Fentanyl vs Morphine

[courageheartx]

fentanyl is 100x more potent than morphine apparently?lol :?:

[medic53226]

My system carries Fentanyl,Dilaudid,Morphine in our pain managament protocol. It is our choice on of which to give, except in chest pain only MS.

[Medic26]

We started using Fentanyl in addition to Morphine about 9 months ago. It seems to be more effective for pain control with our standing orders of 1 mcg/kg, instead of the old 2-4 mg of Morphine that we used to get orders for.......I would assume that this is largley due to the more effective dose and that the Fentanyl has a shorter half life so the docs are more apt to be liberal with additional orders. The only thing we use morphine for now routinely is chest pain.

[Eydawn]

I never quite understood what dilaudid was... isn't it a morphine derivative? Or is it a different class of drug altogether? My only knowledge of it comes from having received it for a badly infected wisdom tooth abscess last Christmas... and it worked very well.

Does dilaudid engage with the same opiate receptors that morphine does?

Wendy

CO EMT-B

[paramedicmike]

Dilaudid is another name for Hydromorphone. It is a morphine derivative. Quite potent as you found out.

Hope this helps.

-be safe

[RuralEMT-I]

We started using Fentanyl in addition to Morphine about 9 months ago. It seems to be more effective for pain control with our standing orders of 1 mcg/kg, instead of the old 2-4 mg of Morphine that we used to get orders for.......I would assume that this is largley due to the more effective dose and that the Fentanyl has a shorter half life so the docs are more apt to be liberal with additional orders. The only thing we use morphine for now routinely is chest pain.

This is what our standing orders are as well. Intermediates will be allowed to use Fentanyl in 2008, after some required training. MS is used for chest pain.

[jjones1418]

We carry both. I like fentanyl myself. It just works so well. Like AZCEP said, it's duration of action is shorter than morphine, so it may be difficult to maintain analgesia with it. It's awesome for trauma patients, especially when a drop in BP is undesirable.

ateupmedic spoke on the pharmacodynamics briefly, and is accurate. A good way to prevent/blunt the hypotension associated with the histamine release from morphine is to give a little benadryl with the morphine. Makes 'em sleepy though.

We use fentanyl in our RSI protocol, use it post RSI for analgesia, use it for basically anything that might hurt. Morphine is preferred in chest pain, but fentanyl is an option as well.

J.Jones CC/NREMT-P, FP-C