Makindo Medical Notes"One small step for man, one large step for Makindo" |
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Related Subjects: |Emergency Drugs |Emergency Drug Antidotes |Emergency Cardiac Drugs |Emergency Endocrine Drugs |Emergency Gastrointestinal Drugs |Emergency Haematology Drugs |Emergency Neuropsychiatric drugs |Emergency Pain drugs |Emergency Respiratory drugs |Emergency Obstetric and Gynaecology Drugs |Emergency Paediatric Drugs
DRUG (UK Name) | MOA | DOSE IV | DOSE PO | INDICATION | CONTRAINDICATION / CAUTION |
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Fentanyl | Opioid agonist providing potent analgesia with some sedation | 25–100 micrograms IV every 1–2 h; ~1 microgram/kg recommended | N/A | Severe pain, adjunct sedation | Respiratory depression, hypotension (vasodilation), potential laryngospasm; caution in pregnancy |
Hydromorphone | Opioid agonist providing analgesia and sedation | 1–2 mg IV every 3–6 h | N/A | Severe pain | Respiratory depression, hypotension; approximately 1 mg IV hydromorphone ≈ 7 mg IV morphine; caution in pregnancy |
Ketamine | NMDA receptor antagonist producing dissociative anaesthesia and analgesia |
Subdissociative analgesia: 0.1–0.5 mg/kg IV
Procedural sedation: 0.5–1 mg/kg IV RSI induction: ~2 mg/kg IV |
N/A | Analgesia, sedation, induction (RSI) | Emergence phenomena (may need benzodiazepine), laryngospasm, increased IOP/ICP, tachycardia, hypertension; avoid in certain ocular/head injuries; caution in pregnancy |
Morphine sulfate | Opioid agonist providing analgesia with sedative effects | 2–10 mg IV every 2–6 h PRN (~0.1 mg/kg) | N/A | Moderate to severe pain | Respiratory depression, hypotension (vasodilation); caution in pregnancy |
Codeine | Weak opioid agonist (metabolised to morphine) | N/A (commonly oral) | 15–60 mg PO every 4–6 h PRN | Mild to moderate pain, cough suppression | Respiratory depression, variable metabolism (CYP2D6), caution in pregnancy and children |
Paracetamol (Acetaminophen) | Analgesic and antipyretic, likely via central prostaglandin inhibition | 1 g IV every 6 h (max 4 g/day) | 500–1000 mg PO every 4–6 h PRN (max 3–4 g/day; UK often advises max 4 g/day in adults) | Mild to moderate pain, fever | Severe hepatic impairment, overdose risk (hepatotoxicity); generally safe in pregnancy (consult BNF) |
Dihydrocodeine | Semi-synthetic opioid agonist | N/A (primarily oral) | 30 mg PO every 4–6 h PRN | Moderate pain | Respiratory depression, caution in opioid-naive, use sparingly in pregnancy |
Tramadol | Weak opioid agonist and inhibitor of noradrenaline/serotonin reuptake | N/A (primarily oral) | 25–100 mg PO every 4–6 h PRN (max ~400 mg/day) | Moderate pain | Risk of seizures, serotonin syndrome (if combined with SSRIs), respiratory depression; caution in pregnancy |