Opioid tolerance patients

High potency (HP) injection - HP injection is a highly concentrated solution of hydromorphone intended for use in opioid-tolerant patients. Do not confuse HP injection with standard parenteral formulations of injection or other opioids. Overdose and death could result. 

Oxycodone CR tablets are not intended for use as an as-needed analgesic. Oxycodone 80 and 160 mg CR tablets are for use in opioid-tolerant patients only. These tablet strengths may cause fatal respiratory depression when administered to patients not previously exposed to opioids. 

Levo-Dromoran If necessary, increase the dose to up to 3 mg every 6 to 8 hours, after adequate evaluation of the patient s response. Higher doses may be appropriate in opioid-tolerant patients. Adjust dosage according to the severity of the pain the patient s age, weight, physical status, and underlying diseases use of concomitant medications and other factors. 

Levorphanol Tartrate The effective daily dosage range, depending on the severity of the pain, is 8 to 16 mg in 24 hours in the nontolerant patient. Total oral daily doses of more than 16 mg in 24 hours are generally not recommended as starting doses in non-opioid-tolerant patients. 

The MS Contin 200 mg tablet is for use only in opioid-tolerant patients requiring daily morphine-equivalent dosages of 400 mg or more. Reserve this strength for patients who have already been titrated to a stable analgesic regimen using lower... 

Special instructions for 80 and 160 mg CR tablets For use in opioid-tolerant patients only. 

CR tablets, 80 and 160 mg, are for use only in opioid-tolerant patients requiring daily oxycodone equivalent dosages of at least 160 mg for the 80 mg tablet and at least 320 mg for the 160 mg tablet. Take care in the prescribing of these tablet strengths. Instruct patients against use by individuals other than the patient for whom it was prescribed, as such inappropriate use may have severe medical consequences, including death. 

Physical dependence is a normal and commonly observed phenomenon in opioid-tolerant patients. Upon abrupt discontinuation of opioids, the cAMP pathway is further up-regidated and parasympathetic tone is markedly increased [1,9]. Patients experience unpleasant, but rarely life-threatening, withdrawal symptoms termed the abstinence syndrome , which includes sweating, shaking, cramping, and diarrhea. 

Relative a single dose greater than 40 mg, or total daily doses greater than 80 mg, are only indicated in opioid-tolerant patients. 

In opioid-tolerant patients, no single ratio is suitable for converting a specific dose of morphine into an equivalent dose of methadone and the conversion to methadone should be performed cautiously. 

Tabla 37.2. Guidelines for perl-operative pain management in opioid-tolerant patients Pre-operative... 

Palladone was initially approved by the FDA in 445 2004 for use in opioid-tolerant patients who required... 

This medication should only be used in opioid-tolerant patients for the treatment of moderate to severe chronic pain. Patients must be instructed not to crush or adulterate the preparation as this could lead to acute toxicity. 

In an open study in 21 opioid-tolerant patients with severe cancer pain who were switched to methadone, the switch was generally well tolerated only one patient required treatment withdrawal, because of respiratory depression [85 ]. Drowsiness was one of the most frequent adverse effects (in six patients) but it was of moderate intensity and responded to dosage reduction. Constipation was problematic in six. Other effects included nausea and vomiting (n = 2), sweating (n = 2), and confusion (n = 1). 

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