Other Opioid Uses

SECTION 4 Drugs Used to Treat Pain and Inflammation 

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Deaths, cardiac and resp have been reported during initiation and conversion of pain pts to methadone Tx from Tx w/ other opioids Uses Severe pain detox w/ maint of narcotic addiction Action Narcotic analgesic Dose Adults. 2.5-10 mg IM q3-8h or 5-15 mg PO q8h titrate as needed Feds. 0.7 mg/kg/24 h PO or IM -s- q8h T slowly to avoid resp depression X in renal impair Caution [B/D (prolonged use/high doses at term), + (w/ doses =/> 20 mg/24 h)], severe liver Dz Disp Tabs, inj SE Resp depression, sedation, constipation, urinary retention, T QT interval, arrhythmias Interactions T Effects W/ cimetidine, CNS depressants, protease inhibitors EtOH T effects OF anticoagulants, antihistamines, barbiturates, glutethimide, methocarbamol ... 

Many commonly held assumptions about codeine and other opioid use need to be modified, according to a consensus statement issued by the American Academy of Pain Medicine and the American Pain Society. 

Oxycodone, like morphine and other opioids used in analgesia, can be abused and is subject to criminal diversion. Breaking, chewing or crushing oxycodone CR tablets eliminates the controlled delivery mechanism and results in the rapid release and absorption of a potentially fatal dose of oxycodone. 

Tramadol ER must be swallowed whole and must not be chewed, crushed, or split. Chewing, crushing, or splitting the tablet will result in the uncontrolled delivery of the opioid and could result in overdose and death. This risk is increased with concurrent abuse of alcohol and other substances. Tramadol, like other opioids used in analgesia, can be abused [1,2]. 

Increased respiratory depression has been seen with hydroxyzine and opioids in one study, but not in two others. The US manufacturers warn that hydroxyzine may enhance the effects of opio-... 

To show how fast memories fade, 1 recently contacted Ted Stanley after finding out by surfing the Net that he was an expert on the opioid drugs. 1 wanted to get his ideas about the gas used in the Moscow incident. We had pleasant conversations on the phone, but neither of us remembered the other. 

OPIOID ANALGESICS (narcotic analgesics) are ANALGESICS typified by morphine. They have powerful actions on the CNS, and act to alter the perception of pain. Because of the numerous possible side-effects, the most important of which is dependence, such agents are usually us under strict medical supervision and are normally only available on prescription. Other notable side-effects include depression of respiration, nausea and vomiting, sometimes... 

Nationally, the annual number of deaths from opioid overdoses now exceeds the number of deaths caused by motor vehicle accidents [reference CDC website]. Regardless of whether we view these issues from the perspective of patients, physicians, or regulators, the status quo is clearly not acceptable. As the public health agency responsible for oversight of pharmaceutical safety and effectiveness, we recognize that this crisis demands solutions. We are committed to action, and we urge others to join us. 

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