of meloxicam?
7.5-15mg once daily
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counselling for meolxicam and celecoxib?
If you develop swollen ankles, difficulty in breathing, black stools or dark coffee-coloured vomit, stop taking the medicine and tell your doctor immediately.
Do not take aspirin for pain relief as it will increase the risk of side effects with this medicine.
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Contraindications for celecoxib?
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Dose of celecoxib
- For OA - up to 200mg daily
- For Pain- 400mg then 200mg daily then after for a max of 5 days
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Adverse effects of Dextropropoxyphene?
cardiac toxicity
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Dosae of Dextropropoxyphene?
100mg every 4 hours
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Precautions of using tramadol??
- Epilepsy
- Other serotonin drugs
- Renal Impairment
- Elderly
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Adverse Effects of tramadol?
headache, sweating, sleep disorder, dyspepsia
seizure
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Dose of tramadol?
- 50-100mg every 4 hours - max 400mg
- 12h CR- 50-200mg
- 24h CR - 100mg daily initially
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Counselling for tramadol?
- his medication may make you feel drowsy and may increase the effects of alcohol. If you are affected, do not drive or operate machinery.
- Be careful when you stand up as this medicine might make you feel dizzy if you stand up too quickly.
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