Question

How would you determine which of the following pain medication(s) to give a patient who:

1) Has just had breast augmentation surgery?

2) Has chronic neck and back pain from a car accident?

3) Has terminal metastatic cancer?

4) Had their wisdom teeth removed?

5) Suffers from migraines?

6) Has rheumatoid arthritis?

Analgesic Strength (relative) 1/360 1/222 1/138 1/13 to 1/20 1/10 1/10 Equivalent dose (10 mg Oral morphine) 3600 mg 2220 mg 1380 mg 130-200 mg 180 mg (PO) 200 mg 30 mg SC/IM/IV, 300 mg PC 10 mg (10 mg) (30 mg PO) 6.67 mg 3.33 mg 2.5-3.33 mg 2-2.5 mg 1.5 mg SC/IV/IM, 7.5 mg PO 10 mg PO, 1 mg IV 3.33 mg 0.1 mg (100 mcg) IM/IV Aspirin (non-opioid) lbuprofen (NSAID, non-opioid) Naproxen (NSAID, non-opioid) Dextropropoxyphene Codeine Tramadol Pethidine (meperidine hydrochloride) 1/3 Hydrocodone Morphine (oral) Oxycodone Morphine (IV/IM) Methadone (acute) Diamorphine (Heroin; IV/IM) Hydromorphone Oxymorphone Methadone (chronic) Fentanyl 1.5 3 3-4 4-5 5 7 2.5 to 5 50-100

Answer 1

1. non-narcotic, valium, fentanyl
2. aspirin, whiplash relievers, dextropropoxyphene
3. Methadone (Dolophine, Methadose), Hydrocodone., Oxycodone (OxyContin, OxyIR, Roxicodone), Morphine (Apokyn, Avinza, Kadian, MS-Contin, and others)
4. ibuprofen
5. ibuprofen, naproxen, aspirin + acetaminophen + caffeine
6. nsaid – naproxene , ibuprofen

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