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Names
Codeine
Hydrocodone
Morphine
Oxycodone
+acetami
Hydrocan
Tussigon
MS Contin,
Kadian,
Avinza,
Oramorph,
MSIR,
Roxonal,
OxyIR,
OxyContin
+IB:Ibudone,
Reprexian,
Vicoprofen
Action
Indication
Depresses
pain
impulse
transmissi
on at SC
by
interactin
g with
opioid
receptors;
decreases
cough
reflex, GI
motility
Mild to
moderate
+aspirin:
Percodon,
endodan
+acetaminophe DepoDur:IC
n:Duocet
P and
Norco, Vicodin
increase
CNS
depression
Acts directly on Depresses
the cough
pain
center in the
impulse
medulla to
transmissio
suppress
n at the SC
cough; binds to level by
opiate
interacting
receptors in
with opioid
CNS to reduce
receptors
pain
+acetaminophe
n:Endocet,
Percocet
Mild to
moderate pain
Moderate to
severe pain
Moderate to
severe pain
Merperidin
e
Demerol,
+IB
Inhibits
ascending pain
pathways in
CNS, increases
pain threshold,
alters pain
perception
Proxyp
hene
Darvoc
et
Mild
agonist
Depresses
pain
impulse at
the SC
level by
interacting
with opioid
receptors
Moderate
to severe
pain
Bone/dent
al pain,
headache,
migraine,
myalgia,
nonprodu
ctive
cough
Contra/Ca
ution
Breastfee
ding,
hypersens
itivity to
opiates,
respirator
y
depressio
n, ICP,
seizure
disorders,
severe
respirator
y
disorders
Hyperactive
and non
productive
cough,
Agitation,
bone and
dental pain,
dyspnea in
end stage
cancer or
pulmonary
disease,
rapid
sequence
incubation
Acne,
Hypersensiti
rosacea/vulgari vity,
s, Cushings,
addiction (
measles,
opioid/alcoh
perioral
ol),
dermatitis,
hemorrhage
varicella,
, bronchial
abrupt
asthma,
discontinuation, ICP,
benzyl allergy
paralytic
ileus,
hypovolemi
c shock,
MAOI
therapy
Renal
Impairment
?
Postherpetic
neuralgic
Hypersensitivity,
addiction
(opiate),
asthma, ileus
pain
preoperati
vely,
postoperat
ively
Acute pain
postop
ER:
migrane
Obstertic
Hypersensi
tivity,
severe
respiratory
insufficien
cy, MAOI
therapy
CAUTION:
elderly,
patients
require
long term
analgeis,
kidney
dysfunctio
n
Side
Effects
Seizures,
circulatory
collapse,
respirator
y
paralysis
GI upset
Circulatory
depression,
cardiac
arrest(children)
syncope,
pulmonary
edema,
bronchopneum
onia,
respiratory
arrest (children)
Depressant
effect on CNS
and cause
sedation <
Insomnia,
Tinnitus,
seizures,
gastritis,
shock,
dysepsia
cardiac
arrest,
chest pain,
edema,
tachycardia,
blurred
vision,
miosis,
diploia,
gynecomast
ia, biliary
tract
pressure,
gonadal
suppression
,
thrombocyt
openia,
repiratory
arrest,
apnea
DepoDur:
increase ICP
and CNS
depression
ICP,
seizures,
serotonin
syndrome,
depressed
corneal
reflex,
blurred
vision,
tinnitus,
diaphoresi
s
CNS
toxcitiy:
tremor,
confusion,
seizure
Resp
depression
, seizures,
hypo
Morphine 6
glucuronide:
renal
impairment
more likely
to
accumulate
metabolite
Caution:
Respiatory Inssuficenty
Elevated ICP
Morbid obesity
Sleep apnea
Paraltic ilelus
Myasthenia gravis
preganacy
Naloxone HCL
Naltrexone HCL
Trade Name
Narcan
Revia
Action
Opioid overdose
Adjunct to psychosocial
Indication
treatments of alcoholism
Contraindication/caution
Hypersensitivity
Side Effect
NonOpiod analgesic
NSAIDS ( asprin, Ibprofuen, naproxen, cyclooxygenase 2 inhibitor, and others)
Acetaminophen
NonOpiod analegesix
Tramadol Hydrochloride
Miscellaneous analgesic
Lidocaine
Trade Name
Tylenol
Ultram
Lidoderm
Action
+hydrocodone:Vicodin
+Oxycodone: Perocet
Blocks peripheral pain
impulses by inhibiting
prostaglandin synthesis
+acetaminophen:Ultrac
et
Creates a weak bond to
the mu opioid receptors
and inhibits the
reuptake of NE and
serotonin
Indication
Lowers febrile
temperature by acting
on hypothalamus
Lacks antiinflam effect
Mild to moderate pain
and fever
Moderate to moderately
severe pain
Known drug allergy
( allergy to opioids),
intoxication of alchol,
G6PD deficiency
Side Effects
hypnotics, centrally
acting analgesiscs,
opiods, or psychotropic
drugs
Drowseiness dizziness
headache nausea
constipation respiratory
depression seizures
Serotonin syndrome