DIlaudid

[JakeEMTP]

It works well for pain control but is easy to overdose since the doses are so low. Don't let your druggies know as they will be breaking into your ambulances to score.

Agreed. We used to carry Dilaudid. There were people showing up at the ED with complaints of pain du jour. They insisted that they were allergic to Fentanyl, Morphine, Tylenol and the only thing that helped them was Dilaudid. Needless to say, we no longer carry it.

It is a great drug though.

[croaker260]

SO here a question: All things being equal, which would be your fist choice opioid? For orthopedic pain? For cardiac?

I have always leaned rather strongly toward Morphine, but would liek a feel for your impression on the effectiveness of Dilaudid side bey side with morphine.

Whoa! I had no idea there were so many shortages currently until I pulled up http://www.fda.gov/D...s/ucm050792.htm and started looking through.

What the heck? How does this happen? I truly don't understand, since there's such a huge profit in pharmaceutical markets, how some of the most used items in pharmacopeia suddenly go "short"- is it intentional, to drive up the price? If so, there's a HUGE ethics mess there...

Wendy

CO EMT-B

Preaching to the choir here. Part of the problem is the huge profit is mainly in drugs that are still on patent. Once it drops off, the profit margin drops because now any one can make the "generic". Thats why so many of the drugsthat are in shortage are the drugs that have been around for 50 years....(give or take)

So, stopping production also boosts the demand, then increases the profitt margin. The PHARM companies are participating in all sorts of market manipulation.

Just look up the NItro Spray. A year or so ago it was around a $100.00 bottle..before that much less. Now its pushing 300-600/bottle!!!! Tell me that's not artificial inflation. Because of this we are going back to tabs...its simply too expensive to keep buying the spray.

Edited January 22, 2012 by croaker260

[1EMT-P]

Dilaudid or Hydromorphone is a very strong class II narcotic pain medication, it works really well for controlling severe pain, but you have to be careful when administering it that you don't give it too quickly & that you watch for issues such as respiratory depression. The usually dosage is between 1-2 mg IM/IV/SC.

Edited February 8, 2012 by 1EMT-P

[island emt]

The most recent shortages here are Valium , Versed and just this week Zofran. Fentanyl is in short supply and there are many other meds on the short list that are being watched carefully.

We have been getting weekly updates on what is in short supply or hospitals have run out of.

[zmedic]

As others have mentioned, high addiction potential. That alone makes me wary of giving it. I don't think addicts are inherently bad people, I think genetically there are many people who have genetic predispositions for addiction. Given that, I'd rather not expose people to addictive substances if I have a choice. I'm sure that there are many cocaine users, meth heads etc who wish they had never tried the stuff.

That being said it seems to work very well on sickle cell pain. Also for some reason maybe some better effect than morphine in those with high morphine tolerances. Had a burn patient the other night who was on methadone at home, morphine wasn't really touching her pain but 2mg dilauded x 2 over 3 hours did well.

[Kaisu]

I carried it on CCT. I found it very useful.

Interesting learned from experience bit - We often had renal/hepatic failure patients that were extremely restless, combative, etc.. probably because of elevated ammonia levels among other things. Taking them on 3 - 4 hour transports was a daunting prospect when they were fighting restraints. I found that 1 mg of ativan followed by 1 mg of dilaudid put them into peaceful sleep. Don't know why that combination but I used it a lot.

[Chris Smith]

Croker aren't you a pa medic?

[croaker260]

Croker aren't you a pa medic?

Nope, Idaho for the past 13 yrs, and in the south prior to that.

[Chris Smith]

My bad. Mixing folks up.

[runswithneedles]

Had a burn patient the other night who was on methadone at home, morphine wasn't really touching her pain but 2mg dilauded x 2 over 3 hours did well.

Until recently I never knew methadone was used for anything more than just helping a heroine junkie kick the habit. Does methadone have the similar side effects to other opioids such as N/V,depression of respiratory drive etc?

Edited February 13, 2012 by runswithneedles