Pain
Hydromorphone
Hydromorphone is more lipid soluble and five times more potent than morphine.
It is particularly useful when fluid restrictions are in place and high dose opioids are required.
Metabolism is via Cytochrome P 450.
The drug is eliminated via the kidneys and there are no active metabolites.
In patients with renal failure receiving high dose hydromorphone, the incidence of neurotoxicity increases (2).
Table 2. Adapted from Dosing Guideline for Hydromorphone in Children, (H.Siden) (3)
Route |
Younger Child < 50 kg |
Older Child > 50 kg |
Comments |
Response Time |
Duration of action |
IV/SC intermittent |
0.015 mg/kg q 4 h |
1-2 mg q 4h |
Administer slowly at least over 2-3 min |
15 min |
4-5 hrs |
PO |
0.05-0.1 mg kg dose up to 5 mg dose every 4-6 hrs |
|
|
30 min |
3-4 hrs |
IV/SC continuous |
Starting dose 2-8 mcg/kg/hr as starting dose |
|
Dilute with normal saline for SC |
|
|
